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, August 07, 2017

Weekly Australian Health IT Links – 7th August, 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

A huge week with the ADHA releasing is new Strategy for Digital Health while we had their secutity team being less than certain about the security of the myHR.
Enough for one week!
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Health Ministers approve Australia’s National Digital Health Strategy

4th August, 2017
Digital information is the bedrock of high quality healthcare. The benefits for patients are significant and compelling: hospital admissions avoided, fewer adverse drug events, reduced duplication of tests, better coordination of care for people with chronic and complex conditions, and better informed treatment decisions. Digital health can help save and improve lives.
To support the uptake of digital health services, the Council of Australian Governments (COAG) Health Council today approved Australia’s National Digital Health Strategy (2018-2022).
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Australia's new digital health strategy has been approved

By Allie Coyne on Aug 4, 2017 4:13PM

Shift to opt-out e-health records officially endorsed.

The strategy governing Australia's move to default e-health records for all citizens as part of a push towards a digital health services ecosystem has received the official stamp of approval by the country's governments.
The Council of Australian Governments (COAG)'s health council today approved the national digital health strategy 2018-2022 following a meeting in Brisbane.
The country's health ministers said the strategy "put the consumer at the centre of their health care and provides choice, control, and transparency".
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Australia leaps towards a digital healthcare system as COAG approves a national strategy

Lynne Minion | 04 Aug 2017
Australia has made a major stride towards a digital healthcare system today with state and territory health ministers approving the much-anticipated national digital health strategy.
Digital information is the bedrock of high quality healthcare, and the 2018-2022 strategy is designed to lower hospital admissions, adverse drug events and the duplication of tests, while promoting better coordinated care for people with chronic and complex conditions.
In a communique issued after the COAG health council meeting in Brisbane, the ministers said digital health would provide patients with choice and control.
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How ADHA is trying to secure GP clinics

By Allie Coyne on Aug 3, 2017 6:30AM

As opt-out change looms.

It’s no secret that your local doctor’s office is unlikely to have the best protections when it comes to securing your personal health records.
In this small business environment, technology often gets pushed to the bottom of the priority list when contending with life or death matters.
It means medical practices often fall victim to ransomware attacks that exploit vulnerabilities in old software - like the recent WannaCry epidemic - and hold patient and practice data to ransom.
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eHealth records coming to emergency departments in NSW, Queensland

Pilot involving use of My Health Record in hospitals
Rohan Pearce (Computerworld) 31 July, 2017 11:35
The Australian Digital Health Agency (ADHA) is preparing to launch a pilot involving the use of the federal eHealth record system — My Health Record — in hospital emergency departments.
“The Australian Commission on Safety and Quality in Health Care will work with hospitals within Nepean Blue Mountains and North Queensland Primary Health Networks to develop a pilot model over the course of the project,” an ADHA spokesperson told Computerworld.
This model will then be piloted in other hospitals in Australia, the spokesperson added.
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My Health Record pilot for emergency rooms

By Dylan Bushell-Embling
Wednesday, 02 August, 2017
The Australian Digital Health Agency (ADHA) has launched a hospital emergency department trial to provide clinicians with access to important health information using the My Health Record digital system.
The pilot will be conducted by the agency in partnership with the Australian Commission on Safety and Quality in Health Care (ACSQHC), and will initially involve hospitals within the Nepean Blue Mountains and North Queensland Primary Health Networks (PHNs).
A pilot model developed over the course of the project will then be trialled in other hospitals in Australia.
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Measuring Australia's digital divide: the Australian digital inclusion index 2017

01 Aug 2017
CREATORS
The 2017 ADII provides the most comprehensive picture of Australia’s online participation to date.
DOI 10.4225/50/596473db69505

Description

The ADII has been created to measure the level of digital inclusion across the Australian population and to monitor this level over time. Using data collected by Roy Morgan Research, the ADII has been developed through a collaborative partnership between RMIT University, Swinburne University of Technology, and Telstra.
The ADII was first published in 2016, providing the most comprehensive picture of Australia’s online participation to date. The ADII measures three vital dimensions of digital inclusion: Access, Affordability, and Digital Ability. It shows how these dimensions change over time, according to people’s social and economic circumstances, as well as across geographic locations. Scores are allocated to particular geographic regions and sociodemographic groups, over a four-year period (2014, 2015, 2016, and 2017). Higher scores mean greater digital inclusion.
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Patients want their test results via text

Jocelyn Wright | 4 August, 2017 |  
Most patients would prefer to receive their test results by text message or mobile phone call rather than in person, a survey suggests.
Asked how they would like to receive results of skin biopsies, blood tests or skin swabs, almost 80% of patients preferred a quicker method than speaking directly to the doctor.
The survey of 78 Queensland patients attending an outpatient dermatology clinic showed that, for normal results, the most popular methods of communication were text message (59%) or email (17%).
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InterSystems launches recruitment drive for its pioneering NT digital health system roll out

Lynne Minion | 04 Aug 2017
Recruitment is underway for the Northern Territory’s ambitious overhaul of its health information technologies, with InterSystems seeking IT experts and clinicians to work on the implementation of a health system-wide digital medical record.
The five-year Core Clinical Systems Renewal Program, which will see four beyond-end-of-life clinical systems replaced, will make the NT the first Australian state or territory with a single system for all of its public healthcare sites.
InterSystems TrakCare will be implemented at every point of care across all of the Territory’s public health facilities, including five existing public hospitals, the new Palmerston Regional Hospital, 54 remote health centres and all community-based health services, including those in the most remote locations.
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Fax-free healthcare hindered in aged care

By Megan Stoyles on August 2, 2017 in Industry, Technology
Fax machines – introduced in Australia in the 1980s – are still used widely in aged care, challenging a new push from government to replace them with electronic messaging in the broader health sector.
On 26 July the Australian Digital Health Agency announced “fax-free healthcare is one step closer” with a tender to secure confidential electronic messaging technology between healthcare providers “irrespective of the software they are using, the organisation they work for, or with whom they are communicating.”
The digital health agency was established in July 2016 by the Federal Government to improve health outcomes for all Australians through the delivery of digital healthcare systems and the national digital health strategy for Australia.
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31 July 2017

Are we on the AIR yet?

Posted by Felicity Nelson
Mention the words “Australian Immunisation Register” in a room full of vaccination experts and see how quickly the mood slides into one of disquiet and defensiveness.
Frustration with the register was plainly evident at last month’s Adult Immunisation Forum held in Melbourne.
Advocates for adult vaccination have been hankering for a lifetime immunisation record for more than a decade. In September last year, the federal government finally granted their wish by transforming the longstanding Australian Childhood Immunisation Register (ACIR) into the Australian Immunisation Register (AIR).
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Royal Flying Doctor Service soars into the cloud

  • The Australian
  • 12:00AM August 1, 2017

David Swan

The Royal Flying Doctor Service’s Queensland section has transitioned to a cloud-first IT strategy, a move it took after a number of network outages and staff complaints.
The not-for-profit organisation, which has 400 employees across Queensland, said deploying Riverbed’s SteelHead and SteelCentral solutions had reduced the data on its network by 70 per cent and increased visibility into its network performance.
The RFDS said the revamp was driven by a goal to more effectively manage its limited IT resources, and had improved staff productivity and satisfaction.
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What happens to data when a patient dies?

2 August 2017
TECH TALK
Although immortality still eludes modern medicine (many would say, thankfully), ‘e-mortality’ is already here, and is here to stay.
The global shift to using e-health records means a person’s digital healthcare data can potentially stick around forever. And there’s growing interest from governments and doctors about how that data could be put to good use.
The Australian Government is looking at a ‘secondary use framework’ for the My Health Record that will include ideas for what — other than direct care — the data can be used for.
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Breathalyser app diagnoses disease

By Australian Hospital + Healthcare Bulletin Staff
Tuesday, 01 August, 2017
Imagine if diagnosing a disease was as easy as breathing into a phone app. No needles and blood samples, no delayed diagnosis. This may soon be possible thanks to new technology developed in South Korea. 
Leveraging a phone app, the researchers use gas concentrations in human breath to diagnose certain diseases.
Working under Professor Il-Doo Kim, the Korea Advanced Institute of Science and Technology (KAIST) research team has developed diagnostic sensors using protein-encapsulated nanocatalysts, which can diagnose certain diseases by analysing biomarker gases in a person’s exhaled breath.
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Govt commits to national real-time script monitoring

31 July 2017

NEWS 

A national real-time prescription monitoring system will be up and running within 18 months, the Federal Government says, as it pledges to finally act on a lingering public health disaster.
For more than a decade, the system has been seen as key to tackling prescription drug misuse and fatal overdoses.
Minister for Health Greg Hunt fronted the cameras on Friday, declaring that the system, which will monitor S8 drugs and be integrated into GP prescribing software, will finally be rolled out to the tune of $16 million in funding.
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Doctor sees flaws in prescription addict blacklist idea

Marissa Georgopoulos and Sharri Markson, Mt Druitt-St Marys Standard
August 1, 2017 4:28pm
A PRESCRIPTION addict blacklist warning of drug addicts abusing the system may not be enough to combat the issue, a western Sydney doctor says.
The real-time monitoring system for substances such as oxycodone, morphine and dexamphetamine is a Federal Government bid to crack down on “doctor shopping” by pill poppers.
Federal Health Minister Greg Hunt said Australia had seen “needless loss of life” from misuse of addictive prescription drugs — which he described as a “growing trend”.
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Legal, ethical and rights issues in adoption of My Health Record

Article Title: Legal, ethical, and rights issues in the adoption and use of the “My Health Record” by people with communication disability in Australia

Aims and method: The aim of this review was to explore the legal, ethical, and rights issues surrounding the use of the Australian My Health Record by people with communication disability. The method involved a narrative review of the legislation and literature.
Results: The My Health Record offers substantial benefits to people with a communication disability around the exchange of health information. However, the way that both health and disability service providers implement My Health Record will impact substantially on how people with communication disability use the system. Lack of knowledge or awareness are key barriers that could impact how service providers engage with people with communication disability who wish to use the Record.
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Clinical App: Integrated tools for complex diseases

31 July, 2017 Staff Writers  
There are a lot of apps that patients with complex diseases might find useful.
The problem arises when they have to navigate between them all, juggling subscriptions and re-typing information.
Thrivor is an app, initially targeted at oncology patients, that combines a few of these useful tools — appointment manager, consultation recorder, private messaging for carers, and even integration with the transport app Uber.
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31 July 2017

Will virtual reality kill off the cadaver?

Imagine it’s 10 years in the future. You’re a medical student studying anatomy, but there are no weighty tomes, dense with text and two-dimensional cross-sections of body parts. Instead, an anatomy class has more in common with a trip to an art gallery, with you wandering around and inspecting bodies as a guide narrates the journey via a headset.
But it’s even better than an art gallery. As you walk around a body you can choose whether you want to hide the skin, zoom into the skull, or pull out the thorax for a closer inspection. It may sound a little morbid, but rather than a cadaver, this is a collection of pixels beamed to your virtual reality headset.
Australia is leading the way in this cutting edge virtual reality which could drastically change how many doctors are trained, with some proponents claiming the technology could eventually replace the need for cadavers.
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Artificial intelligence: augmenting or replacing doctors?

Authored by Jane McCredie
“ARTIFICIAL intelligence [AI] could put doctors and lawyers OUT of a job in FIVE YEARS’ time,” trumpeted a headline in Britain’s Express earlier this year.
Could it be true?
There’s no doubt technology is radically changing the nature of work across most areas of human endeavour.
One of the many challenges confronting us as a society is the question of how to distribute meaningful employment, and the wealth associated with it, in a world where we just won’t need as much human labour as we used to.
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Artificial intelligence gives robots and autonomous machines a future

  • The Australian
  • 12:00AM August 3, 2017

Chris Griffith

It’s 2050 and you’re not allowed to drive. In fact, you’ve forgotten how. And you can’t get a licence anyway. Fitness devices and computers monitor your health daily. Even the toilet analyses what you offer up to check for disease. And you, like many, have had your genes sequenced. You know the diseases you’ll likely face in life.
Marilyn Monroe is back starring in movies via an avatar program that talks and acts like her, with machines having learned her speech and mannerisms from her films.
Indeed, there will be a bot version of us that lingers on after we die, that reads our will to relatives and friends, and consoles them. Maybe you can toast yourself at your wake. A bad bot version may be out-and-about settling old scores.
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Pioneer Glucose non-invasive measurement device: A$1499

To avoid the little prick of a blood glucose monitoring lancet and testing strip device, you can now pay A$1499 for a non-invasive measurement device from the company that brought you the robotic lawnmower.
First it was the A$1799 robot lawnmower from Pioneer Robotics, and now it’s a non-invasive glucose measurement device from Pioneer Dreamcare.
Dubbed the “Pioneer DreamCare Dr Glucose Non Invasive Measurement Device”, we’re told it is a “non-invasive glucose measurement system based on the method of metabolic heat conformation (MHC)".
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MyHealth1st becomes the #1 independent optometrist online marketplace

Major agreement adds a further 350 optometry practices to MyHealth1st
HIGHLIGHTS:
  • 1ST Group signs subscription deal with Eye2Eye Media Group to add a further 350 optical stores to the MyHealth1st platform
  • 1ST Group optometry market share increases from 3% to 60% of all independent optometrists in just 12 months
  • Initial agreement includes the MyHealth1st online appointment booking product suite, opening opportunities to introduce 1ST Group’s digital products such as EasyFeedback and EasyRecalls
  • MyHealth1st independent optometrists are estimated to serve over 5 million Australians
  • Rapid expansion in optometry supports 1ST Group’s vision of providing a digital healthcare services platform that enhances the patient’s experience with, and access to, their healthcare network
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HealthOne an e-health record for all?

Liane Topham-Kindley liane@nzdoctor.co.nz Tuesday 01 August 2017, 1:40PM
The electronic shared health records system HealthOne is operating throughout the South Island as of today, with Nelson Marlborough DHB officially joining the system.
Now all DHBs in the South Island have access to HealthOne allowing general practice teams, hospital clinicians, pharmacists and a growing number of community providers access to shared information including test results, allergies, medications, previous hospital admissions and appointments and medical imaging.
It’s a significant achievement given the Government has been grappling for years to try to establish a national electronic health record.
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31 July 2017

Medical Republic launches Connectivity and Interoperability Summit

Posted byTMR Staff
The Medical Republic and Wild Health Summits will bring together the country’s thought leaders for a day of interrogation around our rapidly evolving health interoperability ecosystem.
Tim Kelsey, CEO of the Australian Digital Health Agency; Tom Bowden, Chairman of secure messaging market leader HealthLink; Dr Karen Price, founder and moderator of Australia’s largest GP social network, GPs Down Under; Zoran Bolevich,  CEO of eHealth NSW; Dr Louise Schaper, CEO of the Health Informatics Society of Australia; Professor Enrico Coiera, head of the Centre for Australian Health Innovation; and Dr Ged Foley, CEO of IPN Medical Centres; are just a selection of the speakers who will come together on 16 October at Sydney’s Belvoir St Theatre, to thrash out some of the key issues facing the country’s healthcare system – particularly with respect to “connectivity” and “interoperability”.
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Govt steps in to stop NBN blame game

By Ry Crozier on Aug 1, 2017 12:16PM

Demands data from across industry.

The Australian Communications and Media Authority will compel 21 businesses in the NBN ecosystem to reveal data about how they resolve issues in a bid to halt the current blame game between NBN Co and internet providers.
Communications Minister Mitch Fifield said the action was a direct result of government intervention to stem what has been a damaging fortnight for the NBN project.
NBN Co has been under siege over the poor performance of end user services. The company responded yesterday by attacking ISPs for not buying enough network capacity.
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  • Updated Jul 31 2017 at 9:14 AM

What a bunch of ding dongs! Here's why the NBN is far worse than you think.

Malcolm Turnbull's NBN hasn't even been connected to my house yet, and already it has slowed my internet connection and rendered my smart home almost useless.
I am not making this up.
The National Broadband Network, which in my neck of the woods is based around decades-old Hybrid Fibre Coax (HFC) copper technology, was connected to my suburb a month ago, the exact same time that my non-NBN internet connection took a turn for the worse, its upload speed dropping by two-thirds to around 700kbps on a typical day, and less than 100kbps on a bad day.
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NBN Co boss declares war with internet providers

By Ry Crozier on Jul 31, 2017 12:36PM

Blames ISPs for performance problems.

NBN Co has blamed a “price war” between internet service providers as the root cause of consumer discontent over its services.
CEO Bill Morrow today responded to a fortnight of sustained pressure on the network builder to reduce or revamp its wholesale charges to encourage ISPs to buy enough bandwidth to support their users.
However, the company appears to have ruled out any substantial further review of its price scheme and instead launched a full-scale attack on internet providers, laying the blame for poor-performing services squarely with them.
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Enjoy!
David.

An Uncomfortable Truth: Digital Health In Australia Is Trapped By Politics And Its History.

I think it is time to point out how trapped the ADHA and Tim Kelsey are:

The situation is this:

1. The myHR is not anywhere near a good solution to support Digital Health as it is insecure, clunky, evidence free and not liked by clinicians. If it was useful for them they would have adopted it - as would have the public but they have shown their indifference by needing to be dragooned into having a health record compulsorily.

2. Politically over a billion dollars has been spent and neither side is prepared to recognise the truth and can (abandon) it - even if they could understand what the issues are. We are thus stuck with it.

3. The Digital Health industry is struggling with all the money and focus being on the myHR, which they realise is badly flawed.

All this means we have a second class and largely doomed Digital Health program which money will continue being spent on to very little effect. Worse still, the ADHA is forced to continue to say all is well and we are going forward at a great rate when they know - I suspect - that they are basically stuck with an inferior route forward. What a bind!

It is awful but these are 'the facts on the ground' and it is hard to know how we can break out of this impasse and move forward. An audit that shows how useless it is maybe?

Heavens it is depressing to be stuck in this awful nowhere land!

David.

Sunday, August 06, 2017

I Think I Have Worked Out What Is Wrong With The National Digital Health Strategy – It Is Far Too Incomplete To Really Assess!

Late on Friday we were all given access to the new Digital Health Strategy For Australia.
For those who have snoozed over the weekend here is the link where you can obtain the document. I have published this blog early to foster as much discussion as possible!
The document is a nicely produced 63 page document which, sadly, is only about half the job. These two paragraphs show what I mean:
From page 15.
“The Agency will operate as a leader and facilitator, supporting and empowering health consumers, healthcare providers and industry. Given the Agency’s ongoing commitment to co-production, the next step in implementation is to co-design a Framework for  Action with the broader health and care sector to agree an implementation plan. This co- design is imperative to ensure that the national priorities of this Strategy complement existing investment in digital health initiatives by industry and state and territory health departments and the broader health sector.”
So we have to wait to see any concrete plans with their associated costs, benefits, timetables and so on. It is this implementation plan that will be the making (or not) of the total package of which I would argue we have now a good deal less than half I would suggest. The timeframe for all this to be done is vague but 2018 – 2022 seems to be intended.
Another key section is this (page 6):
“By the end of 2018, a public consultation on draft interoperability standards will confirm an agreed vision and roadmap for implementation of interoperability between all public and private health and care services in Australia. Base-level requirements for using digital technology when providing care in Australia will be agreed, with improvements in data quality and interoperability delivered through adoption of clinical terminologies, unique identifiers and data standards. By 2022, the first regions in Australia will showcase comprehensive interoperability across health service provision.”
To me this para puts real interoperability off a fair way into the distance.
Bluntly we are to wait a fair while to see some really concrete plans and costs – and what we have to date is a marketing document (largely for the myHR) for politicians to keep their interest up.
We all remember how the 2008 National E-Health Strategy was agreed and approved by COAG but never funded so it never went anywhere. That plan actually had some real projects and objectives. I wonder will this vaguer one be easier to swallow. We have been running around this track for a fair while already without getting anywhere much nationally while GP, and the States are making real progress. (Another big gap in the plan we have to date is a proper analysis of where we are with Digital Health – save for a pile of anecdotes. Among other things missing are a decent technology scan and I have to say a real downplaying of the importance of GP Digital Health for some reason). Along these lines I believe we will all be disappointed to see that there is still no evidence provided on the value and impact provided by the myHR - just how long can this level of expenditure go on in the evidence free way we see at present?
For my last comment I offer the principles section:

Principles

The following guiding principles have underpinned the development of Australia’s National Digital Health Strategy:
          Putting  users  at  the  centre The Strategy has been developed to deliver on the needs of patients and health professionals as articulated in the national consultation process (and through ongoing user research). User needs and their context of use are placed at the centre of decision making, supporting improved prioritisation and user experience.
          Ensuring privacy and security Australians expect strong safeguards to ensure their health information is safe and secure, respected, and their rights protected. They expect that their health data is only used when necessary and with their consent. The strategic priorities consider security, privacy and protection of sensitive personal information, balanced with safe information sharing and maintaining consumer and clinician trust.
        Fostering  agile  collaboration The strategic priorities recognise that appropriate co-design and co-production methodologies are important for ensuring that digital health solutions developed for use in Australia meet the evolving needs of users and stakeholders.
      Driving a culture of safety and quality The safety and quality of digital health solutions and services are of critical importance. The Strategy seeks to embed a systems approach to safety, quality and risk management throughout the design, development, implementation and use of digital health solutions and services.
          Improving equity of access Digital health solutions and services have the potential to empower and to address longstanding barriers to equity of access in healthcare. The Strategy is developed based on the principle that all Australians deserve to benefit from the opportunities presented by digital health, and strategic priorities are aimed at improving health system accessibility across the socio-economic spectrum.
          Leveraging    existing  assets  and  capabilities Australia is making significant advances in the delivery of digitally enabled health and care across Australia, through the development and operation of national digital health foundations. This Strategy was developed with respect to existing assets and capabilities and aims to avoid duplication.
          Judicious   use   of   tax payer  money Development of strategic activities is based on sound investment of funds to eliminate waste, deliver value for taxpayers, and ensure that investments are assessed on the basis of delivering the best health and care outcomes for all Australians.
I will leave it to the reader to decide how many of these principles are actually being followed through.The lop sided valuing of patients over their GPs etc. and the known issues around security are hard to ignore.
I await the second half of the Strategy with more than passing interest. Informally I have been told that the work to fill in at least some of the gaps I (and others) have identified will be underway pretty soon. Will be good to see that happen!
David.

AusHealthIT Poll Number 392 – Results – 6th August, 2017.

Here are the results of the poll.

Do You Believe Providing Emergency Departments Access To The myHR Will Make A Significant Difference To The Quality Of Emergency Care?

Yes 4% (7)

Maybe 17% (28)

Probably Not 58% (94)

No 20% (32)

I Have No Idea 1% (1)

Total votes: 162

The numbers speak for themselves. There is a fair bit of scepticism about this plan.

A really great turnout of votes!

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

David.