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, April 06, 2020

Weekly Australian Health IT Links – 06 April, 2020.

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

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Again the dominant theme is COVID-19 and the various adaptions we are seeing to the pandemic with electronic prescriptions and telehealth. One gets the feeling there are going to be all sorts of issues emerge as these technologies are rolled out.
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Pharmacies given green light on emailed photos of scripts

Doctors can send images directly to patients or their pharmacy of choice
2nd April 2020
Pharmacies can now accept emailed photos of prescriptions following the introduction of Medicare-subsidised telephone and video consultations.
Doctors can send images directly to the patient or to their preferred pharmacy, excluding S8 scripts There is also an option to mail the prescription or send a fax.
The Pharmacy Guild has welcomed the change.
Professor Michael Kidd, principal medical adviser for the Department of Health, said the introduction of funded telehealth was “probably the most major change that we've seen to how our Medical Benefits Schedule works since it was established so many years ago”.
The General Counsel for the Department of Health confirmed that GPs and pharmacies could communicate via email.
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RACGP welcomes move to allow GPs to send electronic prescriptions

RACGP 3 April, 2020
The Royal Australian College of General Practitioners (RACGP) welcomes today’s announcement that the government has acted on our calls to relax the laws to allow GPs to send electronic prescriptions to patients.
The Australian Government Department of Health today announced new interim arrangements for prescriptions to support telehealth services.
Under the arrangements, patients can get a prescription from their GP sent to their phone or email, which they can send to a pharmacy. Patients can also choose to have their GP send their prescription direct to their pharmacy of choice and their medication can be delivered to their door.
RACGP President Dr Harry Nespolon welcomed the move as a breakthrough for GPs to continue providing quality care to patients during the COVID-19 pandemic.
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4 April 2020

Telehealth on path to rip govt’s COVID plans (and general practice) asunder

Posted by Jeremy Knibbs
How did general practice get here?
Where both the federal government and the general public aren’t aware that the profession that is their front line defence against the most serious crisis since both world wars, is rapidly drowning in front of their eyes. (See our survey story on how 50% of GP practices are reporting losing more than 30% of income).
What have we done?
How did we come to guarantee the future of the banks, private hospitals, the childcare centre industry, a good chunk of small business and a swathe of other groups , and not the people who are at the frontline of the health crisis fight of our lives and who are risking their lives each day just by turning up to work?
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Australia launches COVID-19 app, WhatsApp chat

By Justin Hendry on Mar 30, 2020 10:51AM

But no contact tracing functionality, yet.

The federal government has launched an app and WhatsApp group to provide Australians with information and advice about the fast changing coronavirus pandemic.
Prime Minister Scott Morrison revealed the digital offerings on Sunday, two weeks after the government first committed $2.4 million towards building an app.
Morrison said the app, which is available on both iOS and Android devices, was “a trusted place of advice and information” for citizens about COVID-19.
It builds on the new Australia.gov.au homepage released by the Digital Transformation Agency last week to help centralise information on the current coronavirus pandemic.
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DTA takes interest in Australian-developed COVID-19 contact tracing app

By Ry Crozier on Mar 31, 2020 7:34AM

Could launch as early as this week.

The federal government appears set to launch contact tracing functionality in an app as early as this week after picking-up on the work of a privately-developed effort over the weekend.
ImpactApp had been set to launch on Monday this week following a collaborative effort between 30 Australians - including three small businesses - over the past 10 days, according to a social post.
Contact tracing is an emerging surveillance capability being used by governments and health authorities worldwide to track the movements of confirmed COVID-19 cases in a bid to contain the spread of the virus.
The federal government launched a COVID-19 app over the weekend, without contact tracing functionality, but Prime Minister Scott Morrison has previously said that capability was being worked on.
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Tuesday, 31 March 2020 12:04

New email phishing scam exploits Coronavirus fears

A new type of email phishing scam has been discovered which warns people that they’ve come into contact with a friend/colleague/family member who has been infected with the coronavirus, according to one global security firm.
According to security awareness training and simulated phishing platform provider KnowBe4, the email instructs people to download a malicious attachment and proceed immediately to the hospital, with the particular “social engineering scheme” appearing to come from a legitimate hospital, “which is why it’s so alarming and could trick even a cautious end user”.
The victim of the phishing scam is instructed to fill out a pre-filled Excel form, which KnowBe4 says is actually a macro-laden Office document that serves as a trojan downloader and is currently only detected by a handful of anti-virus applications.
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Stop mandatory drug reporting scheme in face of coronavirus: doctors

By Farrah Tomazin
March 31, 2020 — 7.30pm
Doctors and pharmacists have asked the Andrews government to delay a mandatory drug reporting scheme that could help Australia avoid a US-style opioid crisis because they fear it could detract from the fight against coronavirus.
From Wednesday, GPs and pharmacists in Victoria will be required to record a patient's information and immediately check records for any signs of dependency every time they prescribe opioids, benzodiazepines and other powerful prescription pills.
The real-time prescription monitoring system, known as SafeScript, is designed to help reduce the death rate from accidental overdoses by curbing what is known as “doctor shopping”.
But with SafeScript to become mandatory in Victoria from Wednesday, doctors and pharmacists have called on Health Minister Jenny Mikakos to delay the program in view of the challenges primary healthcare workers now face trying to deal with COVID-19.
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Victoria first state to adopt mandatory prescription monitoring

From 1 April, all prescribers in the state will be required to view patients’ prescription histories.
31 Mar 2020
Victorian GPs and other prescribers will be mandated to view patients’ prescription histories in SafeScript prior to writing or dispensing a prescription for a medicines monitored through the system, in a bid to reduce potential harm from medication misuse.

Victoria is the first state to adopt a mandatory system.

SafeScript assists healthcare professionals with identifying high-risk patient circumstances, but does not prevent them from prescribing or dispensing a medicine they believe is clinically necessary.

There were
3395 authorised prescribers of opioid pharmacotherapy drugs in 2019.

Dr Rob Hosking, Chair of RACGP Expert Committee – Practice Technology and Management (REC–PTM), told newsGP Victoria mandating of SafeScript will ‘absolutely’ help push for a nationwide adoption of prescription monitoring.
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Coronavirus: Telehealth expands in Australia

Medicare funded telehealth is up and running in Australia, but there is confusion and teething problems as its availability expands. The new system lets patients have remote video and phone consultation with GPs or other health practitioners, and for it to be bulk billed to Medicare.
The Department of Health told The Australian that new Medicare telehealth items have been used to deliver more than one million services to almost 850,000 patients since March 13.
The department has published a broad list of consultation types that are funded. As well as GPs, there are social workers, psychologists, speech pathologists, pregnancy support, consultant physicians and mental health practitioners offering specified services.
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2 April 2020

Mobilise your virtual clinical workforce at speed and at scale with MediRecords

Sponsored
The Coronavirus outbreak has significantly disrupted the delivery of primary and allied health care to the point where some healthcare businesses need to rapidly change how they deliver care to their patients by offering new virtual models including telehealth and phone care
Our healthcare workforce needs to be deployed and provided with the clinical tools needed to manage the urgent on demand healthcare needs of all Australians. We also need to create new service models that provide protection for our healthcare workers who will be working long hours under difficult circumstances.
Technology has a significant role to play in supporting this unexpected disruption. MediRecords is a cloud-based clinical and practice management solution for primary care, acute and urgent care. Over the last month, we integrated with Amazon Connect, an omnichannel cloud-based contact center telephony solution in direct response to a COVID-19 health workforce challenge. MediRecords has been deployed in a number of large-scale implementations in government and at speed by applying the latest technologies and an agile approach to execution.
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Drugs to your door: MedAdvisor bets on telehealth expansion

By Emma Koehn
March 31, 2020 — 9.00am
Prescription management startup MedAdvisor will amp up its telehealth services on the back of the government's $1.1 billion coronavirus package to make online and phone consultations eligible for Medicare rebates across the country.
"We’ve seen a four times uplift in the number of requests for GP link services — we’re expecting strong uptake," Robert Read, chief executive of the ASX listed company, said.
MedAdvisor told the market on Tuesday morning it would roll out its 'GP Link' telehealth service so that its users could access sessions with their own GP or a doctor already on the MedAdvisor platform.
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Practices must adapt to stay afloat as telehealth takes off

GPs have welcomed the telehealth expansion, but say adaptation to the new reality will be key for practices to remain viable.
01 Apr 2020
GPs have to adapt to stay viable – even by shifting into ‘survival mode’ during the pandemic.

That is the message from Dr Emil Djakic, GP and Deputy Chair of the RACGP Expert Committee – Funding and Health System Reform (REC–FHSR).

He told newsGP that the major telehealth expansion – which came after strong advocacy from the RACGP – will ‘fully empower’ general practice to serve the community.

But Dr Djakic stressed that adaptation is essential, given coronavirus is placing financial pressure on an already strained primary care sector.

‘I think we can all recognise that the business model that we were all working with last month is now not the same business model. So the goalposts have clearly changed,’ Dr Djakic said.
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Nurses get intensive care training online

Nurses will get government-funded intensive care training to bolster the health system, while Australians are being urged to ease demand by staying at home.
Finbar O'Mallon
Australian Associated Press April 2, 20208:40am
Thousands of registered nurses will undertake online courses to prepare for deployment in intensive care wards during the coronavirus pandemic.
Up to 20,000 nurses will train for high demand and intensive care needs, including fitting ventilators.
The government is also funding up to 10,000 refresher courses for out-of-work nurses to bolster the health sector.
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GPost message app gaining attention

The founder of a new messaging tool backed by one of Silicon Valley’s top legal firms is in advanced discussions with federal and state government departments in Australia that want to use the service to transform public coronavirus communications.
GPost, developed by a ­Melbourne-based company, is a geolocating public messaging tool capable of delivering information directly to individuals at geographic locations.
It integrates with mapping software and location-based electronic services, effectively mapping the world and making each point a mail destination.
Importantly, it requires only an internet connection through either mobile, fixed line or Wi-Fi, so it can operate when mobile networks are down, such as during natural disaster emergencies.
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Alcidion launches Patientrack coronavirus assessment tool

Melbourne, Australia - Alcidion Group Limited (ASX: ALC) has developed a new COVID-19 assessment tool in its early warning software Patientrack to help hospitals identify potential cases sooner.

Patientrack, which is already used by hospitals across Australia, New Zealand and the UK to detect deadly conditions like sepsis and acute kidney injury, can now be used by nurses to carry out critical assessments of each patient presenting to hospital with a respiratory illness.

The COVID-19 assessment tool is already live and in use at a NHS UK Trust and is available to all hospitals using Patientrack at no additional cost. Alcidion has also configured the New Zealand Ministry of Health COVID screening assessment in its Patientrack solution, developed with input from a respiratory physician.

When using the tool, hospital staff on the ward are guided to a series of questions covering the patient’s symptoms, including the patient’s circumstances and their physiological measurements. This key information is then entered directly into Patientrack, so nurses can track observations via a computer or mobile device, ensuring the data is accessible to all healthcare staff.
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Alcidion enhances Patientrack software with new COVID-19 assessment tool

Clinical leads will be able to use the software information internally to gauge a site-wide view of their hospital to see all affected patients and their status across the hospital.
March 29, 2020 11:38 PM
Melbourne-based healthcare software solutions provider Alcidion has designed a new COVID-19 assessment tool in its early warning software Patientrack to help hospitals identify potential cases sooner. Patientrack, which is used by hospitals across Australia, New Zealand and the UK to detect deadly conditions like sepsis and acute kidney injury, can now be used by nurses to carry out critical assessments of each patient presenting to hospital with a respiratory illness.
The COVID-19 assessment tool is live and in use at a NHS UK Trust and is available to all hospitals using Patientrack at no additional cost. Alcidion has also configured the New Zealand Ministry of Health COVID screening assessment in its Patientrack solution, developed with input from a respiratory physician.
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NHS Fife extends Patientrack across Board and renews for five years


Highlights:
  • NHS Fife - a Health Board in Scotland extends use of Patientrack across the whole estate – including a minimum of 10 hospitals.
  • Previous annual contract renewed for five years
  • $1.47M total value to be recognised over five years to 2025
  • NHS Fife is one of Alcidion’s longest-serving customers, first implementing Patientrack in 2011
Melbourne, Australia - Alcidion Group Limited (ASX: ALC) has signed an extension and renewal agreement with NHS Fife for an additional five-year term, extending the Board’s use of the electronic bedside monitoring system across the whole estate (minimum 10 hospitals).  The total value of the new contract is $1.47M over five years, to 2025.

NHS Fife is a regional hub in Scotland, serving a population of 370,000 residents. Under the expanded renewal agreement, NHS Fife will now deploy Patientrack across the whole estate, a minimum of ten hospitals including two main acute hospitals and a network of community and day hospitals, amounting to approximately 1342 beds.
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31 March 2020

HealthEngine announces end to end integrated consumer telehealth ecosystem

The worsening coronavirus (COVID-19) crisis in Australia has prompted many healthcare practices across the GP, Dental, Allied Health and Medical Specialist sectors to adopt technology tools to reduce exposure of their staff and patients to the contagion.
Practices need to find ways to help patients without having to be physically present. This includes providing telehealth consultations from the practice to triage patients or allowing a healthcare provider to continue to see patients whilst self isolating or quarantined from home. The latest Federal Government announcement to lift the previous restrictions and complexity associated with the Telehealth Medicare items will further help adoption which is critical for patient care and the financial viability of many practices.
“For providers who are skeptical, unsure or new to telehealth, there’s a required change in mindset and workflows associated with phone and video consultation and that’s just the first hurdle. Another challenge for practitioners is that many solutions being rushed to market are clunky and lack the integration or automation for tasks that practitioners aren’t used to performing. We knew there was a better way and our HealthEngine team has acted quickly to bring an end-to-end, fully integrated consumer telehealth ecosystem to serve providers and patients across Australia,” said Dr Marcus Tan, HealthEngine Founder, CEO and Medical Director.
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Friday, 27 March 2020 15:03

InterSystems helps accelerate COVID-19 testing at Australian labs

Health and data management vendor InterSystems took less than two days to deliver customised digital interfaces to five Australian clinical laboratories gearing up to deal with COVID-19.
The five labs – including St Vincent’s Pathology Service, Austech Medical Laboratories, and Goulburn Valley Health Pathology – all ordered PCR analyser machines to increase their COVID-19 testing capacity and deal with the current crisis.
They all requested customised digital interfaces to their InterSystems TrakCare laboratory information systems, which the company delivered in 24-48 hours – before the new machines even arrived.
According to InterSystems, the TrakCare interfaces reduce data entry and ensure that each laboratory’s testing rules and protocols are followed.
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Ministry asks health IT sector to consider charges during Covid-19

Sunday, 29 March 2020  
eHealthNews.nz editor Rebecca McBeth
The Ministry of Health has asked health IT suppliers to consider reducing their charges for additional demand during the Covid-19 outbreak.

A letter sent to industry from MoH deputy director-general data and digital, Shayne Hunter, says the New Zealand health and disability sector is seeing unprecedented demand for health IT products and services, as a result of Covid-19.


Hunter asks suppliers to consider their charges for additional demand, while still taking account of commercial realities.

“The Ministry would appreciate it if charges for the additional products and services we require are fair and reasonable, and that you give consideration to covering your direct costs, with a significantly reduced margin on top,” the letter says.
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Friday, 03 April 2020 00:12

Broadband services drive up NBN data demand to record weekly high

Video conferencing, video streaming and accessing cloud-based office applications have driven a large increase in data demand on the NBN access network as more Australians turn to their broadband services for work, education and entertainment, according to a new report.
The launch of National Broadband Network operator NBN Co’s Australian Broadband Data Demand report, reveals the highest throughput (the measure of data flowing through the nbn access network) recorded in a week during each of the following three periods: the daytime business hours, early evening hours and busy evening hours.
The report release comes as more Australians self-isolate and increasingly rely on services over the NBN to remain connected to work, school and higher education, entertainment, family and friends.
Since the last week of February - when social distancing measures were not yet in effect - the peak download throughput recorded each week in the evening busy hours has increased by 25% to 13.8 terabits per second (Tbps).
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Wednesday, 01 April 2020 13:43

Labor calls for free NBN broadband access for families, children

The Australian Labor Party has called for an NBN rebate — and free NBN broadband access for a period of at least 12 months — to help connect families and children with no Internet at home, ensuring access to broadband for children it says are potentially missing out on the benefits of connectivity.
The call coincides with new home isolation measures announced by the Federal Government as Australia battles to stem the spread of the coronavirus epidemic – and the National Broadband Network operator NBN Co, and five retail service providers, have been authorised by the competition regulator the ACCC to work together on measures to keep telecommunications networks operating effectively during the COVID-19 crisis.
The call for an NBN rebate comes from two senior Opposition shadow ministers — Tanya Plibersek and Michelle Rowland — who say that “at a time when connectivity has become even more essential for society, ensuring that children have access to broadband at home is critical”.
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Wednesday, 01 April 2020 15:18

IPSTAR releases new ‘unmetered’ plans for rural, remote NBN Sky Muster service users

Internet service provider IPSTAR Broadband has announced new plans for its rural and remote customers using the NBN satellite Sky Muster Plus service, giving increased unmetered usage of the service for web browsing, reading,sending emails, and scrolling through social media.
The Australian operated Thai-owned IPSTAR says the changes - which came into effect at the start of April - mean that the typical household will have 70% of all internet usage unmetered compared with 30% previously, with the only metered services being video streaming and activities on Virtual Private Networks (VPNs).
The two new plans IPSTAR Broadband is offering are priced at $60 per month for 50 GB or $110 per month for 150 GB.
IPSTAR Broadband Managing Director, Shannon Fisher, said the new offering would ensure regional, rural and remote Australians “did not miss out”.
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NBN Co and biggest carriers to jointly tackle telco congestion

By Ry Crozier on Apr 1, 2020 10:12AM

With 'unusual traffic management and capacity optimisation techniques'.

NBN Co and its five biggest retail service providers may jointly implement “unusual traffic management and capacity optimisation techniques” to keep services performing for those who need them most during the coronavirus pandemic.
A working group comprising NBN Co, Telstra, Optus, Vodafone, TPG and Vocus has been set up and given permission to collaborate and take extraordinary action.
That permission comes in the form of an Australian Competition and Consumer Commission (ACCC) interim authorisation, unveiled today.
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Tuesday, 31 March 2020 09:15

Australia 86th of 159 countries when it comes to cost per Mbps

Australia stands 86th in the world when it comes to the cost of an Mbps of broadband data, according to a study by vouchercloud, a company that belongs to the global e-commerce marketplace Groupon. The data showed that Australians pay US$1.15 (A$1.86) per Mbps.
Australia's speed ranking put it at 63rd while its average price for a connection was 101st out of the 159 countries who figured in the list.
Romania had the lowest prices per Mbps at US$0.05 (A$0.08) while Yemen came in last at US$811.40 per Mbps. (The complete list can be seen here.)
A statement from vouchercloud said it had used user-submitted broadband speeds from Speedtest and broadband price averages from cable.co.uk to get the average cost of an Mbps.
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Minister insists NBN can handle the working from home surge

The network can cope with traffic during the day going up by 100 per cent, and that it is holding up well to increased demand, writes Communications Minister Paul Fletcher.
Paul Fletcher Contributor
Mar 30, 2020 – 10.00am
As we respond to COVID-19, there are suddenly lots more Australians working from home.
They are on their laptops and mobiles, connected to their work network, sending and receiving files, video conferencing using Skype or FaceTime or other apps, and otherwise sending data back and forth.
Many people are wondering if the network can cope with this surge in demand.
In fact, with the rollout of the National Broadband Network now 95 per cent complete, we are much better positioned than if this had happened a few years ago.
The design of the NBN sees around 92 per cent of premises across Australia connected to a fixed line service, using very high capacity fibre optic cable for most or all of the distance to the customer premises – either fibre to the premises, to the curb, to the node, or hybrid fibre coaxial (HFC).
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Lack of commute sees early evening throughput on NBN increase by 30%

Peak data during business hours is up by one-fifth and the 9 pm peak has increased by one-quarter.
By Chris Duckett | April 2, 2020 -- 22:56 GMT (09:56 AEDT) | Topic: Coronavirus: Business and technology in a pandemic
The company responsible for deploying the National Broadband Network (NBN) across Australia has lifted the lid on how its network has been performing as the coronavirus pandemic sweeps across the planet.
On Thursday, NBN said it was starting a new weekly report to show the highest data throughput across three time periods. Over the last full week of March, they have been: Business hours from 8 am to 5 pm; early evening hours from 5 pm to 8 pm; and evening busy hours from 8 pm to 11 pm.
Over this period, NBN said it had seen peak increases of 21% to 9Tbps, 30% to 12.8Tbps, and 25% to 13.8Tbps, respectively. During business hours, data throughput had increased by 70%.
The government-owned wholesaler added that it had the capacity to handle the increased data.
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NBN satellite complaints spike over back end of 2019

Overall complaints are down by almost one quarter for the three months to the end of 2019.
By Chris Duckett | April 1, 2020 -- 03:06 GMT (14:06 AEDT) | Topic: Networking
The number of complaints received by Australian telcos over the past 12 months has dropped by almost one quarter, according to figures released by the Australian Communications and Media Authority (ACMA) on Wednesday.
Across the year to December 31, the number of complaints per 10,000 services in operation (SIO) fell by 24% to 93, while the year to September 30 involved a drop of 20% to 97.
Fixed broadband was easily the most complained about service type, registering 341 complaints per 10,000 SIO, followed by NBN broadband with 126 complaints per 10,000 SIO. NBN voice registered 90, while mobile complaints happened 63 times per 10,000 SIO, and traditional fixed voice was the least complained about service with 47.
Almost all service types saw drops across the year to December 31, with fixed broadband having 21% fewer complaints, NBN broadband complaints being down 36%, NBN voice dropped by 15%, and traditional voice complaints were down by 49%. Mobile services bucked the trend with a 1.6% increase in complaints.
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Wednesday, 01 April 2020 11:15

NBN Co, telcos get ACCC authorisation to co-operate during COVID-19 crisis

National Broadband Network operator NBN Co and five retail service providers have been authorised by the competition regulator the ACCC to work together on measures to keep telecommunications networks operating effectively during the COVID-19 crisis.
Under the interim authorisation a special working group formed by NBN Co and the RSPs will share information, coordinate strategies to manage congestion and take other steps to address significant demand changes caused by the COVID-19 pandemic and the large numbers of people now at home during the day.
The Australian Competition and Consumer Commission (ACCC) - which will be an observer on the special working group - says authorisation allows the NBN Co and the RSPs to support consumers and small businesses adversely impacted by the pandemic.
The coordinated effort by NBN Co and Australia’s five biggest telcos - Telstra, Optus, Vodafone Hutchison, TPG and Vocus - comes at the request of the Minister for Communications, Cyber Safety and the Arts, Paul Fletcher.
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Aussie Broadband rallies industry behind NBN Co

By Ry Crozier on Mar 30, 2020 10:54AM

"Put all the naysayers to bed once and for all".

Aussie Broadband managing director Phillip Britt is rallying internet providers to get behind NBN Co and its team as they put in “insane hours” and alter work practices “to keep everything running” for internet users.
Britt took to social media on Sunday to lend public support to NBN Co, arguing the company is handling the challenges of COVID-19 “way better than any other business I have seen at their scale.”
“Like many with offshore processing elements, they have been hit by country shutdowns but recovered within a couple of days whilst others are still working out ‘where to next’,” Britt said. 
“I believe they have achieved this through good automation and having modern systems which can be accessed in different ways (think web-based as opposed to legacy application platforms). 
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Monday, 30 March 2020 00:54

Medical hack – sharing a ventilator

Faced with a shortage of equipment, a Canadian doctor has rigged up a ventilator to serve nine patients concurrently.
Rather than persist with the endless "doom and gloom" associated with COVID-19, we would like to deliver some good news stories instead.
According to reports, the Perth and Smiths Falls District Hospital in Ontario, Canada, had just four ventilators (along with four more unrepairable units) and the COVID-19 pandemic soon proved the working ones to be wildly insufficient.
The so-called "evil genius," anaesthetist Dr Alain Gauthier, who just happens to hold a PhD in diaphragmatic mechanics, said he changed the device to serve nine patients simply to give people the best chance of survival. He also noted that the idea was based on previously published research from 2006.
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Enjoy!
David.

Sunday, April 05, 2020

It Looks Like Ramping Up TeleHealth Consultations In Response To COVID-19 May Not Be All That Straightforward.

At least one specialist health journalist is now reporting real issues with the rapid introduction of telehealth to avoid some COVID-19 risks. See here:
4 April 2020

Telehealth on path to rip govt’s COVID plans (and general practice) asunder

Posted by Jeremy Knibbs
How did general practice get here?
Where both the federal government and the general public aren’t aware that the profession that is their front line defence against the most serious crisis since both world wars, is rapidly drowning in front of their eyes. (See our survey story on how 50% of GP practices are reporting losing more than 30% of income).
What have we done?
How did we come to guarantee the future of the banks, private hospitals, the childcare centre industry, a good chunk of small business and a swathe of other groups , and not the people who are at the frontline of the health crisis fight of our lives and who are risking their lives each day just by turning up to work?
Is it going to be the “same as it ever was”?
Are we doomed to keep regarding general practice as a disparate group  that will loyally keep coming back for more because of their patients and their love of the job?
Not this time.
If the government doesn’t step in quickly and fix this current and rapidly unfolding mess, the profession is going to be ripped apart by rapid structural change, financial ruin and technology.
And we will never be able to put it back together again.
The federal government’s well-intentioned rapid introduction of telehealth to all MBS items for GPs is starting to rip apart  general practice. And no one is noticing.
Opening up telehealth had to be done. Patients were going home to isolate as was required. Doctors are too, in some cases. It was the only solution to a myriad of problems presented by the nature of the crisis.
But the simplicity of the government’s telehealth solution is looking increasingly like a recipe for a much bigger disaster than cruise ships, PPE shortages and not shutting down earlier.
Telehealth is far more complex than the government has calculated. According to experts, this is probably because the government didn’t really listen that carefully to telehealth lobbyists in the past about how they should and could introduce it to our healthcare system.
The government didn’t pay attention because the government has been, with some justification, obsessed with the idea that telehealth was too easy to abuse. It is. But telehealth experts are now pointing out that this lack of understanding is catalysing a new front in the COVID-19 crisis: the rapid degeneration, and potential collapse, of general practice.
A GP leader in the e-health space, who chose to remain anonymous, told The Medical Republic that any introduction of telehealth would always have needed significant training and education of GPs, along with appropriate funding for infrastructure, and careful planning of the MBS items to be made available.
“What the government doesn’t yet realise is that this isn’t a whole lot of extra money trickling down to primary care and it’s not supporting people on the frontline,” she said.
Vastly more here:
While it may be (indeed it is certain) that there some other factors contributing to the impact of the changes wrought by COVID-19 on GP the sudden ramp up of use remote consultation electronically is certainly a component.
The clearest indication of the truth of this is provided by a presentation given a week or so ago which was hosted by the Digital Health CRC and chaired by Dr Norman Swan via Zoom.
Here is a link to the recording of the session – it lasts a little over 1.5 hours.
The presentation title was:

COVID-19 and digital technology: The roles, relevance and risks of using telehealth in a crisis

Here is the event description:
Panel chair - Dr Norman Swan (physician and journalist)
Panellists include:
Professor Trish Greenhalgh (Primary Care Health Sciences, University of Oxford, UK)
Dr Amandeep Hansra (GP, Bondi Doctors, NSW, Australia)
Dr Neale Fong (WA Country Health Service Board Chair, WA, Australia, and medical practitioner)
Karrie Long (School of Nursing and Midwifery, La Trobe University and Director, Nursing Research Hub, The Royal Melbourne Hospital, Victoria, Australia)
Dr Daniel Stefanski (Staff Specialist Infectious Diseases Physician, Queensland Health, Queensland, Australia).
Set against the backdrop of the COVID-19 crisis, our webinar panellists will discuss the role telehealth can play in primary and secondary care. The panel will present practical strategies for healthcare professionals and outline the risks and rewards of telehealth for practitioners and patients alike.
Key topics will include how to:
  • identify and adopt successful telehealth models
  • modify business models for practices when implementing telehealth
  • use remote triaging and online consultations to manage situations like COVID-19
  • engage technology to support infection control and protect staff and patients
  • best utilise existing online consultation platforms and implement new systems
  • build a health workforce and patient ecosystem that is confident in using telehealth technology
  • consider clinical governance issues in relation to telehealth
  • select patient settings where telehealth is most valuable
  • enable video consultation capability and why this might be appropriate
  • address common telehealth challenges and communicate benefits
  • find relevant resources and where to access support
Is COVID-19 the disruption that will lead to changes in the way we use technology over the longer term? During the discussion you will find out what our experts think.
This webinar is proudly bought to you by the Digital Health CRC in collaboration with Curtin University and La Trobe University.
Here is the link:
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All the presenters were excellent and highly informative and expert with the special shout-out to Professor Trish Greenhalgh who skillfully showed just how much training, insight and thought was needed to undertake phone / video consultation safely and with proper record keeping.
The further you go on listening to these presentations the clearer it is that this mode of consultation is very different, has its own set of rules and needs to be undertaken with a considerable understanding of the risks / rewards of the approach.
The bottom line is that this is a really different mode of delivering care – and I am not sure there is any depth of understanding on this reality, just yet. Additionally we need to be very clear as to when we need to revert to the more usual one-on-one mode of consultation!
Watch the webinar recording and see what I mean! A lot of further work is needed.
Comments welcome.
David.

ps. There is a practical summary of how to go about telehealth here:

https://www.ausdoc.com.au/opinion/how-get-best-out-telehealth-covid19-era

Well worth a browse. The changes in work processes and adaption to new ways of working will be pretty big!

D.

AusHealthIT Poll Number 521 – Results – 5th April, 2020.

Here are the results of the poll.

What Impact Will The COVID-19 Emergency Have On The Digital Health Start-Up And Event Industries?

Disastrous 11% (12)

Pretty Bad 22% (25)

Minor 11% (12)

None 55% (62)

I Have No Idea 1% (1)

Total votes: 112

Make of this poll what you will. I am not sure Digital Health Event Organisers would agree. At the very least, additionally, some start-ups are struggling with finding on-going funding, and are being impacted.

Any insights on the poll welcome as a comment, as usual.

A great turnout of votes.

It must also have been a very easy question as only 1/112 readers were not sure how to respond.

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

David.