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, May 18, 2020

Weekly Australian Health IT Links – 18 May, 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

-----
As some restrictions slowly lift there is maybe some more digital health news, but only a slight improvement and much too much still about the virus.
Security is again a feature with attacks happening all over it seems!
-----

Digital health platform aids clinicians in COVID-19 treatment

11 May, 2020
A $4 million digital health project involving health services, clinicians and researchers will enable front line medical workers treating COVID-19 patients to use real-time data and analysis to improve health outcomes.

The Digital Health CRC‘s Clinical Data and Analytics Platform (CDAP) will help decision-making by clinicians by providing nationally available real-time analytics on the progression of COVID-19 to severe disease.

Digital Health CRC CEO Dr Victor Pantano said COVID-19 had created an unprecedented challenge.

 “We currently don’t have well established and proven treatments for COVID-19 anywhere in the world,” Dr Pantano said.
-----

$4m digital health project to help front line medical workers battle COVID-19

By Matt Johnston on May 11, 2020 1:30PM

Leveraging real-time data and analytics.

Front line medical workers treating COVID-19 patients are set to benefit from a $4 million digital health project bringing together health services, clinicians and researchers to improve health outcomes with the use of real-time data and analytics.
The Digital Health CRC's Clinical Data and Analytics Platform (CDAP) will provide nationally available data on the coronavirus’ progression to help uncover why some people experience only mild symptoms while for others it can be fatal and inform clinicians' decision-making.
The platform serves as a way to capture a broad range of clinical and patient reported data spanning the entirety of a patient’s journey, from diagnosis through to long-term follow up, complementing existing analytics projects by allowing rapid data linkage across different sources such a pathology and radiology.
Chief executive of the Digital Health CRC, Dr Victor Pantano, said part of the challenge in taming the pandemic is that there aren’t any well-established or proven treatments for the disease anywhere in the world.
-----

Austin Health deploys suite of AI-powered solutions to improve COVID-19 patient care

Dean Koh | 13 May 2020
Melbourne-based tertiary and quaternary health service Austin Health has deployed a series of AI-infused solutions to improve COVID-19 patient care and reduce administrative burden on its hospitals. 
A community self-assessment platform was developed which saw over 2,000 completing the assessment, allowing the hospital to advise more than four out of five people taking the assessment that they did not need to present at hospitals – helping to free up resources and reducing the potential exposure of people deemed at low risk.  
Austin Health has also rolled out a COVID-19 symptom monitoring system for at-home patients reporting severe or deteriorating symptoms. The solution includes leading-edge capabilities, such as an enhanced respiratory audio analytics feature and links the patient to a clinician when required.  
Other tools and platforms under their COVID-Care suite of solutions include a symptoms management solution that uses AI to assess COVID-19 patients’ respiratory and other targeted symptoms and a secure portal allowing patients to access results and manage appointments and rescheduling.
-----

Last week a GP wrote Australia's first ever e-script: Here's what doctors can expect

It's been decades in the making but the health system's long-awaited e-prescribing adventure has begun
13th May 2020
Meet Dr David Corbet, who has just earned a very unique place in Australian health care history.
Last Tuesday, the GP from Anglesea, on Victoria’s Surf Coast, wrote the first ever legal electronic prescription which was successfully dispensed by a pharmacy.
OK, no moon-landing but in terms of the struggle involved in bringing 21st Century technology to bare on an act that occurs literally hundreds of millions of times a year, it is probably close. 
“It was very simple,” Dr Corbet says of the first e-prescription (which was for an asthma medication).
“The user interface on the practice software is essentially the same you would normally use for writing a script, except that it has an e-script button and you can select which way you want to send it.”
-----

How an SMS bot helped NSW Health cut COVID-19 test result wait times

By Justin Hendry on May 14, 2020 6:56AM

And other lessons from the pandemic.

NSW Health has drastically reduced the amount of time taken to return negative COVID-19 pathology results to patients using a SMS text bot engine that automates the contact process.
eHealth NSW chief information officer Zoran Bolevich told the AWS Summit in Sydney that the “really clever work” had “cut down the waiting time from days to hours” for patients.
It has also saved “thousands of hours of productive time” for NSW Health Pathology, which has performed the majority of Australia’s COVID-19 tests, and other healthcare workers.
The system, which was released just weeks into the height of the pandemic, was developed by AWS, Deloitte, Microsoft and Mulesoft to ease pressure on pathology and hospital staff.
Bolevich said it had enabled the state’s laboratory information system to “feed a negative result through an SMS text bot engine … and deliver those negative results to patients”.
-----

COVIDSafe privacy protections now locked in law

By Justin Hendry on May 14, 2020 11:28AM

Contact tracing app bill passes with minor improvements.

The privacy protections behind Australia’s COVIDSafe contact tracing app are now enshrined in law after the underpinning legislation passed through parliament with minor improvements.
The Privacy Amendment (Public Health Contact Information) Bill cleared the senate without amendments on Thursday morning, two days after it was introduced by the government.
The legislation seeks to allay privacy concerns within the community, replacing an interim determination issued under the Biosecurity Act when COVIDSafe was launched last month.
It introduces strict penalties of up to five years jail for those that collect, use, disclose (include outside of Australia) or decrypt COVIDSafe data for any purpose other than contact tracing.
-----

COVIDSafe update closes denial of service bug and makes notifications optional

Defence Minister has also confirmed that the number of Australians with the app will not impact decisions to lift restrictions.
By Chris Duckett | May 14, 2020 -- 06:23 GMT (16:23 AEST) | Topic: Coronavirus: Business and technology in a pandemic
The Australian government has pushed out an update to its COVIDSafe app that removes a number of security and privacy issues.
Prime among them is the denial of service attack possible on iOS devices, as demonstrated by Richard Nelson in a blog post. 
When devices running the app encountered a device advertising a malformed Bluetooth manufacturer identifier, the app would repeatedly crash until it was out of range of the attacker and restarted.
"This is a fairly obvious bug that should have been picked up in an automated scan and/or an in-depth security review," Nelson wrote.
When the source code for the app landed last week, other obvious errors such as an enumeration of states, not including Tasmania, were also found.
-----

Health Minister wants telehealth to continue after COVID-19 pandemic

By Rachel Clun
May 7, 2020 — 12.00am
Health Minister Greg Hunt wants doctors to continue treating patients online or by mobile phone after lobbying for telehealth to be part of the post-COVID-19 world.
A spokesman for the Health Minister said he had been working on the telehealth reforms with the sector, including the Royal Australian College of General Practitioners (RACGP) and the Australian Medical Association (AMA).
"Minister Hunt is already engaged with the medical community and other key participants in planning a long-term future for telehealth," the spokesman said.
It comes as an RACGP survey of almost 1200 GPs found 99 per cent were now offering consultations via phone or video.
RACGP president Dr Harry Nespolon said it was wonderful that so many GPs had adopted telehealth "in these trying times".
-----

A majority of Australian public pathology labs now uploading results to My Health Record

Australian Digital Health Agency says nearly 43 million pathology reports have been uploaded to system.
By Aimee Chanthadavong | May 15, 2020 -- 03:10 GMT (13:10 AEST) | Topic: Innovation
The Australian Digital Health Agency (ADHA) has announced all public pathology test results in New South Wales, Queensland, the Northern Territory, South Australia, Tasmania, and Western Australia are now accessible by patients and clinicians via the My Health Record (MHR) system.
The results are immediately available in the system to healthcare providers, according to the ADHA, while patients are only able to review the results seven days after the report is uploaded.
"This gives healthcare providers time to review the report and contact their patient to discuss the results if needed," said the ADHA, which oversees the MHR system.
The ADHA also revealed nearly 43 million pathology reports have been uploaded to the MHR, with more than 3.8 million reports uploaded in March, an 11% month on month increase from February.
-----

Test results from 95% of public pathology labs now online

But what about private pathology?
15 May 2020
Engaging private pathology to upload test results to My Health Record should be a priority for general practice.
The Australian Digital Health Agency (ADHA) has announced all public pathology laboratories in New South Wales, the Northern Territory, Queensland, South Australia, Tasmania and Western Australia are now connected to the My Health Record system.

Work is also progressing to complete connections in the Australian Capital Territory and Victoria, with the latest lab to connect, Northern Pathology Victoria, the first new public pathology service to be established in the state in more than 30 years.

There are significant advantages in having pathology results stored within My Health Record, according to Northern Pathology Victoria Director Dr Prahlad Ho.
-----

Media release - Printouts and faxes for pathology results almost history

15 May 2020: Test results from more than 95 per cent of Australian public pathology laboratories are now available online providing secure and convenient access for patients and clinicians.
All public pathology laboratories in New South Wales, the Northern Territory, Queensland, South Australia, Tasmania and Western Australia are now connected to the My Health Record system and work is progressing to complete connections in the ACT and Victoria.
CEO of peak organisation Public Pathology Australia, Jenny Sikorski, said public pathology labs support the delivery of health care from major teaching hospitals to the most remote locations across Australia.
“Since January, public pathology labs have fast tracked new technologies, collection and testing processes to support patients being screened for COVID-19,” she said.
“Patients can count on public labs to share pathology information with them and their clinicians.”
-----

Govt acts to expose ATO scam callers

By Ry Crozier on May 9, 2020 1:34PM

No longer able to spoof tax office numbers.

The Government claims to have “comprehensively disrupted” scammers pretending to be from the Australian Taxation Office through a technology trial run in collaboration with telcos.
Communications Minister Paul Fletcher said the ATO received over 107,000 reports from the community of impersonation scams in 2019 alone.
The scam calls appeared to come from legitimate - and widely publicised - phone numbers normally used by Australians wanting to call the tax office.
The scammers used software “to mislead the caller line identification CLI technology … of most mobile phones and modern fixed line phones,” the Government said.
-----

Smart patch tracks body's response to diet

Friday, 08 May, 2020
A personalised nutrition wearable is being developed by Melbourne-based start-up Nutromics to measure key dietary biomarkers and help wearers track how their bodies respond to different foods.
The wearable smart patch will deliver precision data to an app to help people personalise their diets and reduce their risk of developing lifestyle-related chronic diseases like type 2 diabetes.
A collaborative team led by Nutromics, RMIT University, Griffith University and manufacturer Romar Engineering — with support from the Innovative Manufacturing Cooperative Research Centre (IMCRC) — is now researching and developing the required manufacturing capabilities to pilot manufacture the device.
Nutromics Co-CEO Peter Vranes said the smart patch leverages emerging technologies to empower people to take greater control of their health.
-----

'You feel like it will be OK': Using virtual reality to treat real depression

By Stuart Layt
May 16, 2020 — 5.53pm
When Montana Tym stepped into the clean white room, a sense of calm washed over her.
“As you open the windows, the walls start to disappear and you’re in a natural landscape … it’s really peaceful,” she said.
The psychology student wasn’t dreaming. She was taking part in a newly developed virtual reality therapy for people with depression or suicidal thoughts.
Researchers from the Black Dog institute and UNSW have developed the “mixed reality” experience involving virtual reality combined with physical feedback like fans blowing to simulate wind.
Professor Katherine Boydell from the Black Dog Institute said the idea was to create a sense of peace and mindfulness in people with clinical disorders to help them get out of what could be quite damaging depressive episodes.
-----

'Unscrupulous act': Toll Group reveals private data stolen by hackers

Paul Smith Technology editor
May 12, 2020 – 5.26pm
Logistics giant Toll Group has revealed that hackers, who breached its systems last week, have stolen private data about client agreements and past employees, and fear they will be put up for sale on the dark web.
In a statement on Tuesday afternoon Toll Group managing director Thomas Knudsen described the attack as an "unscrupulous act," and said the Australian Federal Police were involved alongside the Australian Cyber Security Centre (ACSC) in investigating the crime.
Toll managing director Thomas Knudsen has apologised to clients and employees after revealing hackers have stolen private data. 
The hackers breached Toll's systems last week, using ransomware known as Nefilim, but at the time said no data had been extracted as a result. It is the second major ransomware attack to bring the company to its knees this year.
-----

Toll Group's corporate data stolen by attackers

By Ry Crozier on May 12, 2020 4:39PM

Likely to be published on dark web.

Toll Group has revealed attackers behind its latest run-in with ransomware managed to exfiltrate current commercial agreements and employee data from at least one server.
The logistics giant confirmed the data loss in a statement late Tuesday.
The company was hit with a type of malware known as Nefilim at the start of last week.
One of the characteristics of attacks that use Nefilim is that victims are given a week to pay a ransom or wind up seeing stolen documents on the dark web.
-----
Wednesday, 13 May 2020 10:42

Toll says one corporate server hit by Windows ransomware

Attackers have accessed at least one corporate server at Australian transport and logistics firm Toll Holdings, where data about past and present employees is stored, the company says, adding that details of commercial deals was also stored on this server.
In a statement issued on Tuesday about the attack, the second ransomware assault on its servers this year, Toll said there was no chance it would engage with the attackers' ransom demands.
The malware in question is named Nefilim and the attackers also threaten to leak data from their victims in similar fashion to a number of other ransomware groups.
Toll Group managing director Thomas Knudsen said the company was the victim of an "unscrupulous attack".

“We condemn in the strongest possible terms the actions of the perpetrators. This a serious and regrettable situation and we apologise unreservedly to those affected," he said.
-----
Wednesday, 13 May 2020 11:28

Only small number of Australian firms extorted by ransomware gangs

Australian organisations hit by Windows ransomware appear to be less willing than their counterparts in other countries to give in to ransom demands, with only 12% forking out money to the attackers, in comparison to 27% of organisations globally.
The figures come from a ransomware report compiled by the security firm Sophos over the last 12 months. About 5000 IT decision-makers in 26 countries were queried for the survey. Half the respondents were from organisations of between 100 and 1000 employees, while the other half were from firms of between 1001 and 5000 employees.
In Australia, 200 companies were contacted, while in countries like the US, UK, Germany and India 300 firms were each asked to supply data.
-----

BlueScope confirms a 'cyber incident' is disrupting its operations

By Ry Crozier on May 15, 2020 10:21AM
Steel maker says attack detected in US.
BlueScope has confirmed that its IT systems have been “affected by a cyber incident”, which it said was detected in one of its US businesses.
iTnews reported exclusively yesterday that BlueScope’s production systems were halted company-wide in the early hours of Thursday morning, with the cause believed to be a ransomware infection.
Chief financial officer Tania Archibald said in a regulatory filing that “the cyber incident was detected in one of the Company’s US businesses and the company had acted promptly to respond to the incident.”
-----

AusPost parcel tracking hit by technical issues

By Justin Hendry on May 15, 2020 1:07PM

MyPost account, merchant lodgement also impacted.

Australia Post is experiencing a widespread outage of its IT systems affecting parcel tracking, online MyPost accounts and the ability for business customers to lodge requests.
The postal service acknowledged the “technical issues” in a tweet on Friday afternoon, though the problems appear to have begun around 9:30am AEST.
“We’re currently experiencing technical issues which are impacting a number of services including tracking, MyPost, deliveries, merchant lodgement and calls through to our contact centre,” it said.
-----

Citizen data compromised as Service NSW falls victim to phishing attack

The attack involved the illegal accessing of 47 Service NSW staff members' email accounts.
By Asha Barbaschow | May 14, 2020 -- 04:55 GMT (14:55 AEST) | Topic: Security
Following reports on Thursday morning that a staff member from Service NSW clicked on a suspicious link from an email, the New South Wales government has confirmed it was the target of a malicious phishing attack.
The breach was first thought to have only affected individuals who visited a Service NSW shop front or called the state government service and that those transacting via the app or website channels were not compromised.
But in a statement Thursday afternoon, Service NSW revealed the breach, which occurred on 22 April 2020, had seen customer information held in emails accessed.
"On 22 April, Service NSW launched a comprehensive investigation in response to the discovery of a possible breach. Initial assessments were not clear on the reach of the attack," it said.
-----

Southern's digital vision

Sunday, 10 May 2020  
eHealthNews.nz editor Rebecca McBeth
The Digital Blueprint for Dunedin’s new hospital says it will be a, “digitally enabled facility and support new and emerging technologies that improve the patient and staff experience”. eHealthNews.nz reports.
The vision for Dunedin’s new digital hospital is certainly ambitious, says Southern DHB executive director people, culture & technology Mike Collins.
He acknowledges that with more innovation comes more risk and more cost, but says the Strategic Partnership Group (appointed by the Minister of Health to manage capital projects and programmes) has the appetite for it and the region is ready for change.
The time for transformation
Across New Zealand, the arrival of Covid-19 has already greatly accelerated the pace of digital transformation within the health system.
-----

Robots give surgeons superhuman stability and precision

Thursday, 07 May, 2020
We are all familiar with the now-ubiquitous industrial robot and the more recent emergence of collaborative robots in manufacturing settings. However, another area where robots are finding extensive application is surgery. And while there has been some press in recent times about robots being able to perform surgery autonomously, the practical application of these capabilities is still some years away.
Nevertheless, there is robotic technology that is commonly used in the operating theatre today.
Robotic systems are increasingly being used to facilitate and optimise the positioning of instruments and tools during surgery. These systems simplify operating room workflows and ensure that surgical tools are inserted at the appropriate angle in order to obtain the best possible outcome. The level of precision required often can’t be achieved by humans, who are prone to involuntary tremors and sub-optimal vision. The robots merely place the instrument at the desired location, while the entirety of the procedure is performed by the surgeon. The robot is simply a tool to facilitate planning and optimal instrument positioning. IDTechEx’s new report, Innovations in Robotic Surgery 2020-2030, offers a comprehensive analysis of this emerging technology.
-----

'Robo doc' on duty at Australian hospital

The robot is like a large tablet that rolls around the hospital visiting patients, allowing doctors to communicate via a Facetime like application
11th May 2020
A Queensland hospital has enlisted the help of a new colleague who rolls through wards and can tend to patients at their bedside without breaking strict infection control protocols.
Temi is the “robo doctor” doing the rounds at Greenslopes Private Hospital in Brisbane.
She’s about the same height as a patient in bed, and has a small monitor for a face, which beams across a live picture of the doctor or staff member wanting to speak with the patient.
The hospital’s emergency director Dr Mark Baldwin says the robot has enabled staff to monitor patients in isolation while keeping them safe from infection and saving on precious personal protective equipment (PPE).
"Temi’s head is in fact a small television monitor which has a live feed of the doctor or staff member who wants to speak with the patient," Dr Baldwin said in a statement.
-----
11 May 2020 8:15 AM AEST

Healthcare efficiency: AI technology to reduce hospital readmissions   

Monash University researchers are using Artificial Intelligence (AI) to better understand the cause of hospital readmissions, in turn improving health outcomes and reducing the financial burden on the health system.
In the biggest study of its kind in Australia, researchers applied AI technology to examine 10 years’ worth of patient medical records, looking at 14,000 records and examining the details of over 327,000 hospital readmissions.
They have now developed a prediction model that achieves state-of-the-art prediction accuracy on two patient cohorts – chronic liver disease and heart failure.
The results of this research could help health experts model the long-term prognosis of other diseases in the future. 
The research is a joint collaboration between the Faculty of Information Technology (IT) and the Faculty of Medicine, Nursing and Health Sciences, specifically through the School of Clinical Sciences and Monash Health.
-----

Australian-made wearable biosensors to gather precision data on chronic disease

By Matt Johnston on May 8, 2020 2:03AM

'Smart patch' offers personalised nutrition information.

A wearable ‘smart patch’ being developed in Australia is touted as massive help for people experiencing chronic lifestyle-related disease like Type 2 diabetes by gathering data on how their bodies react to different diets.
Melbourne-based company Nutromics is developing the alternative to painful finger pricks and blood tests to measure key dietary biomarkers in real time.
Data from the wearable is then sent to an app, allowing users to precisely track how their bodies respond to different foods.
-----

Huge trial looms for 'very promising' AI tool to boost IVF success

By Melissa Cunningham
May 14, 2020 — 11.53am
Briony Amey has a bundle of precious photos of her son Rory when he was a day-old embryo inside an incubator.
The photos of him as a tiny embryo were used in an artificial intelligence-powered selection process in which Rory was chosen for having the greatest likelihood of successfully growing into a baby.
Australian fertility experts are now testing the technique, which uses artificial intelligence to improve the odds of a successful pregnancy, in of the largest trial of its kind in the world.
Rory was born five weeks ago as the coronavirus pandemic gripped Australia.
"It is amazing to think one day we will be able to show those photos to him," said Ms Amey.
-----

Deloitte collect $9.5m for stage one of myGov rebuild

By Justin Hendry on May 11, 2020 3:27PM

Beta platform slated for September.

Deloitte has scored a $9.5 million deal with the Digital Transformation Agency to build out the first stage of the Facebook-inspired digital services platform that is tipped to replace myGov.
The big four consultancy was handed the six-month contract last week to further develop a prototype government digital experience platform (GovDXP) that it began building in January.
Deloitte was paid just under $1 million earlier this year to develop the prototype in a 90-day sprint using government user research and architecture requirements.
The prototype platform, which the government is pitching as its answer to online services for citizens, was expected to be complete by May, though its current status is unknown.
-----

NBN on time and passing the COVID test

The National Broadband Network is on track to deliver on promises made six years ago and be accessible by 7 million Australians.
May 14, 2020 – 7.59pm
Malcolm Turnbull's chapter on the NBN Co in his book The Bigger Picture and the latest NBN quarterly results are appropriate bookends to the completion soon of the largest single piece of infrastructure in Australia's history.
Six years ago, when Turnbull was communications minister, NBN made a commitment to enable all standard installation premises in Australia to connect to the NBN wholesale access network by 2020.
At the time this was a brave call. The NBN was a complete mess and Turnbull was not quite sure what the new management he had appointed would find inside the business.
In late 2013 he brought in former Telstra executive JB Rousselot as head of strategy and transformation and appointed a seasoned American telco executive, Bill Morrow, as CEO. Morrow, who had to fix a toxic corporate culture, appointed Stephen Rue as chief financial officer.
-----

Broadband tax start date delayed to January 2021

By Justin Hendry on May 14, 2020 5:00PM

As laws finally pass parliament.

Long-delayed legislation for a broadband tax on non-NBN Co operated fixed line services has finally passed parliament, ending an three-year saga that was interrupted by last year’s election.
But the tax is now slated to begin on 1 January 2021, instead of 1 July 2020, after the federal government secured last-minute amendments to the bill in the senate on Thursday.
The Telecommunications (Regional Broadband Scheme) Charge Bill 2019 passed alongside a complementary bill to establish NBN Co as Australia’s new default fixed-line operator.
The bills, which were first introduced in mid-2017, were reintroduced last November after the government’s former bills lapsed at the close of the last parliament in April.
-----
Thursday, 14 May 2020 10:10

Broadband demands hit a record high for NBN Co during COVID pandemic

Broadband demand remains high in Australia with the operator of the National Broadband Network NBN Co revealing data demands on its services are well above pre-COVID pandemic baseline levels as Australians continue to observe social distancing and remote working requirements.
NBN Co says there is continuing high demand for both data and new service connections as Australians continue to rely heavily on the nbn for their work, study, telehealth, online shopping, social and entertainment needs.
The weekly Australian Broadband Data Demand report shows the highest throughput recorded in a week during daytime business hours, early evening hours and busy evening hours.
-----
Thursday, 14 May 2020 12:04

NBN Co exceeds quarterly revenue, activation targets, wins Government praise

The Federal Government says National Broadband Network operator NBN Co has demonstrated “operational and financial resilience” during the initial phase of the COVID-19 pandemic and has welcomed the company’s “strong” 2019-20 third quarter results.
The Government’s comments follow NBN Co’s announcement of its third quarter results - exceeding its rollout, revenue and activation targets - with the company reporting that it made 670,000 residential and business premises Ready to Connect to the nbn access network in the third quarter alone, enabling a total of 11.2 million premises to order a service as at 31 March 2020 - with the build of the network "remaining on track" for completion of the initial rollout by 30 June 2020.
-----

More Australians seeking faster NBN plans

The NBN is continuing to edge closer towards completion, with the government-owned company building the network lifting average revenue per user and posting narrowing losses in what is tipped to be one of its last quarterly results before an expected privatisation.
NBN Co on Thursday posted total revenue of $2.8 billion for the nine months to March 31, 2020, up 38 per cent on the same time a year earlier.
Operating expenses were down from $1.65bn to $1.556bn, while total earnings before interest, taxes, depreciation and amortisation (EBITDA) showed a loss of $732m, compared with a $808m loss a year earlier.
One of the network's crucial metrics, the monthly average revenue per user (ARPU), is up to $45 compared with $44 a year earlier, which chief executive Stephen Rue said was a result of Australians purchasing plans at higher speeds. NBN Co’s target is to reach an ARPU of $51 by FY2022.
-----

NBN rollout to be finished in weeks

May 14, 2020 – 10.55am
NBN Co boss Stephen Rue says the national broadband network is weeks away from completion, but third quarter results reveal revenue remains stubbornly short of the necessary target.
By the end of March, 11.2 million residences were ready to connect, just 300,000 short of the 11.5 million number that NBN Co considers will mark the completion of the initial roll out of the network. Mr Rue said that number would be hit before the end of June.
That figure excludes around 100,000 difficult-to-access premises, and does not include properties in the process of being built. But it means the network, which was conceived more than 10 years ago, is now available to nearly every home in Australia.
That does not mean most Australians are now using the NBN. Of the more than 11 million homes that can access the NBN, just 7 million of those have been activated.
-----
Tuesday, 12 May 2020 12:35

Government invests $37.1 million to strengthen telecoms 'emergency resilience’ post-bushfires

Telecommunications resilience in bushfire and disaster prone areas to ensure communities can stay connected during emergencies has been strengthened by a $37.1 million investment from the Australian Government.
The $37.1 million package includes funding to improve the resilience of regional and remote mobile phone base stations to keep them operating for longer during bushfires.
Of the $18 million for the base station program, $10 million from the Mobile Black Spot Program, will be spent on upgrades to the base stations.
The main cause of base station outages in the 2019-20 bushfires was loss of mains power, and the Government says the money will fund longer lasting backup power sources, such as batteries and diesel generators for base stations built under Rounds 1 and 2 of the Mobile Black Spot Program - with a new competitive grants process to fund up to 50% of the capital cost of upgrades to other mobile base stations.
-----

Upgrades on the cards as NBN Co secures extra $4 billion from banks

By Fergus Hunter
May 12, 2020 — 12.02am
NBN Co has given itself the option of bringing forward major network upgrades to improve internet speeds and connectivity after securing an extra $4.1 billion in private financing.
The government-owned company expects the rollout of the National Broadband Network will be completed within the existing $51 billion funding envelope but now has the capacity to invest in upgrades after a "very positive" response from lenders.
NBN Co secured a total $6.1 billion in debt finance from banks, $2 billion of which falls within the current $51 billion rollout budget. The government said the company's decision to secure an additional $4.1 billion was sensible and gave it flexibility.
Communications Minister Paul Fletcher said the financing would "provide the company opportunities to invest and create even more value for Australians guided by future corporate plans".
Of the $4.1 billion, $2.6 billion will be available for "strategic investments with a positive return beyond the initial rollout phase and repayment of the commonwealth loan" subject to ministerial approval, according to the government. That could include bringing forward potential network upgrades.
-----

NBN borrows $6b in surprise debt spree

May 12, 2020 – 12.01am
NBN Co has raised $6.1 billion in debt facilities in its first foray into private capital markets, three times the amount the government-owned telco initially flagged it would borrow.
But NBN Co and the government insisted the higher-than-expected figure did not reflect a cost blow-out, saying there had been no change to the projected $51 billion cost of building the national broadband network.
The first $2 billion of the raising will help fund the final stages of the national broadband network roll out, which is due to be completed by the end of June. A spokesman said the remaining $4.1 billion could be used for future investment or for debt refinancing.
-----

NBN Co sources $6.1 billion from banks

By Ry Crozier on May 12, 2020 7:45AM

Bolsters working capital, upgrades possible.

NBN Co has secured access to a total of $6.1 billion from Australian and international banks, well above the $2 billion it had initially sought.
Finance Minister Mathias Cormann said the credit facilities “demonstrated … strong support in the market for the NBN business plan and outlook.”
He said the additional $4.1 billion - on top of the initial $2 billion NBN Co said it would need back in mid-2018 - had been secured “at very competitive prices" and via "arrangements with a number of Australian and international banks".
“There is no requirement for NBN Co to draw down on these additional facilities immediately, but the Government agrees with the company that it makes sense to have these facilities in place, to give it flexibility and given current economic conditions,” Cormann said in a statement.
-----
Enjoy!
David.

Sunday, May 17, 2020

There Is More To Providing Care Via Telehealth Than Might First Seem. It Is Vital That Standards Are Maintained!


This appeared last week:

Doctor–patient communication and relationship in telehealth

Authored by
Sabe Sabeson
Danny Tucker
TELEHEALTH involves the provision of health care using technology such as videoconferencing and telephones. It has traditionally been used by clinicians to improve access to care for regional and rural communities and vulnerable populations. As part of measures to control the spread of coronavirus disease 2019 (COVID-19), telehealth has rapidly gained acceptance as a routine model for providing care at home, even for metropolitan patients. Professionals adopting this mode of communication include GPs, specialists and other health care providers. This model has proven useful for regular consultations and supervision of oral and intravenous therapies. Acknowledging some limitations, safe provision of care using telehealth is possible, but some elements still require face to face interaction.
The approach to telehealth is well established and many organisations have developed guidelines. Typically, a distant clinician provides a service to patients, and other health professionals, such as pharmacists, nurses and pathologists, provide support for documentation, prescribing, ordering of investigations and performing physical examinations. In most outreach settings, the patient is known to a small number of visiting clinicians.
However, the role of telehealth has been extended in the recent months due to the COVID-19 pandemic and doctors may have to alter their approaches to doctor–patient communication in telehealth by factoring in additional considerations as listed below:
  1. Clinicians may have to rely on family members as support persons for the patient. Attending family members who don’t reside in the same house may need to consider physical distancing policies. Other members may be encouraged to join a consultation via videoconferencing.
  2. Medication prescriptions and investigations may have to be organised by the providing clinicians themselves.
  3. It is important to consider converting to telephone consultation if internet congestion interrupts video calls.
  4. End-of-life discussions and breaking bad news – conversations that are usually undertaken face to face – may need to occur via telehealth. Current frameworks for end-of-life and breaking bad news discussion apply to telehealth, with attention to technical considerations.
  5. Consultations may take place by specialists, GPs and junior medical officers who are not familiar with the patient. Confirmation of patient identity must occur.
  6. Working from home and dialing into homes may require mechanisms for maintaining the privacy of both doctor and patients.
Doctor–patient communication in telehealth
Doctor–patient communication is an essential aspect of any therapeutic relationship between a patient and their doctor. It is influenced by many factors, including personality and communication style of both patient and doctor, the physical environment and patient education level. Only 7% of emotional communication occurs through the content of speech, whereas 22% depends on the tone of voice and 55% by posture, gaze and eye contact. In addition to technological considerations, the dynamics of doctor–patient communication and relationship may be different in a telehealth consultation. Although the parties are not in the same room, other clinicians and multiple family members may be present as support persons or facilitators. This approach allows families and other clinicians to adopt the role of addressing perceived gaps in communication.
Many studies have shown that patients can experience effective and satisfactory doctor–patient communication through technology-based consultations and that patients can establish a close relationship with clinicians regardless of ethnic and cultural backgrounds (here, here, here, here, here and here).
By synthesising the literature and guidelines and using personal experience of setting up and running telehealth models across a large geographic area for many years, we have identified the following advice to enable clinicians to offer a quality service via telehealth:
Mindset
Patients and their support people are struggling with both their current diagnosis and fear about the pandemic. Therefore, traditional frameworks for doctor–patient communication and relationship-building used in face to face interaction are still necessary for telehealth consultations, including aspects of compassion and empathy.
Technological aspects
Ensuring that audio and video qualities are acceptable and that you can hear and see each other clearly and that head and shoulders are in the middle of the screen and the camera is at eye level.
Maintaining privacy
Privacy considerations include ensuring that the health professional’s family members do not see patient-sensitive material. A secure computer in a closed environment is required.
Surroundings
A quiet location avoiding interruptions or noise at both patient’s and provider’s end is essential for an efficient telehealth consultation, especially for health professionals working from home. Some videoconferencing platforms allow blur or replacement of the background.
Confirming identity
Until now, most of the telehealth consultations were provided by clinicians well known to the patient. In the current situation, many doctors, including less experienced medical officers, who may not be familiar with the patient, need to provide consultations. The confirmation of the patient’s identity needs to take place before commencing.
Establishing rapport, relationship and trust
  1. Introduce yourself to the patient and their family members, and establish eye contact by keeping the eyes at the level of the camera.
  2. Spend some time initially discussing non-medical matters such as family, how they are coping with the current COVID-19 situation, fears and concerns.
Transfer of information
  1. Speak slowly and use non-technical language.
  2. Use visual aids to explain the situation. This may include online whiteboards, writing on paper and sharing of screens to show medical imaging and pathology where appropriate.
  3. Summarise the consultation and check that they have understood the information. Where possible, consider sending a copy of the consultation summary to the patient as well as the GP.
  4. Before completing the consultation, provide opportunities to the patient and family members for addressing current and future concerns by encouraging questions and offering contact details.
  5. Highlight the importance of vaccinations, hygiene and physical distancing measures for the patient and family members.
Breaking bad news and communicating prognosis and end-of-life issues using telehealth
Traditionally, clinicians ensure end-of-life discussions and breaking bad news conversations are performed through face to face interactions. With physical distancing measures and the need to reduce unnecessary travel, this aspect of health care may now need to occur through telehealth. There are many frameworks available for breaking bad news and end-of-life discussions which are applicable in a telehealth setting.
There is more here with some helpful acronyms to assist in quality delivery of care.
There are also 2 excellent webinar recording from the Digital Health CRC relating to telehealth deployment in the COVID-19 era.
They can be accessed from this link:
To me the key point here is that if a practitioner is planning to offer these services will find their path greatly eased and really re-assured if these resources are carefully reviewed!
David.

AusHealthIT Poll Number 527 – Results – 17th May, 2020.

Here are the results of the poll.

Are The Digital Health Deployments In Response To The COVID-19 Health Emergency Going To Lead To A Permanent Increase In Adoption And Use Of These Services (Telehealth, Remote Monitoring etc.) Into The Future?

Yes 76% (67)

No 23% (20)

I Have No Idea 1% (1)

Total votes: 88

It seems that a large majority feel COVID-19 will cause permanent changes in the way things are done using Digital Health.

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

A very low number of votes for some reason.

It must also have been a very easy question with 1/88 readers were not sure how to respond.

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

David.