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."

Monday, July 31, 2017

Weekly Australian Health IT Links – 31st July, 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

Quite a lot happening this week with a new draft of the National Digital Health Strategy apparently being reviewed prior to release to Health Ministers in the next month or two.
Also some interesting announcements on other ADHA projects that will play out over the next little while as well as some other initiatives from the DOH.
Lots of further unhappiness also revealed regarding the NBN. This will be a pretty slow burn I reckon!
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Digital records pilot to deliver lifesaving benefits for hospital patients

Patients requiring urgent medical care will benefit from a hospital emergency department pilot that gives clinicians fast, secure access to health information such as allergies and medicines that may not otherwise be available in hospital information systems.
The pilot will help drive the uptake of My Health Record, a digital system that enables healthcare providers to share secure health data and improves the safety and quality of patient care. To date, over 5 million people have a My Health Record and over 10,143 healthcare providers are connected.
“Where My Health Record is being utilised, we are seeing reductions in duplicated testing and lower hospital re-admission rates.
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Software Developers Community Announcement: Common - Clinical Document and Shared Health Summary

Created on Wednesday, 26 July 2017
The Australian Digital Health Agency is pleased to announce the updates to the following end products:
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Doctors claim medical records system puts patient safety at risk

Kara Vickery, Janelle Miles, The Courier-Mail
July 26, 2017 12:00am
PROBLEMS with Queensland Health’s electronic medical record system are angering health workers, with fed-up senior doctors circulating a document slamming the technology and those in charge of it.
The document claims the integrated Electronic Medical Record (iEMR) puts patient safety at risk, is difficult to navigate and “unintuitive”.
The document, obtained by The Courier-Mail, likens the program to two of Queensland’s biggest health disasters, and claims the integrated Electronic Medical Record (iEMR) puts patient safety at risk, is difficult to navigate and “unintuitive”.
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Greater online support for troubled youth

Youth mental health organisation Reach Out has launched a new mobile platform for young people to access help during tough times.
Source: AAP
Ashleigh Holder intended to die but ended up in hospital. Recovery has been a long journey.
Ms Holder, now an ambassador for youth mental health project Reach Out, said she didn't recognise she had a problem with anxiety back in 2011, and didn't even know what anxiety was.
"Anxiety impacted my ability to attend uni, go to my part-time job and spend time with family and friends," she said at the launch of the Reach Out mobile-first platform for youth mental health in Melbourne on Wednesday.
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ReachOut launch new online service to assist young people with mental health

ReachOut Australia, the digital mental health service for young Australians and their parents, today launched a brand new platform providing a one-stop-shop for young people to connect to personalised support when they need it most.
ReachOut Australia CEO Jono Nicholas was joined by Federal Health Minister Greg Hunt and Telstra CEO Andrew Penn to unveil the mobile-first platform, which was co-designed with 174 young people.
Nicholas said the new ReachOut.com platform connects young people to free, anytime help – and focuses on prevention, self-help and early intervention.
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Fax-free health care a step closer

By Australian Hospital + Healthcare Bulletin Staff
Wednesday, 19 July, 2017
Healthcare practitioners are a step closer to direct and secure communications with each other — without cumbersome fax machines. 
New technology will enable health data to flow securely from one healthcare provider to another — irrespective of the software they are using, the organisation they work for or with whom they are communicating.
The technology is being developed by a clinical consortium following a tender process earlier this year. Under the auspices of the Australian Digital Health Agency, work is underway with HealthLink and Telstra — with a range of healthcare providers across a variety of locations engaged in current trials. The objective is to develop solutions that allow secure messaging between healthcare providers with different clinical information systems messaging vendors, in a way that can be scaled nationally.
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Tech suppliers clamber for Medicare payments deal

By Justin Hendry on Jul 26, 2017 9:41AM

But way forward unclear.

The Department of Health is confident it can find suppliers to replace its Medicare payments processing system before 2019.
But the agency has been told by industry that it should proceed with a "modular, flexible and staged" approach for the complex build of the new platform.
The proposed platform will replace 200 separate applications and 90 different databases that currently deliver 600 million payments worth $50 billion every year for Medicare, the pharmaceutical benefits scheme, veterans and aged care recipients.
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Health Privacy and Confidentiality

Health Privacy and Confidentiality, Chapter 23, in Tensions and Traumas in Health Law, I Freckelton and & K Petersen (Eds) (2017) Sydney: Federation Press, Forthcoming
17 Pages Posted: 14 Apr 2017  

Danuta Mendelson

Deakin University, Geelong, Australia - Deakin Law School

Gabrielle Wolf

Deakin Law School
Date Written: February 15, 2017

Abstract

The notion that a patient has the right to maintain the confidentiality of information disclosed in the course of a therapeutic relationship with a health practitioner has been entrenched in Western civilisation for thousands of years. For the first time, however, we have begun to witness an erosion of this entitlement, especially in Australia in recent years. The Australian Federal Parliament has created a system of co-linked national electronic health records that, by virtue of new technology, permits government bodies and myriad other third parties to access and disseminate individuals’ health information both lawfully and without authority, almost invariably in the absence of patients’ knowledge and consent. Commonwealth legislation has also facilitated the substitution of patients’ traditional right to confidentiality of their health information with a much broader and less clearly defined right to “personal privacy”. This chapter examines how these changes have led to a fundamental upheaval of longstanding understandings about the protection of information communicated and learned in the once secluded space of the consulting room.
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National approach to prescription drug misuse

The Australian Government will invest over $16 million to deliver the national roll-out of real time prescription monitoring for medicines to directly address the needless loss of life from misuse of these drugs.
Page last updated: 28 July 2017
28 July 2017
The Turnbull Government will invest over $16 million to deliver the national roll-out of real time prescription monitoring for medicines to directly address the needless loss of life from misuse of these drugs.
The Real Time Prescription Monitoring system will provide an instant alert to pharmacists and doctors if patients received multiple supplies of prescription-only medicines.
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Govt commits $16m to national prescription tracking system

By Justin Hendry on Jul 28, 2017 12:35PM

To prevent doctor shopping.

The federal government will spend more than $16 million on a national real-time prescription monitoring system to target the misuse of certain prescription drugs.
The system will be used to instantly alert pharmacists and doctors if patients receive multiple supplies of prescription-only medicines that contain morphine, oxycodone, dexamphetamine and alprazolam.
The introduction of real-time prescription monitoring has long been called for by the Australian Medical Association and Pharmacy Guild.
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28 July 2017

Hunt pledges real-time prescription monitoring

Posted by Julie Lambert
Federal Health Minister Greg Hunt has promised to roll out national real-time prescription monitoring by next year and support a further expansion of pharmacists’ scope of practice.
Mr Hunt also pledged to dump a sunset clause on store location rules which protect pharmacies from undue competition, saying the sector needed certainty to stay viable.
The minister announced the commitments at the Pharmaceutical Society of Australia’s annual conference in Sydney today.
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Pharmacists to start "real-time" monitoring your use of Panadeine, Nurofen Plus

Bhakthi Puvanenthiran
Published: July 28 2017 - 3:04PM
Your pharmacist will soon be keeping real-time tabs on your consumption of Panadeine and Nurofen Plus, in a push to cut the number of deaths caused by over-the-counter medication.
The Victorian-wide scheme will allow hospitals, GPs and pharmacists to monitor patient's reliance on prescription drugs.
Drug deaths have surged over the past five years, led by addictive medications such as Valium, which has been linked to more fatalities than illegal narcotics.
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Death data prompts real-time recording call

24 July, 2017
The Pharmacy Guild has renewed calls for real time recording of controlled medicines after new data revealed prescription drugs cause most overdoses.
Over two thirds of the 668 Australian overdose deaths in 2013 were caused by pharmaceutical opioids, according to ABS data published by Fairfax Media.
The Guild’s Victorian branch president, Anthony Tassone, says pharmacists and doctors shouldn’t have to tackle prescription drug dependence without the full knowledge real-time recording would provide.
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  • Updated Jul 27 2017 at 11:00 PM

Dr Smartphone and the digital health revolution

by Martin U. Müller
The airplane had just taken off when one of the passengers lost consciousness. Eric Topol pulled his smartphone out of his pocket and immediately performed an electrocardiogram (EKG) on the passenger. He used the device to do an ultrasound scan of the man's heart and measured oxygen levels in his blood.
He was then able to give the all-clear and the plane could continue its journey. The man had lost consciousness merely due to a temporarily slowed heart rhythm.
Topol is a cardiologist in La Jolla, California, and it wasn't the first time he had encountered such a situation while flying. On one occasion, he used his mobile phone to determine that a passenger had suffered a heart attack and the plane had to land immediately.
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  • Jul 28 2017 at 12:00 AM

Why digital health is no match for human touch

by Jill Margo
For all its brilliance and its benefits, there is one thing machine medicine it can't do. It can't heal.It can diagnose and it can recommend treatment, but without a human soul it can't provide that intangible element that makes so many people feel better.
One day smart devices may be able to deliver much of the science of medicine but they will not be able to practice the art of medicine. How could they?
This art is expressed in the way doctors apply the science to patients. It is a nuanced, social and cultural process that deals with grey zones, employing intuition and compassion in the context of the patient's personal situation. In the art of medicine, it's often said that the doctor is the drug.
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  • Updated Jul 28 2017 at 12:00 AM

Digital health's 'feature creep' is being watched by authorities

by Antony Scholefield
In Australia, a patient with cancer can track symptoms on their smartphone, then use the same phone to access medical records held on their GP's software. Later, their oncologist can use a different smartphone to calculate medication dosages.
And all three phone apps in this scenario – CancerAid, MediTracker and DoseMe – would be Australian inventions.
Future patients could use an Australian invention to diagnose respiratory diseases by merely breathing into their smartphone's microphone. ASX-listed company ResApp is researching this, supported by millions of dollars from investors.
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DHA and Pharmacy Guild promote 'digital health'

By Technology Decisions Staff
Wednesday, 26 July, 2017
The Australian Digital Health Agency (DHA) and the Pharmacy Guild of Australia have entered into a partnership aimed at driving adoption and use of the My Health Record system by community pharmacies.
Each year 230,000 people are admitted to hospital, and many more experience reduced quality of life, as a result of unintended side effects of their medicines. This comes at a cost to the system of more than $1.2 billion.
“The Agency and the Guild have a mutual interest in continuing to develop and deliver community pharmacy digital health capability that will lead to significant improvements in the quality and delivery of care provided to consumers,” said the DHA’s chief executive, Tim Kelsey.
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Guild, Digital Health Agency team up

The Pharmacy Guild has joined forces with the Australian Digital Health Agency to help build pharmacies’ digital health capabilities

Both the Agency and the Guild are strong advocates for the widespread adoption and use of the My Health Record system by community pharmacists to better the health of the public.
The Agency and the Guild have now entered into a collaborative partnership aimed at driving adoption and use of the My Health Record system by community pharmacies (supported by education and training) and maximising the medicines safety benefits.
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Medibio boss intends to hit mental illness hard

  • The Australian
  • 12:00AM July 26, 2017

Sarah-Jane Tasker

Jack Cosentino says he is an “impatient CEO” and the hectic pace he has set in his first five months as head of biotech Medibio — overhauling management, refreshing the board and sacking unwanted shareholders — backs that description.
The chief executive of the Australian-listed company says the aggressive pace will continue because he plans to deliver what will be the “largest mental health company on the planet”.
“I’ve done a lot of projects in healthcare but for my board and I this one is very personal — it’s mission driven,” he said.
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ASX Release 24th July 2017

nViso agrees perpetual global license, takes strategic stake in ePAT

Highlights:
·         ePAT has reached a key agreement with nViso for a perpetual, exclusive, global license to use nViso Artificial Intelligence (AI) technology for pain assessment in healthcare
·         ePAT welcomes new strategic investor to the share register, nViso* who are recognised internationally for their expertise in artificial intelligence and micro expression analysis
·         Partnership between the two parties will accelerate the development and commercialisation of AI in innovative mobile applications
·         Payment to nViso will be shares and cash, aligning the parties to commercialisation success
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Big data in healthcare: the US experience and potential for Australia

Created on Monday, 24 July 2017
By Chief Medical Adviser, Meredith Makeham.
In this technologically advanced age, we are able to draw knowledge from many interesting sources which were not previously available to us.
As they are increasingly integrated into healthcare, electronic and digital technologies enable the collection of increasing amounts of data. Data which we are able to translate into knowledge, to help us make more informed decisions, and to improve the quality of services.
Professor Atul Butte, of the Stanford School of Medicine reminded us that within “mounds of data is knowledge that could change the life of a patient, or change the world.”
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Researchers build circuit boards for biological computations

By Juha Saarinen on Jul 25, 2017 6:52AM

Basic and complex logic gates created.

Researchers from Microsoft and the University of Washington have created nanoscale computational circuit boards using DNA molecules, laying the foundation for biological computing.
Their paper outlines how to create logic gates, the building blocks of computational circuits, "by spatially arranging reactive DNA hairpins on a DNA origami" - arranging DNA molecules at regular intervals on a DNA surface.
The transmission of information takes place when the molecules interact with their immediate neighbours in a domino tile effect.
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How Cloud Computing is Driving Ehealth Innovation for Improved Patient Care

Guest: Andrew Tucker
Presenter: Wayne Bucklar
Guest Bio: Andrew Tucker is the CEO of ITonCloud which helps businesses simplify and automate their IT systems by leveraging the cloud. Andrew has more than 20 years of experience as a successful business owner and passionate entrepreneur. His goal has always been to build and drive ventures to deliver unmatched service levels, customer value and trust.
Segment overview: In today’s Health Supplier Segment, we are joined by ITonCloud CEO Andrew Tucker here to talk about their cloud computing features. Andrew discusses how cloud computing is enabling the next wave of ehealth innovation. In addition, Andrew explains how cloud computing is driving ehealth innovation in the areas of mobility, data management, self-service for patients, operations and analytics of information for hospitals and private practices.
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Dud NBN speeds creating millions of angry voters

  • The Australian
  • 12:00AM July 28, 2017

Anthony Klan

There could be almost two million “seriously dissatisfied” voting-age National Broadband Network customers in the lead-up to the next federal election, based on the internet network’s own figures.
NBN Co chief executive Bill Morrow tried this week to downplay mounting complaints, saying only 15 per cent of users were dissatisfied. However, given every household will be forced onto the network, the absolute numbers are huge and could cause major headaches for the federal government.
By June 2019, the NBN expects to have passed 10.6 million premises, with 6.7 million premises connected, of which about 90 per cent, or six million, will be homes, with the remainder businesses.
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Bill Morrow mulls NBN pricing shift but Canberra needs to free his hand

  • The Australian
  • 12:33PM July 25, 2017

John Durie

NBN’s Bill Morrow is right when he places the NBN rollout into the context of it each week taking on 50,000 new customers and connecting 100,000 new homes, this would be a challenge for any company.
As outlined in today’s column, NBN is in the middle of a massive land grab, with all fixed-line customers up for grabs and the big telcos, in competition with 23 separate companies, are trying to resell the service directly and another 100 firms indirectly.
The aim of the game is to sign up customers by whatever means and explain to them later what they have done.
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ACMA expects formal 5G standards by late-2018

The Australian Communications and Media Authority expects formal standards for the first phase of 5G to be in place by mid- to late-2018, and deployments to start a year or two after that.
ACMA acting chairman Richard Bean told a telecommunications conference in Sydney last week that while everyone expected 5G to supplement, and probably replace existing standards like 4G over time, it was generally accepted that standardisation and harmonisation was still at the formative stage.
"(Everyone knows) that 5G is expected to deliver what is essentially a super-fast version of today’s mobile broadband networks, massive scale machine-to-machine communications necessary to support the Internet of Things, and ultra-reliable and low latency communications to support things like remote control of industrial or medical processes," Bean said.
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  • Updated Jul 24 2017 at 11:00 PM

NBN Co CEO Bill Morrow says he has a plan to solve customer complaints

It is safe to say that no chief executive in Australia faces the customer relationship management issues on a scale as big as NBN Co's Bill Morrow.
Also, it's safe to say there is no other CEO in Australia who must answer for all of the problems created by others, whether they are broadband retail service providers or politicians.
Morrow's primary problem is that as he seeks to meet the Turnbull government's ambitious targets for the rollout of NBN Co's wholesale broadband network, complaints are escalating dramatically.
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Telcos refuse to guarantee NBN speed

  • The Australian
  • 12:00AM July 24, 2017

Anthony Klan

None of the nation’s major telcos will guarantee that customers will experience super-fast internet under the National Broadband Network, or even that they will deliver the same speed packages being sold to them by the agency in charge of the $49 billion project­.
NBN Co, a wholesaler, sells a range of monthly connection packages to the telcos of 12 megabits per second, 25Mbps, and super-fast connections of 50Mbps and 100Mbps.
The telcos are also required to buy from NBN Co costly “bandwidth” to ensure those speeds can be achieved at peak times, such as after 5pm weekdays, when many people are using the internet at the same time.
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Full-fibre NBN will cost about as much as FttDP: experts

Switching the national broadband network to using fibre-to-the-distribution-point technology is an interim solution; the correct solution, which will cost about the same, is to go full fibre.
This is the considered opinion of Mike Quigley, former chief executive of the NBN Co, who was asked by iTWire to offer a view on using FttDP in preference to the fibre-to-the-node technology that the majority of Australians will get under the NBN Co's current network rollout plan. Rod Tucker, Laureate Emeritus Professor at the University of Melbourne and a member of Labor's Expert Panel that advised on the NBN, was in agreement on this point.
A switch to FttDP has been repeatedly advocated by the head of the non-profit, Internet Australia, Laurie Patton.
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Going full fibre will mean loss of face for Fifield: academic

Using fibre-to-the-distribution-point technology for the NBN instead of fibre-to-the-node will enable the Turnbull Government to save face and also provide a better network, a senior academic who was involved with the project at its inception says.
Rod Tucker, Laureate Emeritus Professor at the University of Melbourne and a member of Labor's Expert Panel that advised on the NBN, told iTWire in response to queries that if NBN Co made a switch from FttN to FttP, then it would reflect badly on Communications Minister Mitch Fifield.
"After all the recent criticism levelled at FttP by Fifield, how could NBN Co be expected to admit that he is wrong and that FttP is now affordable?" he asked.
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Only bipartisan NBN policy switch can save us: IA's Patton

Internet Australia executive director Laurie Patton has repeated his call for the government and Opposition to come together and commit to using fibre-to-the-distribution-point for as much of the possible of the remainder of the NBN rollout.
In a statement issued on Sunday, Patton said the non-profit believed that NBN Co, the company rolling out the broadband network, must abandon its "flawed policy" of using the copper-based fibre-to-the-node and move to FttDP (what NBN Co calls FttC or fibre-to-the-curb). Patton said the move "is essential for Australia's economic and social development".
Patton has been a constant critic of the multi-technology mix option - which includes a small number of FttP connections, FttN, FttDP, HFC, wireless and satellite - adopted by the Coalition Government for the rollout, after it came to power in 2013. The Labor Party, which began the rollout in 2009, had a policy of fibre-to-the-premises for 93% of residences, with the remainder to be served by wireless and satellite.
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Enjoy!
David.

Sunday, July 30, 2017

I Wonder Will This Get To Operational This Time? There Seem To Have Been A Few False Starts.

This press release appeared a few days ago.

National approach to prescription drug misuse

The Australian Government will invest over $16 million to deliver the national roll-out of real time prescription monitoring for medicines to directly address the needless loss of life from misuse of these drugs.
Page last updated: 28 July 2017
28 July 2017
The Turnbull Government will invest over $16 million to deliver the national roll-out of real time prescription monitoring for medicines to directly address the needless loss of life from misuse of these drugs.
The Real Time Prescription Monitoring system will provide an instant alert to pharmacists and doctors if patients received multiple supplies of prescription-only medicines.
This system will save lives and protect the community. This is something of absolute national importance.
Real time monitoring has been called for by the Australian Medical Association, Pharmacy Guild and by many families across the country who have been devastated by the loss of a loved one to misuse of prescription medicine.
We have listened to these calls and today we are taking action.
With this injection of funding – and close collaboration with states and territories – we have the means to provide a nationally consistent, mandated system for real time monitoring of controlled drugs.
I look forward to continuing our work with all states and territories to make this national approach a reality.
This issue of misuse of prescription medicine is a growing trend in our community, and although it is not the only response required, it is a very important step.
Real time reporting will assist doctors and pharmacists to identify patients who are at risk of harm due to dependency, misuse or abuse of controlled medicines, and patients who are diverting these medicines.
This can happen if a patient has developed a dependency on controlled medicines, or is selling these medicines to others, including for the purposes of manufacturing other illegal drugs.
Controlled medicines include morphine, oxycodone, dexamphetamine and alprazolam.
The Australian Government first funded the development of the Electronic Reporting and Recording of Controlled Drugs system to assist state and territory governments to improve their monitoring and regulation of controlled medicines in 2013.
This project was initiated with $5 million allocated under the Fifth Community Pharmacy Agreement (2010-15).
It is an important public health and medicine safety measure, providing regulators, doctors and pharmacists with information regarding supply of controlled medicines and other medicines with potential for misuse.
(ENDS)
Here is the link:
This article provides a clearer outline of the history!

Govt commits $16m to national prescription tracking system

By Justin Hendry on Jul 28, 2017 12:35PM

To prevent doctor shopping.

The federal government will spend more than $16 million on a national real-time prescription monitoring system to target the misuse of certain prescription drugs.
The system will be used to instantly alert pharmacists and doctors if patients receive multiple supplies of prescription-only medicines that contain morphine, oxycodone, dexamphetamine and alprazolam.
The introduction of real-time prescription monitoring has long been called for by the Australian Medical Association and Pharmacy Guild.
While a large-scale pilot of real-time monitoring of over-the-counter sales of medicines containing codeine has already been conducted, implementation of the national electronic reporting and recording of controlled drugs (ERRCD) system - first funded by government in 2010 - to monitor all prescribing and dispensing has been patchy.
Tasmania remains the only state to have successfully introduced the medication tracking system.
New South Wales is in the process of implementation, as is Victoria, which allocated $29.5 million in the 2016-17 state budget for the effort and will roll out the centralised tracking system next year.
More here:
There is also more coverage here:
28 July 2017

Hunt pledges real-time prescription monitoring

Posted  by Julie Lambert
Federal Health Minister Greg Hunt has promised to roll out national real-time prescription monitoring by next year and support a further expansion of pharmacists’ scope of practice.
Mr Hunt also pledged to dump a sunset clause on store location rules which protect pharmacies from undue competition, saying the sector needed certainty to stay viable.
The minister announced the commitments at the Pharmaceutical Society of Australia’s annual conference in Sydney today.
He said it was utterly unacceptable that 600 Australians a year died from the misuse of prescription drugs such as morphine.
“We will now move immediately to real-time monitoring.”
A system to track dispensing records across state borders would mean a pharmacist asked to fill an Endone script in Albury, for example,  could find out immediately if the patient had had the drug dispensed over the border in Wondonga an hour or a day before, he said.
“The fact that we don’t have that in Australia is a legacy and an error which we will address.”
He said the commonwealth would contribute $16 million to the scheme.
RACGP President Dr Bastian Seidel welcomed the commitment to real-time prescription monitoring, noting accidental overdoses of pharmaceutical prescription opioids now killed more Australians than heroin overdoses.
Lots more here:
The bottom line here is that we have had a pretty fragmented approach to all this since 2010 and it is long past due for the various jurisdictions and interests to just stop it and get this going.
The will tell if it is 3rd (or is it 4th) time lucky!
In passing I can’t help wondering just where the ADHA is in all this and where it will fit as a project to be sponsored by the national strategy?
David.