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, April 20, 2017

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

April 20, 2017 Edition.
It the last week President Trump seems to have gone all military on us with cruise missiles, huge bombs and a stand-off with North Korea which seems to be loving all the attention!
Markets all over have got nervous. Additionally confidence of Pres. Trump delivering major legislation any-time soon is certainly fading.
In OZ we have had the usual Budget run-up and a huge number of kites have been flown! Most will never see the light of day! Political agreement as to both the problems and even more so what to do with them seems rare indeed. We will all have to  just wait and see!
May 9, 2017 is Budget Day if you are wondering.
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Here are a few other things I have noticed.
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National Budget Issues.

Too many stuff-ups about to put economic reform into reverse

Ross Gittins
Published: April 10, 2017 - 5:57AM
I have bad news and worse for advocates of micro-economic reform. First, the jig is up. There'll be few if any further major reforms. Second, the backlash against mounting wreckage from failed reforms is about to begin.
Since the reform push has degenerated into little more than business rent-seeking – let's cut tax on business and increase it on consumers; let's push the legislated balance of power in industrial relations further in favour of employers – it's neither surprising nor regrettable that voters have called a halt.
Micro reform has lost all credibility with voters. Most oppose company tax cuts for big business, cuts in penalty rates and a freeze on the minimum wage. Neither side of politics will pursue these "reforms" with any enthusiasm.
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Scott Morrison's housing fix: no change to negative gearing, affordable rentals

James Massola, chief political correspondent
Published: April 10, 2017 - 12:00AM
The federal government is spending $6.8 billion each year to fix housing affordability for renters but the problem is getting worse, not better, according to Treasurer Scott Morrison.
And while the overall rate of home ownership in Australia fell from 71 per cent to 67 per cent between 2002 and 2014, young people are being hit hardest by soaring house prices in Sydney and Melbourne, in particular, and are being forced out of the housing market.
For 25 to 34 -year-olds in this period, home ownership rates fell by nearly 10 percentage points to less than 30 per cent and for 35 to 44-year-olds, it fell by more than 10 points to 52.4 per cent.
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Cuts to the $22 billion NDIS behemoth would cost more in the long run

Jessica Irvine
Published: April 10, 2017 - 12:00AM
Everyone knows the National Disability Insurance Scheme is a great idea, but hopelessly over budget – an expensive Labor extravagance – right?
Don't buy the lie.
The $22 billion behemoth is certainly vulnerable to cost-over runs (which I'll get to).
But the most remarkable thing about this important scheme is the extent to which it has, since its conception in 2011, remained on-budget and on-time.
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Cradle-to-grave housing plan

  • The Australian
  • 12:00AM April 10, 2017

Simon Benson

The Turnbull government will pursue a “cradle-to-grave” housing affordability package in the budget likely to include a mutual-obligation superannuation plan for first-home buyers, tax breaks for downsizing the family home in retirement and a social housing plan to alleviate rental stress.
The government is also considering a plan to unlock and better use federal government land for housing, to address big housing supply issues facing the states.
In a speech to be delivered today, Scott Morrison will also place the rental crisis at the heart of the housing package, with incentives planned for institutional investment in social and affordable housing.
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Budget measures to encourage migrants out of capital cities

Adam Gartrell, Political Correspondent
Published: April 9, 2017 - 2:32PM
The Turnbull government is considering new measures to encourage more migrants to settle in regional or remote areas to relieve pressure on house prices and infrastructure in Sydney and Melbourne.
With one month until budget day, Immigration Minister Peter Dutton says his department is working closely with the treasury and finance departments to assess the likely impact of a possible shift in the migration program.
House prices rose 19 per cent in Sydney and 16 per cent in Melbourne in the year to March, locking more people out of the market.
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Scott Morrison makes the case for negative gearing change

Michael Pascoe
Published: April 11, 2017 - 12:15AM
It's hard to decide which was more impressive: the case Treasurer Scott Morrison made to the Australian Housing and Urban Research Institute for changing our negative gearing rules, or the contortions he subsequently performed to deny any need for changing negative gearing. 
Having promised that next month's budget will "do something" about housing affordability, Morrison appears to have closed off all federal options beyond an improved funding mechanism for social housing. It's small beer indeed around the barbecue-stopper of housing affordability. 
ScoMo is making a considerable show of "doing something" on housing, billing his AHURI speech as the second in a series, presumably culminating in budget presentation.  
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May budget: Axe hovers over government's $648.5 million work-for-the-dole program

James Massola, chief political correspondent
Published: April 11, 2017 - 12:15AM
The Turnbull government's powerful expenditure review committee has discussed axing one of Tony Abbott's first major policy achievements, the work-for-the-dole program.
But a group of backbench MPs have lobbied Treasurer Scott Morrison as part of a rearguard action to save it, with one describing work for the dole as "red meat for the base" and warning that axing it would infuriate the party's conservative supporters.
Fairfax Media has been told axing work for the dole was discussed when the budget razor gang met last week but a final decision has not been made.
The proposal to axe the policy, introduced by Mr Abbott in 1998 as a junior minister in the Howard government, was floated as the Turnbull government continues to hunt for savings.
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Government's piecemeal housing fix simply won't work

Jenny Smith
Published: April 10, 2017 - 3:29PM
The Treasurer's highly anticipated speech on housing affordability on Monday has succeeded in articulating the depth and breadth of Australia's affordability crisis, but failed to provide a comprehensive policy response.
It is a positive development that the federal government recognises that housing affordability, for both buyers and renters, is bad and getting worse. It is also positive that the struggles of low-income households, including families and retirees, is on the agenda.
The problem is in the solutions being put forward. The Treasurer sees lack of supply and private sector investment as the root of the problem and this is driving the policy approach.
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Seniors incentive to free up housing stock, help elderly

Renee Viellaris, The Courier-Mail
April 10, 2017 7:25am
PENSIONERS would receive a financial incentive to downsize their family home under a Budget plan that will release housing stock across the country and ease the pressure on cash-strapped seniors.
Treasurer Scott Morrison is believed to be considering measures to motivate older Australians to reap the equity in their homes and improve their quality of life.
The Courier-Mail has been told that some in the Government believe there is merit in a Budget submission from National Seniors Australia that calls for aged pensioners to downsize or quarantine a portion of cash from the sale of their home to invest in Government bonds.
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Radical overhaul of middle class welfare could fix deficit

Tom Minear, Federal Political Reporter, Herald Sun
April 9, 2017 8:00pm
A RADICAL overhaul of the middle-class welfare system could be the circuit-breaker ­solution to wipe out Australia’s mammoth deficit.
Official modelling obtained by the Herald Sun shows the country could save $36.5 billion over the next decade by slowing the growth of welfare payments to inflation.
Another $28 billion could be returned to the Budget ­bottom line over 10 years if unemployment payments were frozen for as long as the recipients were out of work.
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  • Updated Apr 12 2017 at 12:01 AM

House prices 'dangerously dumb' and 30pc overvalued: Chris Richardson, Deloitte

Recession will be unavoidable if China stumbles because Australian households are being crushed by the world's second-largest debt burden and "dangerously dumb" property prices that are more overvalued than at any time since at least the early 1980s, says a top forecaster.
Modelling to shown by Deloitte Access Economics partner Chris Richardson at the National Press Club in Canberra on Wednesday shows a China crisis would wipe almost $140 billion from Australia's economy, send unemployment up, cut house prices by 9 per cent, and destroy almost $1 trillion of national wealth.
The modelling, which underscores the degree to which Australia's exposure to what happens in China is greater than at any time in the last two-thirds of a century, will also show that the federal budget would blow out by another $40 billion in over just two years.
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What happens if China stumbles? A $140 billion doomsday scenario

James Massola, chief political correspondent
Published: April 12, 2017 - 2:01AM
Australia is more exposed to the economy of a single nation - China - than at any time since the 1950s, when Britain was our major trading partner.
While the gains from that economic relationship have been huge, the risk if China's economy slows are potentially just as large, new modelling warns.
The analysis, from Deloitte Access Economics' Chris Richardson, to be released on Wednesday at the National Press Club, says that if economic growth in China halved from its current rate of about 6.7 per cent to 3 per cent, Australia would be forced into recession as the nation "just doesn't have the ammo to fight it off anymore".
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  • Updated Apr 11 2017 at 5:00 PM

Scott Morrison leaves regulators to do heavy lifting on housing

by Chris Bowen
There are many reasons why negative gearing and the capital gains tax discount need to be reformed. Housing affordability. Budget repair. And importantly, financial stability.
Financial stability is important because it maintains the smooth and efficient flow of funds between savers and borrowers, making the economy more resilient in the face of shocks.
What the GFC taught economies around the world is that there is a real human cost of financial instability – financial distress for families, people losing their homes, business bankruptcies and high unemployment. If there is one thing above all else that Treasurer Scott Morrison should be focused on, it is keeping the financial system stable.
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Federal Treasurer Scott Morrison rules out plan to change negative gearing

EXCLUSIVE, Sharri Markson
National Political Editor, The Daily Telegraph
April 11, 2017 12:00am
SCOTT Morrison’s conservative Cabinet colleagues have shot down a plan to change negative gearing — a Budget policy the Treasurer was considering after new $200,000 Liberal Party research highlighted the critical issue of housing affordability.
The Daily Telegraph has confirmed Mr Morrison had been exploring the case for changes to negative gearing by limiting the deductibility of ­interest on residential investor mortgages.
The Treasurer firmly ruled out negative gearing changes after Prime Minister Malcolm Turnbull told him privately he needed consensus from the leaders of the Right, Immigration Minister Peter Dutton and ­Finance Minister Mathias Cormann, before he would consider the Budget measure.
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It keeps getting rejected but the idea of using retirement savings for first homes won’t go away

April 10, 2017 10:38pm
IT’S the housing funding idea that keeps getting clubbed by the experts but won’t go away, and now it’s dividing Cabinet.
Using superannuation to help buy a first home is being condemned by ministers who insist the consequences would be harmful rather than helpful. And officially no such proposal exists.
But it keeps being raised as a live Budget option and is most associated with Treasurer Scott Morrison, who appeared to be backing it today, and his junior minister Michael Sukkar.
But it is being questioned by other ministers including Finance Minister Mathias Cormann.
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What if inflation rises and wages don't?

Michael Pascoe
Published: April 13, 2017 - 12:15AM
There's a bigger economic threat starting to rumble ominously just beyond our immediate headline hogs of housing affordability and energy: What if inflation rises and wages don't?
It's a problem exercising the minds of retail analysts as their sector (already in a spot of bother) would be the first to feel the obvious impact of such a scenario – weaker consumption spending.
And with consumption accounting for about 60 per cent of the economy and the government relying on real consumption growth of about 3 per cent to keep the overall GDP growth above trend, Houston might not have a problem but Canberra and much of the rest of the nation would. 
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Turnbull enters row over affordable housing measures to dump dipping into retirement savings

April 12, 20174:01pm

Deloitte's Chris Richardson says Turnbull was 'right' to embrace innovation during campaign

authorBlockSingleMALCOLM Turnbull has moved to settled a cabinet brawl before it erupted over using superannuation accounts to fund first homes of young people.
It’s a bad idea, he indicated.
The numbers show a dip into retirement savings isn’t going to happen, and the proposal might not even get as far as the expenditure review committee which decides the contents of the Budget.
That means Treasurer Scott Morrison will have to look elsewhere to find effective Budget measures to increase housing affordability in the crisis cities of Melbourne and Sydney — the big promise at the centre of the May statement.
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Negative gearing, the common good and the political reality

John Warhurst
Published: April 13, 2017 - 12:15AM
The Turnbull government has doggedly defended negative gearing, the policy by which the losses on investment properties can be offset against other income, most recently through Treasurer Scott Morrison before the May federal budget. Many experts blame the policy, in part, for rising house prices, which keep many younger first-home buyers out of the property market. It lowers the taxable income of such investors and thus hurts the overall budget bottom line, too.
But the policy is also popular with many investors, almost to the point that the idea of having an "investment property" has developed something of a cult following. For some people, it seems a way of life that promises otherwise unachievable prosperity.
There is no magic bullet to reining in rising house prices that squeeze out young home buyers in favour of investors. But to just about every responsible party besides the government, reforming negative gearing should be on the table as part of a possible solution. It is the government's apparent obduracy rather than the call for change that which needs explanation.
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Reserve Bank sounds warning about new mortgages

Eryk Bagshaw
Published: April 13, 2017 - 8:03PM
One third of mortgage owners have less than a month's buffer against financial instability, the Reserve Bank has warned, in a review highlighting increased risks in the heated Sydney and Melbourne property markets.
The RBA's half-yearly financial stability review, released on Thursday, also took aim at the noticeable rise in investor credit, stating a decline could trigger a sharp downturn in the market.
"The concern is that investors are likely to contribute to the amplification of the cycles in borrowing and housing prices, generating additional risks to the future health of the economy," the RBA said.
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Scott Morrison must forget the spin and downplay expectations on housing

John Hewson
Published: April 13, 2017 - 4:45PM
Effective management of expectations is fundamental to political success. It is counterproductive, if not fatal, to create expectations and then fail to deliver. This was certainly the defining aspect of Barack Obama's presidency. It is a principal reason for the collapse in Malcolm Turnbull's standing in the polls.
However, as obvious as this may be, our politicians seem incapable of learning the lesson. They are all too anxious to grab an issue, raising the expectations that they can "solve it".
An excellent example is housing affordability. Gladys Berejiklian has sought to make it the hallmark of her premiership. Scott Morrison is happy to make it the focus of his budget this year. Yet, realistically, they can only hope, at best, to make a marginal improvement in the crisis, although admitting it as a crisis may allow them to do somewhat more than would otherwise have been the case.
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Why will no one admit that improving housing affordability means bringing down prices?

Jacqueline Maley
Published: April 15, 2017 - 12:00AM
Is there any political tradition more dispiriting and stupid than the pre-budget dance? The flying of "kites", the choreographed leaks to newspapers, the winky denials from politicians of the same ideas their press office has led journalists to believe are being seriously considered?
That's without even mentioning the infamous "rule-in/rule-out game" – which politicians are fond of saying they will not play, like it's something immoral, akin to admitting you hunt babies on weekends.
Even though they won't play it, the rule in/rule-out game was definitely invented by politicians, because they're obsessed by it. They talk about it all the time.
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Time to admit failed doctrine on low interest rates

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

Alan Kohler

So according to the Reserve Bank, one third of households have no buffer, or a buffer of less than a month’s repayments.
This was mumbled on page 21 of the Financial Stability Review, before moving on quickly to commercial property. No one ran out into Martin Place with hair on fire, no one resigned in sackcloth and ashes, or apologised and, as far as we know, there was no roast from the Prime Minister or Treasurer, declaring their loss of confidence in the central bank.
Interest rates have been cut to the lowest level in history, yet inflation remains bogged below 2 per cent, unemployment is stuck at 5.9 per cent and now a third of borrowers are so far in debt they are bufferless. They are up to pussy’s bow, full stretch, bone on bone: no cartilage.
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Health Budget Issues.

Federal budget 2017: Budget razor gang to consider medicine scheme shake-up

Adam Gartrell, Health Correspondent
Published: April 11, 2017 - 11:45PM
The Turnbull government's budget razor gang is set to consider changes to the $10 billion Pharmaceutical Benefits Scheme designed to bring down the price of medicines and kill off a potentially damaging fight with pharmacists.
Health Minister Greg Hunt is close to finalising a new strategic agreement with pharmaceutical industry body Medicines Australia that will underpin the changes to go before the expenditure review committee within days, Fairfax Media can reveal.
Well-placed sources in the medicines sector say that under the agreement the industry will bring down the cost of some drugs in exchange for price certainty and stability. The agreement will fill the void left after negotiations on an earlier agreement ended in acrimony in 2015.
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You’ll soon be slugged hundreds for X-rays and scan tests, as Medicare cover shrinks

Sue Dunlevy, National Health Reporter, News Corp Australia Network
April 11, 2017 10:00pm
YOU’LL pay more for X-rays and scans with out of pocket costs to rise to over $200 per screening, as the Turnbull Government prepares to ditch its election promise to raise Medicare rebates for the tests.
The broken promise will be a particular slug on cancer patients who need multiple tests for diagnosis and to check their cancer has not returned.
On the eve of the 2016 election, the Turnbull Government pledged to index the Medicare rebate for medical imaging for the first time in 19 years to head off a damaging advertising campaign from radiologists.
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How a $40 medical test became a $1000 test overnight

Harriet Alexander
15 Apr 2017, 12:32 a.m.
Some doctors have increased their fees by up to 400 per cent, knowing the bill would be footed by taxpayers and not their price sensitive customers.
The federal government has parked its attempts to rein in the Extended Medicare Safety Net, despite a blowout in costs that the Department of Health warned in 2015 was largely the result of medical practitioners increasing their prices.
It will not be included in the May budget.
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Health reporting in sickly condition

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

Sean Parnell

Australia has been ranked sixth on a global health transparency index, marked down for a lack of routine, uniform reporting on hospital rates of unexpected death, avoidable infections and unplanned readmission.
While Australia shared top place on the KPMG International analysis for finance, and earned a bonus point for publishing contract and procurement information, deficiencies in ­reporting quality issues held Australia back behind Scandinavian countries and Britain.
KPMG Australia healthcare partner Dan Harradine said there was a need for better and more consistent reporting of poor quality outcomes, and also better measurement and publication of patient outcomes and sentiments, to improve the ­system.
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Health Insurance Issues.

Med-techs propose new prostheses price model

  • The Australian
  • 12:00AM April 10, 2017

Sarah-Jane Tasker

A group of Australian med-tech companies is seeking a meeting with Health Minister Greg Hunt to push a new pricing model for the Prostheses List to end the bitter battle with private health insurers.
LifeHealthcare chief executive Matt Muscio is spearheading the proposal, saying the next couple of months are critical, given a senate inquiry on the controversial pricing list for medical devices is scheduled to report its findings.
“If we’re not part of the solution we are going to remain part of the problem,” Mr Muscio said.
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Private health funds to stop paying to fix botched surgeries

April 15, 20179:19pm
John Rolfe News Corp Australia Network
EXCLUSIVE
PRIVATE health insurers will stop paying for public hospital surgeries that leave policyholders with scalpels or scissors inside them.
Currently a fund, and possibly a policyholder, could end up having to pay twice — once for the bungled surgery and again for the fix.
News Corp Australia can also reveal that with the number of private patients in public hospitals increasing, insurers will seek binding contracts with state governments or public hospitals stipulating quality levels and costs.
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Private health insurance complaints on the rise

Editor: Amy Coopes Author: Amy Coopes on: April 12, 2017 In: private health insurance
Complaints about the private health insurance industry have skyrocketed in recent years and new memberships have slowed, according to a new report from the Private Health Insurance Ombudsman.
The PHIO’s annual State of the Health Funds report showed an uptick in complaints across a range of insurers and regarding a host of issues including refunds for canceled memberships and administrative hurdles switching from one insurer to another, as well as problems with automated payments or delays and glitches in responding to queries.
In 2015-16 the private health insurance industry experienced growth of just 1.35% with 86,939 new memberships, compared with some 158,000 the previous year.Three major funds — HCF, Medibank and Westfund — saw their membership base contract.
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Pharmacy Issues

Pharmacists set for $600m Budget boost to stop overdoses

Wednesday, 12 April 2017 10:28AM
Chemists are in line for a $600 million windfall to expand community pharmacy programs in a bid to stop patients suffering bad reactions or overdoses from their medicines and having to be admitted to hospital.
The West Australian understands the money is likely to be announced in the Budget, helping boost pharmacists’ role in providing primary care services such as screening for chronic disease and ensuring medicines can be supplied in the bush and to indigenous communities.
It comes as the Federal Government gets closer to a deal with major drug makers to slash the cost taxpayers pay for some prescription drugs in return for five years of price certainty.
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I look forward to comments on all this!
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David.

I Wonder Why Discharge Summaries Are Not Discussed With The Patient Before Being Uploaded To The myHR.

This blog appeared last week:

My Health Record in General Practice

Monday, 10 April 2017
Dr Steve Hambleton, MBBS FAMA FRACGP (Hon) GAICD
Follow Dr Steve on Twitter @SteveJHambleton
Amongst my other roles, I've been a GP at the Kedron Park 7-Day Medical Centre in Brisbane for the past 29 years. Many of my patients have been in my care for a long time and I know them very well but I cannot be there for them every day. Like a lot of GPs who have been in the same practice for a long time, I mainly treat people with chronic and complex disease.
I believe one of the responsibilities of General Practitioners is to facilitate patients’ interactions with the health system as a whole, and it’s particularly important for those with chronic ailments. For this reason, I am an early adopter of My Health Record – the secure, online digital summary of a patient’s pertinent medical information, including diagnosis, outcomes, medications, reactions and allergies.
The benefits of the My Health Record cannot be understated. One of my patients with a list of chronic diseases – heart disease, Parkinson’s disease, peripheral vascular disease, kidney disease and chronic myeloid leukaemia – was recently taken to a Queensland public hospital with an acute deterioration in his heart condition. As a result of his various illnesses, the patient had several different specialist doctors attending him, and each of these doctors was able to consult his My Health Record for information on his latest treatments, medications and outcomes. These details informed their own treatment plans. Ultimately, everyone involved, and particularly the patient, benefited from having all of his crucial medical information stored in one accessible digital file avoiding duplicate testing and the inevitable phone calls needed to find bits of information from multiple sources.
Another example benefit of My Health Record adoption involves the automatic inclusion of a patient’s hospital discharge summary. I’ve had patients come to see me so soon after a stint in hospital that their discharge summary hasn’t had time to arrive. Although sketchy on the details, my patient recalled that there were changes in their medications which I should to be aware of. In the old days, I’d have had to chase up the discharge summary, or call the hospital pharmacy, wasting time and resources. Now I can simply check the patient’s My Health Record, which in Queensland public hospitals, now usually contains a recently added copy of the summary that includes all the relevant information – a streamlined system in which, once again, the patient wins.
More here:
Note the last paragraph mentioned: I was given a copy of the discharge summary from my last admission and at the time I said to the intern not to upload the Summary. She had not heard of the myHR etc. so was more than happy to comply.
A day ago I checked and somehow it had been uploaded as there as one detail I was not happy with.
Seems to fascists have taken really taken over.  Looks like automatic does really mean automatic despite consent being specifically being denied.
Might make a call or two and see what is going on.
David.

Wednesday, April 19, 2017

The myHR Becomes A Touch Political Would Seem. Interesting.

This came up in the discussion re access to Opt-Out myHR Records.
Media Release – Catherine King MP
Shadow Minister For Health And Medicare = Member For Ballarat

ANOTHER HEALTH BUNGLE – OPEN SLATHER ON YOUR HEALTH DATA UNDER TURNBULL

” The revelation that hundreds of thousands of health practitioners will be given open access to sensitive health data is extremely concerning.
Reports today say that electronic health records will be automatically set to “universal access” under the Turnbull Government’s opt-out scheme, meaning health practitioners will automatically have access to an individual’s full medical history – whether it is relevant to the treatment they are administering or not.”
This means that a dentist or optometrist could know if someone has had an abortion, or their history of mental illness, even if a person has not disclosed it to them.
“Given the Turnbull Government’s appalling IT record, Australians have every right to be worried about their rollout of this project,” Ms King said.
“Last year, one billion lines of Medicare data with private claims information were freely available for download in a massive data breach on the Government’s watch.
“They need to tell Australians what is happening, or they risk people losing confidence in the system before it even gets off the ground.”
When Labor originally set up the Personally Controlled Electronic Health Record it was an opt-in system, with users setting up access preferences and controls. Now that the system has moved to opt-out, it seems that the Turnbull Government has not set up the same automatic safeguards.
“The information in these records is too important to be another addition to the Government’s list of health bungles. Australians deserve to know how their information will be protected.”
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Here is the link to this release and a lot of other commentary:

https://nacchocommunique.com/category/e-health-my-health-records/

I would have expected the Labor Party to stay well out of this discussion. It seems political warfare means they will really leap on any grist for the mill. (BTW - does anyone have a link to Ms King's current press / media releases? They are not easy to find.)

It really is quite interesting that the Labor spokesman finally has an adverse comment to make given the way the ALP has totally failed to push any accountability for the myHR mess over the last few years. Surely enough time has passed for them to develop a little objectivity as to where their 'baby' has wandered off into a wasteful swamp. I guess this might be the first sign of the worm turning, or not!

David.

Tuesday, April 18, 2017

Despite The Sound And Fury Do We Really Know How Opt-Out Settings Are Being Set?

This article appeared last week:

Optometrists and dentists will know if you’ve had an abortion or mental illness in health record bungle

Sue Dunlevy, National Health Reporter, News Corp Australia Network
April 10, 2017 10:00pm
THE private health records of Australians can be accessed by more than half a million people under the latest bungle with the $2.2 billion electronic My Health Record.
News Corp Australia has learned that the privacy settings on the government’s computerised My Health Record, which lists every medicine a patient takes and records every medical visit and procedure, are automatically set on “universal access”.
This means every registered health practitioner in the nation — 650,000 people — can view them, not just the family GP, unless the patient specifically requested to opt out.
Occupational therapists working for an employer, doctors working for insurance companies, a dietitian, an optometrist or a dentist or their staff can view the record and see if individuals have a sexually transmitted disease, a mental illness, have had an abortion or is using Viagra.
“Potentially your employer’s occupational therapist can look at your record and get information they really shouldn’t be getting access to, its confidential data,” says former AMA president Dr Mukesh Haikerwal who was a government consultant on the My Health Record.
The bungle came about because the record was originally set up as an opt in system and when people set up their record they were given the option to set a PIN number to protect the information and determine who got to see it.
Nearly four million people set up a My Health Record under the opt in system but doctors weren’t using it because four years after it was established 83 per cent of Australians still did not have one.
Last year the Turnbull Government trialled turning the failed record into an opt out system.
One million people in the Nepean Blue Mountains area of NSW and Northern Queensland were given a record unless they opted out.
News Corp has now learned only 147 of these one million Australians automatically given a record under the trial set up a PIN number to protect their health information.
“147 My Health Records created in the trials have access controls set to restrict which healthcare providers can see the record, or have controls restricting access to certain documents in the record,” the Department said.
“This equates to 0.0151 per cent of My Health Records automatically created in the trials. This is consistent with the rates of access controls set by those who have opted to register for a My Health Record,” a spokeswoman for the department said.
There is a great deal more here:

http://www.dailytelegraph.com.au/technology/optometrists-and-dentists-will-know-if-youve-had-an-abortion-or-mental-illness-in-health-record-bungle/news-story/b73cccfaf20b6fe96862e9c021b49ae0

What is claimed is that the records created for those who are being opted in (failed to opt-out) have the security and privacy setting at full access until the individual involved logs into the record and changes things. This is true as far as I understand the system – certainly for access to my record this is the case. Once you can you access the record you get the lot (unless the user has changed access controls - and few do)!

What this means is that there are 2 crucial things that we need to know.

1. Are the populated records created at the time of the decision to go to opt-out or at the time of first attempted access? It seems probable in the trial areas they are created instantly - from user comment in the area involved.

2.Once a record is created what information is it automatically loaded with? Seems might be a bit later but who knows? There certainly seems to be no constraint on automatic uploading of discharge summaries etc.

The worst case (privacy-wise) is that the feeds of pharmacy and MBS data are used to populate the unused but now brought into existence records in a few weeks’ time or whenever. What this then means is that the myHR is populated with all the ‘automatic’ information and sitting there waiting for Shared Health Summaries and other specifically entered material.

Note that the automatic data allows a great deal of private information to be seen and deduced.

If the records are not created and not pre-loaded till use is attempted then there seems to be less of an issue.

I, for one, have not seen enough detail to understand how all this is meant to work.

Until this detail is out in the open we are all in the dark I believe. That said the planned opt-out looks like an approach that will create a lot of empty records which will, over time be automatically populated, given most people will not be really aware they have a record. (Info from users in the trials)

This means that once everyone had a record if you know a patient identifier and have access to the GP or other system you will have pretty total access to the record - unless the individual has gone in and changed access privileges.

So, joining the dots, it is possible to look up IHI's to put into local records if you are at a GP system, with an IHI you can locate a record and the record will most likely be open, given so few patients will have changed that. Overall it seems to me that the Tele was pretty close to the money then. (Remember lots of people have access to GP systems as GPs, staff etc.)

I look forward to explanations of where this is wrong and why. Also a new up-to-date CONOPS would be a really good idea I reckon. Would stop the confusion and wondering - to say the risk of any misinformation.

David.

Monday, April 17, 2017

Weekly Australian Health IT Links – 17th April, 2017.

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

What a week, with little real news until The Daily Telegraph lobbed a bomb. Furious argument resulted and I am not sure where it ended – with no clear official statement from the ADHA as to the truth of not of the claims. Time will tell I guess.
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  • Updated Apr 15 2017 at 11:18 AM

Data-driven 'signature medicine' to drive future treatment

The sheer scale of data will assist in everything from picking up early warning signs of an individual's illness to predicting an epidemic. 
In the modern era, medicine has been chopped up into bits. There is a different specialist for each bit of the body and often one expert doesn't quite know what's happening in other parts of the patient, and doesn't have the time to find out either.
However, this is predicted to change.  And it's not going to happen because doctors have more time or more capacity for care.
Rather, the prediction is that this change will be driven by big data, analytics and the Internet of Things (IoT).
The IoT is the growing worldwide network of objects with sensors, software and built-in connectivity.
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3 rules for using your computer ethically

12 April 2017
What counts as unethical computer use? Is it playing Candy Crush during work hours? Or is it allowing your computer to undermine the doctor-patient relationship?
Representatives from the American College of Physicians have written guidelines to ensure doctors of all stripes use their computers ethically.
Writing in the Journal of General Internal Medicine, they focus on the following three points.
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5 tips for using Facebook in general practice

12 April, 2017 
If your practice intends to use social media, the RACGP recommends you put in place a social media policy for staff.
And to be extra safe, consider developing a code of conduct.
The RACGP has put together a social media policy template that you can adapt to your practice.
Meanwhile, here are some useful tips for using Facebook. Tomorrow we will provide some cool Twitter tactics:
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7 tips for using Twitter in general practice

13 April, 2017
Do it right and you will reap the benefits of social media, which can be an excellent form of advertising for practices and individuals alike.
But bear in mind that it is subject to the Medical Board of Australia’s Guidelines for Advertising Regulated Health Services.
On Wednesday, we covered the main dos and don'ts for using Facebook. 
Today, the focus is on Twitter, thanks to guidance from the RACGP. 
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  • Updated Apr 10 2017 at 8:00 PM

Analytics a key in dispensing change

Artificial intelligence may play a large role in healthcare data. Lyn Osborn/supplied pic
by Lydia Maguire
This content is produced by The Australian Financial Review in commercial partnership with the Commonwealth Bank.
The health sector offers a challenging dichotomy for companies looking to innovate with digital tools like data analytics. There is a clear recognition of the benefits of new technology yet, unlike consumers, corporate customers are shifting very slowly.
Take Sydney-based medical software and information provider MedicalDirector. The company's platforms facilitate over 70 million patient consultations a year, and it has data stretching back over 20 years. As it operates in a highly regulated market with huge inefficiencies – and opportunities – that is exactly the kind of huge data pool that attracts a digital innovator's interest.
According to CFO David Cooper, "MedicalDirector has a statistically relevant sample of de-identified data on general history of patient consultations. That's hugely valuable to industry. It's a wealth of information we can use to optimise healthcare."
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  • Updated Apr 10 2017 at 8:00 PM

Better technology means better patient experience

Commonwealth Bank managing director of commerce and platforms Bronwyn Yam says technology in the US is linking the public and private systems with workers compensation. Supplied
by James Sherbon
This content is produced by The Australian Financial Review in commercial partnership with the Commonwealth Bank
Customers have an ever-growing sense of expectation from service providers. They take their best experience in any context, and apply it to every context. Meanwhile, the health sector is anchored in some very old practices, amid an ecosystem that can be both diffuse and opaque. In this context, a willingness to embrace new ways of doing things is vital. Technology can solve some problems, but only with the cooperation of all market participants.
The attendees at the Emerging Payment Technology CFO Roundtable, held at the International Convention Centre, Sydney, as part of the seventh Annual Australian Healthcare Week, represent a good cross-section of a healthcare industry committed to embracing such change.
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Australia's ambitious action plan for open government

A new 'multi-stakeholder forum', to be established by July, will oversee Australia's open government work plan, with commitments already set through to 2018.
By Stilgherrian | April 12, 2017 -- 07:05 GMT (17:05 AEST) | Topic: Security
The Australian government will soon be launching a wide-ranging review of its laws and processes for data sharing and public release, with the timetable for setting up a forum to oversee this work and related projects expected to be announced within days.
Recent controversies have highlighted problems with how the government currently runs data sharing and publication, or at least aspects of those processes that citizens don't like.
Witness the public outcry over Centrelink's debt recovery program, and the widespread privacy concerns over plans to give the Australian Bureau of Statistics (ABS) access to data from other government departments to cross-match it with its Census data.
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NSW patients first to have direct access to pathology results through the My Health Record

This important milestone has been reached following a successful collaboration between the Australian Digital Health Agency, eHealth NSW and NSW Health Pathology

11/04/2017
The Australian Digital Health Agency (the Agency) has announced that patients in NSW will now be able to view their pathology results through the My Health Record consumer portal and mobile applications.
The benefits of securely receiving, viewing and storing a patient's test results in one place are significant for both the patient and their treating healthcare professionals.
Having pathology results published in a single location means patients can share with any number of treating healthcare professionals their test results. Clinicians too will benefit from having access to their patient's results in circumstances where they did not initiate the requests.
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Optometrists and dentists will know if you’ve had an abortion or mental illness in health record bungle

Sue Dunlevy, National Health Reporter, News Corp Australia Network
April 10, 2017 10:00pm
THE private health records of Australians can be accessed by more than half a million people under the latest bungle with the $2.2 billion electronic My Health Record.
News Corp Australia has learned that the privacy settings on the government’s computerised My Health Record, which lists every medicine a patient takes and records every medical visit and procedure, are automatically set on “universal access”.
This means every registered health practitioner in the nation — 650,000 people — can view them, not just the family GP, unless the patient specifically requested to opt out.
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Editorial: Prognosis bad in medical record bungle

April 11, 2017 12:30am
Editorial
Your medical records may be an open book to 650,000 registered medical practitioners.
THE privacy scandal unfolding in the troubled My Health Record electronic medical records system is ample proof why citizens should be vigilant and maintain a healthy scepticism about governments and Big Brother bureaucracies.
As revealed in today’s The Advertiser, your medical records may be an open book to 650,000 registered medical practitioners.
Had a mental illness? Your dentist can view details. A sexually transmitted disease? A bored pharmacist interstate might be curious. At risk of a hereditary disease? Your potential employer or insurance company might be very keen to know, via their in-house medical staff.
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MyHealthRecord slammed in privacy uproar

Hang on, sharing records is kind of what it's for

11 Apr 2017 at 01:57, Richard Chirgwin
The Australian government has found itself embroiled in a privacy furore, this time for the privacy settings on its MyHealthRecord e-health system.
At issue is the system's default privacy setting, which is that any health professional treating an individual can access their whole health history.
On the upside, that means if you're being treated by multiple specialists for a complex condition, they should all see the same records, without resorting to getting blood test results by fax.
The downside is that people can view data that's arguably beyond their need or specialty – a dentist may not need to know someone is being treated for depression, for example.
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Dr Tony Bartone – ABC Radio – My Health Record

11 Apr 2017
Transcript: AMA Vice President Dr Tony Bartone, Mornings with Ali Clarke, ABC Radio Adelaide, Tuesday 11 April 2017
Subjects: My Health Record
ALI CLARKE: How private are your medical records? And if you're using the My Health Record system, give me a ring - I'd love to hear from you. That's the Government’s computerised record that lists every medicine a patient takes, and records every time you have to head off for a medical appointment or visit.
I'd love to know your experiences of it, because it seems that reports today suggest that your private health records now may be accessed by over half a million people. To find out what has happened, I'd like to say good morning to Tony Bartone, the Vice President of the Australian Medical Association. Good morning, Tony.
TONY BARTONE: Good morning.
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‘My Health’ privacy remains intact

11 April, 2017 
Claims that half a million health practitioners can rummage through a patient’s My Health Record without their consent has been dubbed “false and misleading” by the Federal Government.
Former AMA president Dr Mukesh Haikerwal says that unless a patient elects to opt out of the $2 billion My Health Record system, any of the 650,000 registered health practitioners can view the records.
“Potentially your employer’s occupational therapist can look at your record and get information they really shouldn’t be getting access to, it's confidential data,” he told the Adelaide Advertiser.
But the Department of Health denied Dr Haikerwal’s allegations, labelling the article “misleading and false”.
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My Health Record privacy 'thoroughly enforced': department

11 April, 2017 Geir O'Rourke 
Claims that half a million health practitioners can rummage through a patient’s My Health Record without their consent has been dubbed “false and misleading” by the Federal Government.
Former AMA president Dr Mukesh Haikerwal says that unless a patient elects to opt out of the $2 billion My Health Record system, any of the 650,000 registered health practitioners can view the records.
“Potentially your employer’s occupational therapist can look at your record and get information they really shouldn’t be getting access to, it's confidential data,” he told the Adelaide Advertiser.
But the Department of Health denied Dr Haikerwal’s allegations, labelling the article “misleading and false”.
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Government denies health record privacy risk

12 April, 2017 
Claims that half a million health practitioners can rummage through a patient’s My Health Record without their consent have been dubbed false and misleading by the federal government.
Former AMA president Dr Mukesh Haikerwal says that unless a patient elects to opt out of the $2 billion My Health Record system, any of the 650,000 registered health practitioners can view the records.
“Potentially your employer’s occupational therapist can look at your record and get information they really shouldn’t be getting access to, it's confidential data,” he told the Adelaide Advertiser.
But the department of health denied Dr Haikerwal’s allegations, labelling the article “misleading and false”.
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Technology and innovation in Australia's aged care

By Sean Rooney
Monday, 10 April, 2017
Australia’s aged-care workforce needs to meet the challenges of increased demand, consumer choice, a rapidly changing marketplace and the integration of new technologies.
The existing workforce needs to be renewed as the latest statistics tell us that an estimated 60% of the existing workforce will reach retirement age over the next 15 years. These workers not only need to be replaced, but our aged-care workforce needs to rapidly increase to meet the growing demand for different types of services. By 2050 it is estimated that we will need up to 1.3 million workers in the industry.
The workforce will need to be responsive, knowing that we have a new cohort of older Australians with broader expectations of how, where and by whom their care is delivered.
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Online tool aims to help elderly navigate aged care maze

A free online tool has been set up to help older Australians navigate the maze that is aged care in the country.
Named CarePilot, the site allows the aged to book trusted suppliers who provide a range of service and packages.
The online platform offers expert advice and user-friendly tools to select and book support services, stay organised, manage funds, and connect with family members.
It has been set up at a time when the federal government is looking to largely rid itself of the responsibility of providing such care to the elderly and ailing part of the population.
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Scammers target My.Gov users in bid for personal data

Scammers are taking aim at users of the federal government's My.Gov website in a bid to dupe them into leaking their passwords and credit card details.
The email security firm MailGuard issued a warning about the scam, pointing out that the fake website looked highly convincing.
The company said the source code of the fake site was mostly a copy of the original.
On the bright side, the phishing email that sought to lure My.Gov users was distributed to a relatively small audience, MailGuard said.
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Improving the quality of life for people in pain through novel, cost effective pain assessment tools

 ePAT introduces first version iOS App at Pain Society conference
Highlights:
·         ePAT to participate in leading pain specialist event
·         Demonstrating first version iOS App to potential end-users for feedback
·         Presenting clinical paper at symposium
 ePAT Technologies (ASX:EPT, ‘ePAT’ or the ’Company’) is pleased to announce the Company is continuing to increase its industry recognition within the Australian medical sector, demonstrating its revolutionary pain detection technology to a series of highly-qualified experts.
 The Company is taking an active role at the Australian Pain Society’s 37th annual scientific meeting, which will host 800 pain specialists during the 9-12th April 2017.
The conference attendees represent a prime target audience for end-users of the ePAT app.
The Australian Pain Society is a major industry body aiming to relieve pain through advancements in clinical practice, education and research. The conference is expected to be the only forum in Australia offering multidisciplinary insights into pain management from a variety of medical, nursing and allied health perspectives.
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SA Health CIO defends EPAS following coroner's criticism

State electronic patient record system condemned by inquest into death of former Socceroo
George Nott (Computerworld) 10 April, 2017 08:41
The CIO of SA Health has spoken out in defence of the state’s Enterprise Patient Administration System (EPAS) after it was criticised in an inquest into the death of former Socceroo Stephen Herczeg.
South Australia State Coroner Mark Johns is currently inquiring into the death of Herczeg, who died at the Queen Elizabeth Hospital last September. The 72-year-old died from respiratory failure caused by a ruptured bladder and collapsed lungs after an oxygen tube was connected to his catheter.
According to reports of the inquest, Johns criticised the electronic patient record system’s inability to produce intelligible paper copies of records.
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Whole genome sequencing is medicine’s Snowy Scheme

  • John Mattick, Branwen Morgan
  • The Australian
  • 12:00AM April 13, 2017
We are on the brink of a revolution in healthcare. Genomics soon will help us not just cure but also predict and even prevent diseases such as diabetes, dementia, cancer and heart disease.
And it’s just the start. With enough data on the population’s genetic make-up, breakthroughs in other diseases and mental illness will be almost unlimited.
The technology to gather this data is, for the first time, accessible and relatively cheap. A person’s entire DNA sequence — three billion letters of genetic code — now can be read in Australia in just a few days for about $1500.
The benefits of whole genome sequencing to patients are extraordinary. One recent example, testament to the power of precision medicine, is that of seven-year-old Sydney boy, Alan, whose rare auto-immune disease was found to be due to the combination of two mutations in a single gene. In 2015, just three months before Alan’s diagnosis, US medical researchers had shown that the drug abatacept, originally developed for organ transplant patients, compensates for deficits in this same gene. Without a doubt, abatacept has saved Alan’s life. This is a case where WGS led to an unexpected repurposing of a drug for a previously undiagnosed disease.
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myGov no help in organ donation push

Cate Swannell
It is clear that we still need to do better, although there have marked been improvements in the way the Australian organ donation process works.
In bygone days, if you wanted to be an organ donor, you ticked the “yes” box on your driver’s licence application or renewal and that was that. I’ve always ticked that box, but when I had to renew the licence recently, that box was nowhere to be seen.
In all Australian states, except South Australia, if you want to register as a donor, you now have to do it via the Australian Organ Donor Register. It’s an opt-in system. SA is the only state that retains the driver’s licence system. And SA, just quietly, has the highest donors per million people (24.7) of any Australian state. Queensland, at 15.1 donors per million people, has the lowest.
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Healthcare technology is surging ahead, but needs cohesive policy to boost Australia’s outcomes

By David Braue

10.04.2017
Sponsored Content – Philips Health Systems
Systemic thinking needs to adapt if e-health is to truly deliver.
As the person leading the Australia-New Zealand business of one of the world’s leading health technology companies, Kevin Barrow spends his days thinking about ways to help healthcare providers use new technologies to improve patient care. Yet even the most innovative technology, he notes, can only drive systemic change when policy levers are adjusted to ensure adoption and long-term viability.
That’s often easier said than done, explains Barrow, who has been involved with the medical technology industry for 20 years – including nearly three years as Managing Director for Philips ANZ and General Manager of Philips Health Systems ANZ.
“If you reflect back on the last 50 to 60 years, there really has not been a change in the way healthcare is delivered,” Barrow explains.
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Misuse of prescription medication should be monitored

ANNIKA SMETHURST, The Sunday Telegraph
April 9, 2017 12:00am
DRUG overdoses claim more lives than accidents on Australia’s roads.
It’s a confronting statistic made worse by the fact that twice as many overdoses are linked to prescription medication compared with illegal drugs.
But unlike the road toll, prescription drug abuse remains a taboo subject and has been sidelined by governments despite claiming more and more lives each year.
When Australia’s road toll peaked in 1970 it became the trigger point for action.
That year 3798 road users lost their lives and governments were forced to find a ­solution.
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Ombudsman finds DHS 'deficient' in Centrelink data matching

By Allie Coyne on Apr 10, 2017 9:24AM

But underlying technology is working properly.

The Department of Human Services has failed to properly deliver and communicate its automated data matching program to citizens, the Commonwealth's ombudsman has found.
It said these usability and transparency issues have affected the quality of decisions made by the controversial online compliance intervention (OCI) system. 
The ombudsman's office has been investigating DHS' automated data matching process for Centrelink debt since January, after reports began to emerge about incorrect debt notices being sent out by the system.
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'Not reasonable or fair' Ombudsman slams Centrelink's robo-debt scheme

Noel Towell and Amy Remeikis
Published: April 10, 2017 - 4:25PM
Centrelink's demands on former welfare recipients targeted by its "robo-debt" program were neither "reasonable" nor 'fair", the Commonwealth Ombudsman has found.
Now the public watchdog wants the government to conduct a "comprehensive evaluation" of the controversial "online compliance intervention" before it goes any further.
The Coalition welcomed the Ombudsman's report on Monday morning, saying it vindicated the basic approach of the debt recovery program and that many of the watchdog's recommendations were already in place.
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My Health Record in General Practice

Monday, 10 April 2017
Dr Steve Hambleton, MBBS FAMA FRACGP (Hon) GAICD
Follow Dr Steve on Twitter @SteveJHambleton
Amongst my other roles, I've been a GP at the Kedron Park 7-Day Medical Centre in Brisbane for the past 29 years. Many of my patients have been in my care for a long time and I know them very well but I cannot be there for them every day. Like a lot of GPs who have been in the same practice for a long time, I mainly treat people with chronic and complex disease.
I believe one of the responsibilities of General Practitioners is to facilitate patients’ interactions with the health system as a whole, and it’s particularly important for those with chronic ailments. For this reason, I am an early adopter of My Health Record – the secure, online digital summary of a patient’s pertinent medical information, including diagnosis, outcomes, medications, reactions and allergies.
The benefits of the My Health Record cannot be understated. One of my patients with a list of chronic diseases – heart disease, Parkinson’s disease, peripheral vascular disease, kidney disease and chronic myeloid leukaemia – was recently taken to a Queensland public hospital with an acute deterioration in his heart condition. As a result of his various illnesses, the patient had several different specialist doctors attending him, and each of these doctors was able to consult his My Health Record for information on his latest treatments, medications and outcomes. These details informed their own treatment plans. Ultimately, everyone involved, and particularly the patient, benefited from having all of his crucial medical information stored in one accessible digital file avoiding duplicate testing and the inevitable phone calls needed to find bits of information from multiple sources.
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Enjoy!
David.

Sunday, April 16, 2017

Taking The Day Off Given No Pressing E-Health News! Another Sad Story To Tell However.

Great fun watching the grandchildren hunt for those little morsels of oval chocolate - so fondly remembered as Easter Eggs.

Not sure why Easter is so chocolate rich? Commerce I guess.

Happy Easter if you celebrate the festival!

David.

p.s. An item to get off the chest.

While recovering in hospital last week, in a four bed ward, I listened, as I could not avoid it with only curtains in the way, as an oncologist explained to a 90+ year old that he as now beyond help and would die of his cancer fairly soon. They wanted to make sure all the family understood this and asked could they call him after they next visited.

The display was just the grossest lack of caring for the old man's feelings and privacy and my wife almost burst out in tears - she had been opening his packaged lunch and dinners as his hands were fairly arthritic.

He was a sweet old man and the way this news was spread all over the room as truly awful.

Just saying we need to do better with more than the myHR!  How would you suggest we fix this sort of problem?

D.

AusHealthIT Poll Number 366 – Results – 16th April, 2017.

Here are the results of the poll.

How Do You Rate The ADHA's Performance After Nine Months Since Being Established? (10=Fabulous – 1=Hopeless)

10 1% (2)

9-8 0% (0)

7-6 1% (3)

5-4 5% (10)

3-2 63% (130)

1 29% (60)

Total votes: 205

I think it would be fair to say readers are less than impressed so far. A fair bit of work to do I reckon!

A really great turnout of votes!

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

David.