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."

Saturday, March 25, 2017

Weekly Overseas Health IT Links – 25th March, 2017.

Note: Each link is followed by a title and 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.
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Adventist Health’s trigger tool uncovers thousands of additional harm occurrences

Mar 17, 2017 10:21am
After several years of using manual methods to identify and track patient harm, a real-time alert system helped Adventist Health System uncover thousands of additional instances of harm.
Over an 11-month period, an automated trigger tool uncovered nearly 2,700 instances of patient harm stemming from incidents both inside and outside the health system, according to a study published in The Joint Commission Journal for Patient Safety. Comparatively, the system’s manual method uncovered just 132 instances of patient harm during an 11-month period two years prior.
A major reason for the increase was the sheer number of records that the automated system could process through Adventist Health System's Patient Safety Organization. The trigger tool combed through more than 40,000 records compared to just 440 that were reviewed in the manual process.
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Data breach fear for 26m GP records

Nadeem Badshah
March 18 2017, 12:01am, The Times
An investigation has been launched into the security of a computer system that holds 26 million patients’ records.
The Information Commissioner is looking into a potential breach involving 2,700 GP surgeries. It centres on SystmOne, which is used by family doctors. When GPs switch on “enhanced data sharing” so that records can be seen by a hospital, they also can be accessed by thousands of staff even if there is no medical reason to do so.
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GAO details weaknesses in federal push to share patient data

By Joseph Conn  | March 16, 2017
A federal watchdog group said HHS isn't doing enough to measure how much patients are using their medical records. The Government Accountability Office also found patients aren't accessing their medical records because they can't aggregate all of their information into one medical record, underscoring the need to streamline and standardize systems.
Patients often have to go through different portals for each provider, the GAO said, adding that patients generally have to manage separate login information for each provider-specific portal.
Personal health record technology is available to collect the records, but these systems “are not widely used,” a 55-page GAO report stated.
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DeepMind's first deal with the NHS has been torn apart in a new academic study

  • Mar. 16, 2017, 8:07 AM
A data-sharing deal between Google DeepMind and the Royal Free London NHS Foundation Trust was riddled with "inexcusable" mistakes, according to an academic paper published on Thursday.
The "Google DeepMind and healthcare in an age of algorithms" paper — coauthored by Cambridge University's Julia Powles and The Economist's Hal Hodson — questions why DeepMind was given permission to process millions of NHS patient records so easily and without patient approval.
"There remain many ongoing issues and it was important to document how the deal was set up, how it played out in public, and to try to caution against another deal from happening in this way in the future," Powles told Business Insider in Berlin the day before the paper was published.
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Half of Medication Errors Involve CPOE, Data Shows

Alexandra Wilson Pecci, March 17, 2017

Computerized prescriber order entry systems and pharmacy systems are the most commonly reported factors contributing to medication errors in Pennsylvania healthcare facilities, data shows.

Although health IT tools can help prevent patient safety problems, they can also lead to significant patient safety errors if they're not used correctly, finds research from the Pennsylvania Patient Safety Authority.
Between January 1 and June 30, 2016, Pennsylvania healthcare facilities reported 889 medication-error events that indicated health IT as a contributing factor.
The most frequently reported errors included dose omission, wrong dose or overdosage, and extra dose. The most commonly reported systems involved in the errors were computerized prescriber order entry systems (CPOE) and the pharmacy systems.
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Poorly implemented IT systems lead to medication errors

Mar 17, 2017 10:58am
IT systems designed to streamline medication ordering and administration can contribute to medication errors.
Health IT systems designed to improve prescription ordering and medication administration can just as easily contribute to medical errors.
That’s according to a study released by the Pennsylvania Patient Safety Advisory (PPSA), which found that computerized prescriber order entry (CPOE) systems, pharmacy IT systems and electronic medication administration tools were frequently to blame for medication errors. Nearly 70% of those errors reached the patient.
Last year, researchers at Johns Hopkins published a study indicating that medical errors are the third-leading cause of death in the U.S., a study that drew harsh criticism from many physicians. Some have warned that digital prescription systems miss potential drug errors, and the Office of the National Coordinator for Health IT has called on vendors and providers to reduce the number of “pick list” medication errors.
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Top 10 patient safety concerns for 2017, according to ECRI

A new report says poor information management and faulty CDS implementation pose risks to patients. It also raises concerns about patient identification and process improvement activities.
March 14, 2017 01:10 PM
Health information technology holds enormous potential for improving patient safety, but only when implemented and used correctly. A new study from ECRI Institute spotlights EHR information management practices and clinical decision support as two areas of particular concern.
"The 10 patient safety concerns listed in our report are very real," says Catherine Pusey, RN, associate director, ECRI Institute Patient Safety Organization. "They are causing harm – often serious harm – to real people."
This list for 2017, which derives from PSO event data, focuses on concerns raised by provider organizations and ECRI experts.
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Health IT coalition seeks scrutiny of ONC's regulatory role

By Rachel Z. Arndt  | March 14, 2017
Health IT Now is asking Congress and the Trump administration to examine the role the Office of the National Coordinator for Health Information Technology plays in regulating health IT and how that role relates to other regulatory agencies.
Not-for-profit advocacy group Health IT Now wrote in a letter Monday to HHS Secretary Tom Price that the coalition worries that recent ONC actions could raise costs and slow product development by going beyond what the Health Information Technology for Economic and Clinical Health Act allows the ONC to do.
Under the ONC's "enhanced oversight and accountability" final rule, the office is allowed to review products directly for patient safety concerns. According to the rule, direct review “will promote health IT developer accountability for the performance, reliability and safety of health IT.”
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5 big challenges to utilizing genomic data for precision medicine

Two Advisory Board research leaders discuss the current state of precision medicine – and what it will take for genomics to become part of routine care.
March 14, 2017 05:18 PM
Precision medicine holds the key to better health. And as the industry moves more toward value-based care, its evidence-based principles can help providers ease into the transition.
"It's a big step to go from trial-and-error medicine to evidence-based medicine," said Jim Adams, executive director of research at The Advisory Board. "Even for evidence-based care and precision medicine, genomics data is really important. But it's not one-to-one.
"You can get to precision medicine without genomics data," he added. "There's a lot of work that can be done without the genomic data to achieve precision medicine while we wait for the technology and industry to catch up."
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Do we need to certify digital health Leaders?

James Freed, CIO Health Education England and Andy Kinnear, chair of BCS Health and Care, ran a workshop at the recent Digital Health Leadership Summit on the case for certifying digital leaders, here they summarise what attendees said.
There has been much talk about certification, registration and regulation of digital health leaders, in particular CIOs and CCIOs, in recent (and not-so-recent) years, but this debate seems to be gathering pace since September last year.
That was when Secretary of State for Health Jeremy Hunt, following a key recommendation of the Wachter Review of NHS IT, announced plans for the development of a ‘Digital Academy’ to ensure CIOs and CCIOs, and aspirants to those hallowed positions, are as good as they can be.
Cue much discussion on ‘what good looks like’, and the validity of another NHS University. Indeed, we have written in the past about the role and duty, of CIOs in particular, to demonstrate their ability and their drive.
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3 ways Trump’s FDA nominee could reshape digital health

Mar 16, 2017 11:37am
Under Scott Gottlieb, the FDA could see a subtle policy shift that loosens regulations for the digital health industry, observers tell FierceHealthcare.
President Donald Trump’s nominee to lead the Food and Drug Administration is a strong proponent of deregulating the drug industry, an approach that could be equally beneficial for the digital health industry that has occasionally butted heads with the federal agency.
Last week, Trump announced his intent to nominate Scott Gottlieb, M.D., a resident fellow at the conservative-leaning American Enterprise Institute and a former deputy commissioner for medical and scientific affairs at the FDA during the George W. Bush administration. Gottlieb, who has close ties to the pharmaceutical industry and has been vocal about the need for a new, streamlined approach to drug approvals, was applauded by PhRMA, the industry’s leading lobbying group.
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Despite federal push to offer EHR access, patient engagement is low

Mar 16, 2017 11:50am
A new GAO report says HHS needs to improve the way it measures patient access to EHRs.
Although the vast majority of hospitals and physicians provided access to EHRs in 2015, very few patients took advantage, calling into question the effectiveness of efforts led by the Department of Health and Human Services.
Just 15% of hospital patients electronically accessed their medical records despite 88% of hospitals offering access, according to a report released by the Government Accountability Office (GAO). Nearly one-third of patients accessed EHRs offered by physician practices.
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Study: Patients Typing Visit Agendas into EHRs Improves Communication with Physicians

March 15, 2017
by Rajiv Leventhal
Patients attending a safety-net primary care clinic in Seattle were interested and able to type their agenda into the electronic health record (EHR) visit note, and as a result, both patients and clinicians felt improved communication, according to new research in the Annals of Family Medicine.
More than 100 patients and clinicians at Seattle’s Harborview Medical Center (HMC) participated in the study, which took place in 2015. As the researchers stated, “existing OpenNotes research shows enthusiasm among both patients and clinicians, but this is the first Open-Notes study of cogeneration of clinic notes. Allowing patients to type their agenda into their clinic note before a visit may facilitate communication of health concerns,” they said.
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CHIME Advises HHS Improve Interoperability, Standardization

Recommendations submitted to the Department of Health & Human Services last month prioritize industry-wide standardization to improve health data exchange and interoperability.

March 13, 2017 - The College of Healthcare Information Management Executives (CHIME) recently submitted a list of recommendations to Department of Health & Human Services (HHS) Secretary Thomas Price, MD, on ways to improve patient care delivery in several areas, including interoperability.
In an effort to maintain momentum in improving interoperability, reducing stringent regulations on providers, and streamlining the transition to value-based care, CHIME submitted seven suggestions regarding steps HHS should consider when drafting future legislation.
“CHIME members have moved beyond adopting information technology and to pursuing strategies that promote population health, patient engagement and value-based payment,” members wrote. “However, significant barriers remain to harnessing the full power of these systems. Below are a set of priority areas and recommendations which, we believe, could propel us toward greater innovation in care delivery.”
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More Than 300 Data Breaches to Date in 2017

The latest count from the Identity Theft Resource Center (ITRC) reports that there have been 312 data breaches recorded this year through March 14, 2017, and that over 1.3 million records have been exposed since the beginning of the year.
VisionQuest Eyecare in Indiana reported a data breach on March 2 that affected some 86,000 individual records. This was the largest incident reported so far in 2017, but the company has not revealed any further details about the event.
At the U.S. Department of Health and Human Services (HHS) breach portal, there is an entry for Commonwealth Health Corporation (Kentucky) indicating nearly 700,000 individuals have been affected by a theft of data, but no additional details are available for this incident.
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March 16, 2017

Star Trek's Tricorder a sign of health care to come

"Take two apps and I'll call you in the morning": Game-changing technology puts data in hands of patients

Ontario startup CloudDX has created Vitaliti, a virtual doctor based on Star Trek’s tricorder device, one of several promising new technologies transforming health care. March 8, 2017
Richmond Hill Liberal
A trip to the doctor can be an ordeal.
Take time off work, drive to the health clinic, sit in the waiting room until the doctor can see you, have your throat swabbed or ear examined or head over to the medical lab for blood tests or imaging, then wait some more for the results, for the follow-ups, for the prescriptions ...
Dr. McCoy had a better way. The Star Trek doctor simply pulled out his trusty Tricorder and within seconds, you were diagnosed and on your way to better health.
Soon, you too may boldly go where science fiction has gone before.
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Why telehealth study may underestimate the technology's benefits

Published March 15 2017, 4:51pm EDT
A new study published recently in Health Affairs cuts against the conventional wisdom on one of the biggest trends in healthcare: the increased use of direct-to-consumer telehealth services.
The study found that while these services increase patients' access to care, they also may increase overall healthcare spending—contrary to the widespread expectation that direct-to-consumer telehealth would cut costs.
But if you dig a little deeper, you'll find the study's takeaways aren't nearly as clear as they may seem.
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GOP health plan to boost uninsured by 24 million, CBO says

Published March 13 2017, 6:19pm EDT
About 24 million more people would be uninsured under the Republican plan to replace Obamacare, according to the nonpartisan Congressional Budget Office, creating a daunting political impediment for a proposal that would reduce the deficit by more than $300 billion.
The coverage estimate is a setback for President Donald Trump, who promised that “insurance for everybody” would replace Obamacare, which used government subsidies and an expansion of Medicaid to bring coverage to 20 million people. But Republicans trying to pass the legislation without Democratic support argued that any reduction in the rolls of the insured isn’t as important as what they say will be cheaper coverage.
The CBO, the official scorekeeper of the budgetary effects of proposed legislation, said the GOP proposal would reduce the deficit by $337 billion over 10 years. Trump touted the plan Monday before the CBO score was released.
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Hospital datacenters: Extinct in 5 years?

Prominent healthcare executives are predicting a drastic shift from on-premise IT infrastructure into the cloud. That includes electronic health records, clinical decision support and analytics.
March 13, 2017 09:22 AM
Richard Stroup of Children's Mercy in Kansas City joked that the datacenter of the future will have very few on-site employees. 
Every time Carolinas HealthCare System gets rid of server or storage hardware, someone in the IT department takes out a roll of red tape. They cut off two pieces and lay those down on the floor in the shape of an X, as in: Do not put any new hardware here. 
"I used to be so proud of my datacenter," Carolinas Chief Information and Analytics Officer Craig Richardville said. "Now I just can't wait to get rid of my datacenter." 
Other healthcare executives are of a similar mind. Count Beth Israel Deaconess Medical Center CIO John Halamka, MD, among those. 
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EHR management tops ECRI’s list of patient safety concerns

Mar 14, 2017 10:31am
Two health IT systems—EHR management and clinical decision support systems—are among the top three patient safety concerns facing hospitals in 2017.
Information management within EHRs topped the annual list published by the ECRI Institute, which identified the top ten patient safety concerns through a review of the ECRI’s incident reporting database, member root-cause analyses, a member survey and input from an expert panel.
ECRI’s report urged hospitals to “approach health IT safety holistically” by including IT management professionals and encouraging users to report concerns about EHR usability.
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Apple's ResearchKit generates reliable health data — at least for asthma patients

Good news, since there are so many smartphones

by Angela Chen@chengelaMar 13, 2017, 12:08pm EDT
Health data collected entirely from smartphones can be reliable, research from Mount Sinai Hospital claims. The researchers involved found that Apple’s ResearchKit platform and an app for asthma were fairly accurate when compared to existing patient studies.
Finding and recruiting participants is a big hurdle for medical studies. In recent years, people have started collecting health data from smartphones, which seems sensible given how common smartphones are. But this raises questions about whether data gathered this way can be trusted. Today’s study, published today in the journal Nature Biotechnology, suggests that health care apps may be reliable, at least in regards to asthma. This is good news since smartphone usage is only increasing — there are supposed to be 6 billion smartphones used worldwide by 2020 — and collecting reliable health data from them could be very good for research.
Apple launched ResearchKit, a software medical platform, in 2015. It helps researchers recruit participants for studies; participants can enroll in trials and take surveys or provide other data. Early research partners included big names like the University of Oxford, Stanford Medicine, and the Dana-Farber Cancer Institute. The asthma mobile app from today’s study was one of the five disease-specific apps that Apple launched with the initial release of ResearchKit.
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Artificial intelligence could create smarter EHRs

March 16, 2017
Intermountain Healthcare has approximately 150 protocols built into its electronic health record (EHR) system, alerting clinicians when the patient information they enter indicates certain conditions and then guiding them through further examinations and potential treatments.
A 12-member team of doctors, nurses and analytics experts takes upwards of a year to analyze data and build each protocol, said Marc Probst, the chief information officer at the not-for-profit health system based in Salt Lake City.
Recently, though, Intermountain teamed with a company that uses artificial intelligence (AI) to do the same work. But AI works faster and more thoroughly, taking just 10 days to develop a protocol that included additional data points not previously identified, Probst said.
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Genomics, patient generated health data to be top information sources in five years, survey finds

The lack of adequate EHR interoperability continues to hinder healthcare organizations ability to use patient data in care delivery, the report’s author said.
March 13, 2017 09:42 AM
The importance of genomic and patient-generated data will increase dramatically in the next five years as healthcare managers gain control of Big Data to develop precision medicine.
Forty percent of respondents to a new survey, in fact, said genomic data will become one of the most useful data sources in five years, up from just 17 percent today. And forty percent said patient-generated data will be a top source of data in five years, opposed to 30 percent listed it as a top source today.
“The landscape is shifting from one of despair over the unfulfilled promises of big data to a more realistic vision of what sophisticated analytics can do to transform care delivery,” wrote Amy Compton-Phillips MD, chief clinical officer for Providence St. Joseph Health, who authored the report for NEJM Catalyst
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State Opioid Database Links with EHR in Pilot Program

Alexandra Wilson Pecci, March 14, 2017

In an effort to encourage physicians to use the databases, a pilot program has linked the Colorado Prescription Drug Monitoring Program with the University of Colorado Hospital's EHR/EMR.

Despite the growing number of online prescription drug databases that aim to counter the misuse of opioids and other controlled substances, many physicians don't use them.
In an effort to encourage physicians to use the databases, a pilot program at the University of Colorado Anschutz Medical Campus has linked the Colorado Prescription Drug Monitoring Program (PDMP) with the University of Colorado Hospital's EHR/EMR.
PDMPs are state-run databases to track information related to a patient's controlled substance prescription history and are used to monitor suspected abuse or diversion, according to the CDC.
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Telemedicine OK for ICU Coma Assessment, Researchers Say

Alexandra Wilson Pecci, March 14, 2017

Assessments of coma severity were similar when conducted remotely and in person, Mayo Clinic researchers found.

Telemedicine is a reliable way to assess comatose patients, according to new research. Stroke assessments via telemedicine have been studied before, but research conducted at the Mayo Clinic Hospital in Arizona and published in Telemedicine and e-Health is the first to look specifically at using telemedicine for patients in a coma.
The study was conducted over a 15-month period and included 100 patients who were randomly assigned two Mayo Clinic physicians, one who conducted their assessments at the bedside and another who assessed patients via a desktop workstation on another floor in the same hospital.
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EXCLUSIVE: 'Scotland as a leader in digital health and care'

Article posted on: March 14, 2017
Author: Dr Pieter van de Graaf, eHealth Clinical Strategy Team Leader, Scottish Government
The above may seem ambitious, but it’s exactly the challenge set earlier this month by Scotland’s Cabinet Secretary for Health and Sport, Shona Robison MSP, at a major conference in Edinburgh. It’s a challenge that the Scottish Government is looking forward to meet in close partnership with colleagues across NHS Scotland, local authorities, Third Sector, academia and industry.
The Digital Health and Care Scotland conference, organised by Holyrood Events, saw around 300 delegates from across health and social care sharing and reflecting on achievements to date, exploring current issues and challenges, and discussing future priorities.
The Cabinet Secretary’s message that, in health and social care, like other aspects of everyday life, digital is no longer an ‘add-on’ was recognised by many delegates. Digital is increasingly central to everything we do and every decision we make, whether as a clinician, a carer or a patient.
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ECRI's top 10 patient safety dangers for 2017

Mar 14, 2017 12:17pm
Providers should be aware of these 10 patient safety dangers in 2017.
ECRI Institute has identified its 10 greatest patient safety dangers for 2017. Among them: antibiotic stewardship and identification errors.
The list is compiled each year to help providers identify areas for improvement and innovation. The ECRI report also includes strategies that hospitals and other providers can use to address these concerns in their own facilities.
"The 10 patient safety concerns listed in our report are very real," Catherine Pusey, R.N., the associate director of ECRI Institute’s patient safety organization said in announcement. "They are causing harm—often serious harm—to real people."
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Poll: Where readers stand on artificial intelligence, cloud computing and population health

Healthcare IT News conducted a post-HIMSS17 survey to gauge real implementations of the conference’s big buzzwords. Respondents also revealed their favorite part of this year’s conference.
March 10, 2017 01:53 PM
The showroom floor came in tops as favorite part of HIMSS17.
When IBM CEO Ginni Rometty delivered the opening keynote at HIMSS17 she effectively set the stage for artificial intelligence, cognitive computing and machine learning to be prevalent themes throughout the rest of the conference.
Other top trends buzzed about in Orlando: cloud computing and population health.
Healthcare IT News asked our readers where they stand in terms of these initiatives. And we threw in a bonus question to figure out what their favorite part of HIMSS17 was.
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Safety huddles offer a pathway to address EHR failures

Mar 13, 2017 11:49am
Daily safety huddles offer an opportunity to address EHR patient safety concerns.
A group of Texas informatics researchers are urging hospitals to utilize daily safety huddles to identify EHR shortcomings that impact patient care.
Widely adopted on the clinical side, hospitals and health systems have used daily safety huddles to identify patient safety concerns and discuss medical errors. But a one-year review of patient safety huddles in a midsized tertiary care hospital found those huddles frequently included discussions related to EHRs, according to a study published in the Journal of the American Informatics Association.
Researchers at the Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety and Baylor Scott and White Health found that safety huddles spanning 249 days identified 245 EHR-related safety concerns, representing 7% of all safety concerns addressed in the huddles. Two-thirds of the concerns were traced back the EHR system either working incorrectly or not at all.
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Big EHR vendors set their sights on smaller targets

Mar 13, 2017 11:16am
Looking for new customers, electronic health record companies are turning their attention to physician practices and small hospitals.
Electronic health record system vendors are turning their attention to an untapped market: Physician practices and small and rural hospitals.
Those healthcare settings present an opportunity for new sales of EHR systems, according to a report by Healthcare Dive.
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Some docs skeptical of house call apps

Mar 13, 2017 9:52am
Some patients are adopting apps that allow them to summon a doctor for a house call.
Apps that allow patients to summon a doctor for a house call may be the way of the future, but many physicians are skeptical of the trend.
Docs that participate in such programs like that it allows them to get back to the basics of medicine, according to an article from MedPage Today. But some physicians have expressed concerns that certain apps may lead to subpar care, as docs treat conditions they’re not trained to handle.
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42% of providers set to deploy digital transformation projects

Written by Jessica Kim Cohen | March 10, 2017 | Print | Email
Ten percent of providers and payers are currently working on digital transformation projects, but this number is expected to increase throughout 2017, according to an IDC report.
For the report, titled Payer and Provider Investment Plans for Digital Transformation, IDC Health Insights surveyed providers and payers to better understand their investment plans related to clinical communication, connected health, Internet of Things and value-based care.
Here are four things to know.
1. The majority of current digital transformation projects are still in their pilot or research phases.
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Enjoy!
David.

Friday, March 24, 2017

There Is Still A Way To Go To Get Full Engagement With The Populations Who Need E-Health.

This appeared during last week.

Retired Australian’s use of information technology: a preliminary study

15 March 2014
In July 2010, Coffs Harbour, Australia was announced as one of fourteen National Broadband Network (NBN) second release sites and in February 2013, a number of households and businesses in Coffs Harbour had infrastructure installed to enable them to access the NBN (www.minister.dbcde.gov.au (link is external)).
High speed internet and the new generation of internet-based services has the potential to provide better health outcomes, increased social connectedness, enhanced functional capability and caregiver support for those most likely to need these services. A survey of technology use of residents of a retirement home on the Mid North Coast of NSW, Australia, showed a low uptake of technology and low engagement with online activities. An understanding of perceptions of technology usefulness, together with actual usage is necessary to assist in informing public policy and ensure that information, resources and programs aimed at increasing levels of internet uptake and use by older Australians is targeted, appropriate and effective. 

Publication Details

Permanent URI: 
Identifiers: 
DOI: doi:10.2991/itmr.2014.4.1.5
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It is hard to know what to add other than to say this needs to be an ADHA Board work item!
David

The Major Outcome Of COAG Health Minister's Meeting - 24 March 2017 - Covered In The Last Two Lines!!!!

The Communique's last 2 lines:

"Ministers agreed to a national opt out model for the long term participation arrangements in the my Health Record system."

So much for making evidence for the change public and explaining it to the public.

This lot are just so hopeless it is scary - burying such an important step in the last 2 lines of the Communique. And worse it was all done on a Friday afternoon....

I give up!

David.

Thursday, March 23, 2017

The Macro View – Health, Financial And Political News Relevant To E-Health And The Health Sector In General.

March 23, 2017 Edition.
The big issue this week has been the increasing unease in the public around the risks to the economy coming from the housing sector as well as the issue of housing affordability. The Reserve Bank clearly has some concerns:

Reserve Bank of Australia flags new rules to curb investor loans

  • The Australian
  • 9:35AM March 14, 2017
The Reserve Bank of Australia is prepared to take more action if growth in investor home loans remains stubbornly high.
RBA assistant governor of the financial system Michelle Bullock says the Australian Prudential Regulation Authority’s (APRA) 2014 directive that banks limit annual growth in their loans to investors to 10 per cent has addressed some risks.
“While the resilience of both borrowers and lenders has no doubt improved, the initial effects on credit and some other indicators we use to assess risk may fade over time ... (and) we are continuing to monitor their ongoing effects and are prepared to do more if needed,” she said in speech today.
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Overseas we have seen the US raise interest rates and gradually accumulating evidence the world economy is very slowly improving. I hope President Trump does not derail things. Despite this some are still a little anxious.
  • Mar 13 2017 at 10:00 AM

Are we edging closer to a 'sell everything' market?

by Joe Rennison and John Authers
One of the longest and most important trends in world finance may be on the cusp of a reversal. US 10-year Treasury bond yields, used as a benchmark in transactions the world over, have been in decline since inflation came under control in the early 1980s.
But in the past week, yields have risen to their highest in almost three years, while the US jobs market has grown its fastest in more than a decade. With equity markets suggesting that growth and inflation are in store under President Donald Trump, and with the Federal Reserve committed to raising its base rates this week for the third time in a decade, some bond market luminaries are convinced that the great "bull market" is over. From now, they expect interest rates to rise steadily.
"I believe the secular decline in yields is over," says Henry Kaufman, the Wall Street economist known in the 1970s as Doctor Doom for his accurate forecasts of higher inflation and interest rates. "It will not come back." His latest book carries the ominous title Tectonic Shifts in Financial Markets.
Wed Update - Looks like the time to bail out has arrived! Trust in the trump-bump has just died!
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Here are a few other things I have noticed.
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National Budget Issues.

Negative gearing deductions cap in 2017 budget frame

  • The Australian
  • 12:00AM March 13, 2017

David Uren

Capping the size of negative ­gearing deductions and cuts to the capital gains tax discount are among options the Turnbull ­government is considering as it brings together a package of housing­ affordability measures for the May budget.
The government is consulting property, housing and community groups over its housing package and is emphasising its belief that the biggest issue is a bottleneck in the supply of housing, rather than excessive demand.
Scott Morrison says negative gearing is an important concession that helps the supply of rental accommodation and he believes there is political mileage in attacking Labor’s sweeping ban on fresh negative gearing. However, the government is not ruling out changes to the tax treatment of housing investment in its discussions with industry.
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  • Mar 13 2017 at 10:03 AM

Cut negative gearing to lower house prices? Don't be 'ridiculous' says Scott Morrison

Treasurer Scott Morrison has rubbished the idea that curbing negative gearing would bring down house prices but made no mention of the effect of cutting capital gain tax concessions, which is under consideration.
Speaking on radio 2GB, the Treasurer said the idea that curbing negative gearing would ease housing prices was "just ridiculous", claiming all it would do was drive up rents.
"I don't just see how an increase in your rent improves housing affordability, particularly if you're renting."
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Abused public servants help bring Turnbull down

Ross Gittins
Published: March 12, 2017 - 9:35PM
There's no clearer sign that the Turnbull government is in deep political trouble than the never-ending saga of the Centrelink robo-debt stuff-up.
A well-functioning government would have closed down the controversy more than a month ago. If the relevant senior or junior minister hadn't had the wit to do it himself, the Prime Minister would have told him to.
Instead, the controversy's been allowed to roll on, while the junior minister, Alan Tudge, and more particularly the man allowing himself to be described as general manager of Centrelink, Hank Jongen, have repeatedly denied that there's any problem with the automated debt recovery system that's been making life miserable for many Centrelink "customers", including many who, in truth, owe the government nothing.
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Here’s a plan: put family home in pension assets test

  • The Australian
  • 12:00AM March 14, 2017

Adam Creighton

Ronald Reagan said the nine most terrifying words in the English language were “I’m from the government and I’m here to help”. Brace yourself: the Turnbull government is here to help with “housing affordability”.
Governments have a poor track record on this score. The infamous first homeowner’s grants put a rocket under house prices and succeeded mainly in shuffling money from taxpayers to vendors.
A new piece of feel-good idiocy is about to emerge, it seems. The May budget reportedly will include measures to allow older people to sell their homes without losing their age pension. Since 1912 the principal residence has been excluded from the pension eligibility test. Financial assets are included.
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Cashless welfare card ‘cuts use of alcohol and drugs

  • The Australian
  • 12:00AM March 14, 2017

Sarah Martin

A cashless welfare card that stops government benefits being spent on drugs and alcohol will be made permanent in two remote communities and looks set to be ­expanded, after trials found it greatly reduced rates of substance abuse and gambling.
The Turnbull government will today release the first major independent audit of the cashless welfare system and announce that the card will continue in Ceduna and East Kimberley, subject to six-monthly reviews.
Establishing a clear “proof of concept” in the two predomin­antly indigenous communities also paves the way for the ­Coalition to roll out the welfare spending restrictions further, with townships in regional Western Australia and South Australia believed to be under consideration.
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Reserve Bank worried about collapse in apartment prices

Peter Martin
Published: March 15, 2017 - 5:32AM
The Reserve Bank is considering tighter bank lending standards amid concern about how the financial system would handle a collapse in housing prices, beginning with Brisbane apartments.
The Bank's assistant governor (financial system) Michele Bullock told a business event in Sydney that the Reserve Bank was particularly uneasy about the "looming oversupply of apartments in Brisbane in particular, and possibly in some parts of Melbourne".
Sydney apartments were less of a worry.
"There are indicators that, in the event of a downturn, there might be systemic issues for the banking system," she said.
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An inconvenient truth gets in the way of the company tax cut chants

Michael Pascoe
Published: March 15, 2017 - 12:15AM
"When profits go up, so do wages," Business Council of Australian president Grant King declared last week as he struggled to keep alive the dream of a tax cut for his members. It would be equally simplistic but a bit closer to the truth at present to turn the statement around: When wages go up, so do profits.
The reality is that higher profits aren't translating into higher wages. Higher wages are something every employer wants for all workers bar his or her own. While labour is readily available, there's no reason to pay more for it and businesses generally don't. The old, closed-system theoretical models hand-cranked by Treasury and parroted by the government and BCA are of limited use.
The government's only apparent plan for economic stimulus – corporate tax cuts – looks lonelier by the day. Sliding away in the polls, embarrassed by the WA election, locked into inaction by internal politics and with another budget looming, the idea of giving foreign companies a present isn't generating wild enthusiasm. The latest Essential poll hot off the telephones finds only 24 per cent of voters supporting the idea, down from 28 per cent last month.
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Australian housing markets 'defy belief' but bank warns against knee-jerk policy reactions

Eryk Bagshaw
Published: March 15, 2017 - 3:46PM
The Sydney and Melbourne housing markets are continuing to "defy belief" but banks have warned that government measures designed to address affordability could actually drive up prices. 
National Australia Bank chief economist Alan Oster said property prices were showing no signs of slowing, despite growing concerns about affordability two months out from the federal budget.
The analysis from NAB shows median dwelling prices have climbed up to nine times higher than gross household incomes in Sydney and seven times higher in Melbourne on the back of surging investor demand. 
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Federal Budget package to help first home buyers

March 14, 20172:59pm
ARE your grandparents blocking the way to you buying a nice home at a relatively low price?
Older real estate owners are among the enemies of affordable housing listed by the government, as it moves towards the May Budget and the promise of measures to boost home ownership.
Treasurer Scott Morrison believes if the elderly could be encouraged to downsize there would be more options for younger buyers frustrated by high prices.
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Can budget 2017 fix housing affordability? Here are seven options

What policy levers can Scott Morrison pull? Here are the most popular policy proposals – and their political likelihood
Housing affordability is battling with energy and penalty rates to be the hot-button issue in Australian politics. There was a time rising house prices was seen as a political win, but now the issue is big enough that the government is making noises about making it a key part of the May budget.
The latest housing finance figures served to highlight that the issue of housing affordability remains unsolved. After a period of relative easing of investor borrowing, the past six months has seen an explosion in investors getting loans.
Investor lending has grown by more in the past year than it has since September 2014. Such growth invariably leads to increases in house prices, so any a cooling in the market appears a ways off:
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'Living in a fool's paradise': Business sounds the alarm on federal budget

James Massola
Published: March 17, 2017 - 12:00AM
The Business Council of Australia has sounded the alarm over the federal budget, warning the Turnbull government its plan to return to surplus by 2020-21 is "fragile" and calling on the Parliament to back further spending cuts.
In its budget submission, the BCA says real spending will rise too quickly at 3 per cent annually from 2020 because of new spending programs and an ageing population outpacing economic growth. Left unchecked, by 2055 spending could hit 30 per cent of GDP, up from 25 per cent now, locking in structural deficits of at least 3 per cent of GDP. That is an equivalent to an extra $50 billion debt per year.
To head off that potentially massive increase in debt, the business lobby group says the Turnbull government must limit spending growth to 2 per cent per year, secure support for its $13.2 billion savings package and if the current savings can't pass the Senate, find savings elsewhere.
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How the two-speed economy worm has turned

Ross Gittins
Published: March 18, 2017 - 12:15AM
If you learn nothing else about the economy, remember that it moves not in straight lines but in cycles of good times followed by bad times, and bad times followed by good.
Nowhere is that truer than with our famed "two-speed economy".
For most of the decade to 2012, the resources boom meant that the two main mining states – Queensland and, especially, Western Australia – were growing much faster than the rest of the economy, which was being held back by the effect of the boom-caused high dollar on other export industries.
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Lift GST, says OECD in dismal report card for Australia

Peter Martin
Published: March 18, 2017 - 1:30AM
The Organisation for Economic Co-operation and Development has castigated Australia for inadequate progress on tax, Indigenous affairs and support for business in a report card to be presented to finance ministers from the group of 20 leading industrial nations in Germany on Saturday.
Entitled Going for Growth, the report examines progress on undertakings made at the 2014 Brisbane G20 leaders meeting overseen by then prime minister Tony Abbott and former treasurer Joe Hockey.
At the Brisbane meeting, Australia pressed world leaders to pledge actions that would inject an additional $2 trillion into the world economy over five years and "create millions of jobs".
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Brace for the sell-off: property market at a tipping point

  • Roger Montgomery
  • The Australian
  • 12:00AM March 18, 2017
It has begun. The much maligned prediction of a sell-off in property prices is beginning to come true.
Of course, you wouldn’t know it looking at the headline-grabbing median prices and the ridiculous prices being paid for shoe boxes in Sydney — “Hey,” says the buyer, “what’s an extra million when the additional interest is $45,000 a year.”
And that is the point. We know the boom in property prices has little to do with anything other than historic low interest rates, which appears to have made paying an extra million at auction as insignificant as an impulse purchase of a bar of chocolate at the supermarket checkout.
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Health Budget Issues.

ACT's out of pocket hospital medical costs twice national average

Daniel Burdon
Published: March 13, 2017 - 12:15AM
Canberrans are paying twice the national average in out-of-pocket payments for hospital medical services, at an average $258 for each patient in an ACT hospital.
Patients in ACT hospitals face an average gap payment for hospital medical services, where the gap was paid, of $258, compared to the $125 national average, the latest quarterly statistics on private health insurance show.
Similarly, the ACT's hospital system have the lowest proportion of specialist services with no gap, at just 78.5 per cent, compared with most other states at about 85 per cent.
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High income earners to be slugged with higher Medicare costs under Greens plan

Adam Gartrell, political correspondent
Published: March 13, 2017 - 12:15AM
High-income earners would pay at least $900 more in taxes under a Greens plan to raise an extra $13 billion for the health budget.
The crossbench party wants all high-income earners - singles on more than $90,000 or families on more than $180,000 - to pay the Medicare levy surcharge, regardless of whether they have private health insurance.
Greens leader Richard Di Natale had the policy costed last month by the independent Parliamentary Budget Office, which found it would raise an extra $13.37 billion for federal coffers over the next four years.
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Push to cut costs of medical devices

  • The Australian
  • 12:00AM March 15, 2017

Sean Parnell

Health Minister Greg Hunt has called for fresh data on the cost of medical prostheses in public hospitals, signalling that the federal government will consider additional measures to reduce the high price of similar devices in the private sector.
As a Senate committee today holds its first public hearing on problems with the private sector’s regulated Prostheses List, Mr Hunt has commissioned a report on the issue from the Independent Hospital Pricing Authority.
Faced with complaints from insurers that the high cost of ­prostheses was helping drive up premiums, the government last year initiated several reforms to the list. Then minister Sussan Ley legislated to cut the price of ­cardiac devices and intra-ocular lenses by 10 per cent, and hip and knee prostheses by 7.5 per cent, to save insurers $86 million in the first year alone, and also revamped the Prostheses Listing Advisory Committee.
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Health Insurance Issues.

Ministerial committee hears of doubts over health policy categories

  • The Australian
  • 12:00AM March 13, 2017

Sean Parnell

Organising tens of thousands of health insurance policies into gold, silver and bronze categories could affect participation rates and premiums, a reform committee has been told.
The Turnbull government asked the Private Health Ministerial Advisory Committee to look at minimum standards for insurance policies, including excesses and co-payments, and align them in comparable categories.
Former health minister Sussan Ley suggested gold, silver and bronze categories would help members navigate the “murky world” of policy variation but it appears such a change could have a greater effect.
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The ‘criminal cartel’ pushing up your health fund premiums

Sue Dunlevy, National Health Reporter, News Corp Australia Network
March 15, 2017 12:00am
A GOVERNMENT price-fixing system for hip and knee replacements has been compared to a “criminal cartel” that adds $150 to your annual health premium.
Medical device manufacturer Applied Medical said the scheme that sees health fund members pay prices five times higher than public hospitals benefits wealthy private hospitals and is being exploited.
The company has been trying to bring cut price medical devices to Australia and even took the government to court over the issue but has been stymied by the system.
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Private health insurance CEOs warned they could be summoned by Senate over soaring premiums

By political correspondent David Lipson
15 March, 2017
Health insurance bosses have been warned they could be summoned to appear before a Senate inquiry over the latest round of premium price rises.
Last month, the Government approved an almost 5 per cent rise in health insurance premiums — three times the rate of inflation and worth as much as $200 more a year to families.

At a glance:

  • 13 million Australians have private health insurance
  • 5pc rise in premiums is three times the rate of inflation
  • It will cost up to $200 a year extra for families
  • 28pc increase in premiums since 2012
A Senate inquiry into the sector is underway, but so far private health CEOs — some who earn more than $13 million a year — have declined an invitation to attend.
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Your premiums are going up, and the Senate wants answers

How much is too much? Especially when you find out how much the CEOs are making.
Starts at 60 Writers
Economy 16 Mar
It seems enough is enough for the Senate as the increasing Private Health Care premiums have led them to put the CEOs on notice.
The government did approve a near 5 per cent last month which sees some with Private Health Care out of pocket more than $200 a year.
The area of interest of the Senate is that these companies are constantly stating that they need to raise the rates but the CEO’s pocket multimillion dollar salaries.  Some reports say that some of the CEOs make more than $13 million a year.
Labor senator Sam Dastyari who has called for the investigation told the ABC, “I believe we should be looking at that power. It will ultimately be the committee in the Senate’s decision”.  Mr Dastyari added, “My view is you should have to front and have to explain.”
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Pharmacy Issues.

Guild calls on Hunt to deliver

While the Health Minister’s APP keynote speech provided much-needed hope and encouragement, the pharmacy sector is at a tipping point, says Pharmacy Guild Executive Director

Minister for Health Greg Hunt impressed the community sector with his off-the-cuff speech at APP last week, writes Guild Executive Director David Quilty in his Forefront editorial published Thursday.
However he adds that there are issues that the Guild is closely working on with Minister Hunt to ensure they are urgently addressed.
“What absolutely distinguished Minister Hunt’s speech was his genuine empathy for community pharmacies as small businesses and for pharmacists as health practitioners,” says Mr Quilty.
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Uni training gaps threaten pharmacy expansion

17 March, 2017 Heather Saxena 
A gap between uni training and the commercial reality of modern pharmacy has been identified as a risk for the future.
The problem is that pharmacists are graduating without enough training in core skills, such as providing vaccinations.
This could jeopardise the push for an expanded role for pharmacists, Pharmacy Guild president George Tambassis says.
His concerns were aired at an APP2017 panel discussion, where it emerged that many pharmacies rely on banner groups, the Guild and PSA to fill in gaps in interns’ under-graduate training.
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I look forward to comments on all this!
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David.