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."

Saturday, July 03, 2021

Weekly Overseas Health IT Links – 03 July, 2021.

Here are a few I came across last week.

Note: Each link is followed by a title and 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.

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https://healthitanalytics.com/news/mass-general-hits-health-equality-via-demographic-data-collection

Mass General Hits Health Equality via Demographic Data Collection

Mass General Brigham announces a campaign to collect demographic data in order to create equitable care for all.

By Erin McNemar, MPA

June 25, 2021 - Mass General Brigham has announced the launch of a campaign to collect more accurate and complete demographic data from the hospital’s more than one million adult primary care patients. This demographic data will consist of information such as ethnicity, age, and medical history.

With the provided information, medical professionals will use it in determining a patient’s vulnerability to certain illnesses and which treatments will be most effective for them. The goal of this campaign is to improve access to healthcare programs and services and provide more equitable care for everyone.

The hospital’s current data for patient's race/ethnicity/language has about a 20 percent rate of missing data depending on the location. Mass General Brigham’s new goal is to have a less than 5 percent rate of missing data across the primary care population.

“There are very clear inequities between patients based on their race, ethnicity and whether English is their primary language,” said Allison Bryant, MD MPH, Senior Medical Director for Health Equity at Mass General Brigham in a press release. “Without quality data, our decision-making falls flat about how we equitably distribute programs and services.”

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https://www.digitalhealth.net/2021/06/hancock-data-strategy/

Hancock: How the data strategy will improve care and fuel innovation

In an exclusive blog for Digital Health, the Secretary of State for Health and Care Matt Hancock outlines how the draft data strategy will help improve care, fuel innovation and save lives.

DHI News Team – 22 June, 2021

In our fight against coronavirus, one of the most powerful tools we possessed was the power of data.

Data helped us to identify the people most vulnerable to coronavirus and ask them to shield, allowed new care pathways like virtual wards, and powered vital research that helped us discover new treatments for Covid that have saved over a million lives so far around the world.

This pandemic has shown once and for all that data saves lives. So just as we recognise the hardship and devastation that this virus has brought, we must also recognise the phenomenal progress we’ve seen in the use of data.

This crisis has led to one of the greatest transformations to how we live and work in peacetime, and it’s the smart use of data has made that possible. We must raise our sights, and go further, learning lessons from the crisis

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https://www.digitalhealth.net/2021/06/patients-to-get-easier-access-to-medical-data-through-nhs-app/

Data Strategy: Patients to get easier access to medical data through NHS App

Patients are set to get easier access to their medication lists and care plans through the NHS App under the government’s new data strategy.

Andrea Downey = 22 June 2021

New requirements for data sharing across the entire health and care system are also set to come into place, with new legislation to be introduced to require all adult social care providers to provide information about the services they fund.

Published today (June 22), the NHSX draft strategy ‘Data Saves Lives: Reshaping health and social care with data’, aims to capitalise on the work undertaken using data during the pandemic to improve health and care services.

In a bid to establish openness, the government committed to publishing the first transparency statement setting out how health and care data has been used across the sector by 2022.

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https://khn.org/news/article/calming-computer-jitters-help-for-seniors-who-arent-tech-savvy/

Calming Computer Jitters: Help for Seniors Who Aren’t Tech-Savvy

By Judith Graham June 24, 2021

Six months ago, Cindy Sanders, 68, bought a computer so she could learn how to email and have Zoom chats with her great-grandchildren.

It’s still sitting in a box, unopened.

“I didn’t know how to set it up or how to get help,” said Sanders, who lives in Philadelphia and has been extremely careful during the coronavirus pandemic.

Like Sanders, millions of older adults are newly motivated to get online and participate in digital offerings after being shut inside, hoping to avoid the virus, for more than a year. But many need assistance and aren’t sure where to get it.

A recent survey from AARP, conducted in September and October, highlights the quandary. It found that older adults boosted technology purchases during the pandemic but more than half (54%) said they needed a better grasp of the devices they’d acquired. Nearly 4 in 10 people (37%) admitted they weren’t confident about using these technologies.

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https://www.healthcarefinancenews.com/news/technology-both-burden-and-benefit-physicians

Jun 23 2021

Workflow can determine whether technology is a burden or benefit to physicians

Knowing how doctors work, seeing "how their brains worked" helped inform new app.

Susan Morse, Managing Editor

Technology is a known benefit and burden for physicians.

So when Ludi, Inc. CEO and founder Gail Peace introduced a new software designed to help physicians log their time, she went to their offices to observe how they used the new technology and how it fit into their workflow.

The idea is for physicians to log their time daily, for no more than 15 minutes a month being spent on the DocTime Log.

None of the physicians clicked on a button asking for more detail. One physician kept pressing submit when once was enough. 

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https://www.ama-assn.org/delivering-care/health-equity/feds-warned-algorithms-can-introduce-bias-clinical-decisions

Feds warned that algorithms can introduce bias to clinical decisions

Clinical algorithms can help guide clinical decision-making, but—if not developed accurately—they also carry the potential to introduce bias and racism that can threaten health and perpetuate inequities already experienced by historically marginalized communities.

AMA Equity Plan 2021-2023

Embedding equity into medicine requires planning and honesty. To meet this moment, the AMA has developed a plan to advance racial and social justice.

Read the Strategy

At the request of Congress, the U.S. Agency for Healthcare Research and Quality (AHRQ) is examining how clinical algorithms may introduce bias into clinical decision-making and the AMA provided information to aid the effort.

AHRQ, an agency of the Department of Health and Human Services, issued a request for information on how algorithms can introduce bias and subsequently “influence access to care, quality of care, or health outcomes for racial and ethnic minorities and people who are socioeconomically disadvantaged.”

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https://www.healthcareittoday.com/2021/06/25/key-insights-and-takeaways-from-the-himss-state-of-healthcare-event/

Key Insights and Takeaways from the HIMSS State of Healthcare Event

June 25, 2021

Brittany Quemby

Last week HIMSS presented their State of Healthcare digital event that presented new data-driven market intelligence to the healthcare ecosystem. The data was fueled by survey insights gathered through the HIMSS Trust—a consortium of leaders across the healthcare and technology space. They presented trends and challenges from four key perspectives:

  • Health Systems
  • Patients
  • Clinicians
  • Payers

In case you missed the live event, below are just some of the insights and takeaways shared during the session.

Start Measuring Digital Health Progress Now!

When it comes to Digital Health, if you’re not measuring your progress..YOU ARE BEHIND! Respondents were asked “How are digital health initiatives currently tracked and monitored?” Findings show that 60% are measuring/tracking digital health program performance whether it be from a system-level dashboard that tracks all initiatives or from a regular/quarterly prorgess updates. 

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https://healthitanalytics.com/news/data-questions-sepsis-prediction-models-predictive-analytics

Data Questions Sepsis Prediction Models, Predictive Analytics 

Researchers at Michigan Medicine suggest that Epic’s sepsis prediction model is less accurate than previously claimed.

By Erin McNemar, MPA

June 24, 2021 - In a recent evaluation of Epic Systems’ sepsis prediction model, scientists suggest that the model identifies those at risk of sepsis just 63 percent of the time. This is much lower than the model’s information sheet claims at between 76 and 83 percent, the researchers said.

This comes as 56 percent of hospitals and health systems in the United States use Epic Systems.

Sepsis presents itself as a challenging issue in healthcare. According to the Centers for Disease Control and Prevention (CDC), one and three patients who die in the hospital have sepsis, but is difficult to predict which patients are at risk of developing the condition.

“Sepsis is something we can know occurs with certainty after the fact, but when it’s unfolding, it’s often unclear whether a patient has sepsis or not,” Karandeep Singh, MD, MMSc, assistant professor of Learning Health Sciences and Internal Medicine at Michigan Medicine, said in a report. “But the cornerstone of sepsis treatment is timely recognition and timely therapy.”

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https://www.beckershospitalreview.com/healthcare-information-technology/physician-viewpoint-monetizing-ehrs-with-open-data-puts-patients-at-risk.html

Physician viewpoint: Monetizing EHRs with open data puts patients at risk

Hannah Mitchell – 24 June, 2021

The most valuable thing inside a hospital's walls may not be its care services or expensive equipment; it might be the troves of patient data stored on EHRs, according to a June 5 article published in the New England Journal of Medicine.

Hospitals are increasingly selling troves of deidentified medical data. Rochester, Minn.-based Mayo Clinic is using its patient data to create an artificial intelligence factory with Google. Nashville, Tenn.-based HCA Healthcare and Google inked a multiyear collaboration to build a health data analytics platform to support its operational workflows. Fourteen health systems partnered to create a firm that aggregates and sells deidentified data and gives more insight on medical conditions such as rare diseases and COVID-19.

The article's authors are researchers from Boston Children's Hospital, Boston-based Harvard Medical School and Durham, N.C.-based Duke University Medical Center.

Five things to know:

  1. HIPAA allows covered healthcare providers, payers and clearinghouses to use patient data freely once it has been deidentified. These policies enable a multibillion-dollar industry of companies who aggregate patient data for profit. Even as patients and physicians navigate difficulties obtaining medical record details in a timely fashion, hoards of unregulated patient data are passing through hospital networks and into the hands of tech companies, the article noted.
  2. Open data can help drive better treatment decisions, yet where the data goes after this might not serve the public. In one example, a data aggregation firm may use the data to target patients for pharmaceutical detailing and encourage physicians to push their products, which can increase drug costs and the overprescription of medicine.

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https://www.healthcareittoday.com/2021/06/24/top-it-priorities-according-to-healthcare-leaders/

Top IT Priorities According to Healthcare Leaders

June 24, 2021

John Lynn

As healthcare leaders, you have the hard job of knowing what to prioritize in your organization.  Every leader is inundated with ideas, projects, and new technology that could help their organization better care for patients.  Sorting through all of these can be a challenge.

What makes this challenge even harder is all the latest buzzwords that keep cropping up and distract our focus.  Being able to know when a buzzword is worthy of your attention is the sign of a great leader.  That often means focusing on the less sexy parts of healthcare IT while you allow the cutting edge technology to mature.

In a survey sponsored by Halo Health, we asked healthcare leaders to identify their most important health IT priorities.  Here’s a summary of what more than 140 healthcare leaders shared:

The top two priorities will likely come as no surprise to anyone in health IT.  Given the number of security incidents and ransomware cases, I’d be upset if data security wasn’t the top priority for a healthcare organization.  Between moving to value based care and the 21st Century Cures Act, interoperability is also on every healthcare organization’s mind.

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https://www.healthleadersmedia.com/innovation/athenahealth-exec-healthcare-tech-will-build-telehealth-remote-care

athenahealth Exec: Healthcare Tech Will Build on Telehealth, Remote Care

Analysis  |  By Jack O'Brien  |   June 23, 2021

Paul Brient, Chief Product Officer at the Watertown, Massachusetts-based electronic health records vendor, underscores the goals of working with Apple and promoting healthcare innovation.

Earlier this month, athenahealth announced that it would support a new iOS15 feature that would allow patients to share their Apple Health data with their providers.

The company stated that the move was made as part of an effort to "enable bringing external insights and innovations to the point of care" while also leveraging athenahealth's FHIR Launch and App Tab experience so that providers "can view their patients' shared data within their native athenaClinicals workflows via an Apple-provided app."

HL: Can you give a high-level overview of the Apple Health news for our audience of healthcare executives and how athenahealth is supporting this? 

Brient: Recently, Apple announced that they are working with several HIT partners, including athenahealth, on an upcoming feature that will enable patients to securely share data from the Apple Health app – including data from certain health records categories like lab test results and immunizations, as well as health information, such as exercise minutes, heart rate, or hours of sleep, from iPhone, Apple Watch and third-party connected devices — directly with their providers. We’re excited to offer this option to empower the patient as a critical part of the care team with control of their data.  

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https://www.theverge.com/2021/6/23/22547397/medical-records-health-data-hospitals-research

Hospitals are selling treasure troves of medical data — what could go wrong?

They don’t need patient consent to use de-identified data

By Nicole Wetsman Jun 23, 2021, 2:22pm EDT

Healthcare organizations and hospitals in the United States all sit on treasure troves: a stockpile of patient health data stored as electronic medical records. Those files show what people are sick with, how they were treated, and what happened next. Taken together, they’re hugely valuable resources for medical discovery.

Because of certain provisions of the Health Insurance Portability and Accountability Act (HIPAA), healthcare organizations are able to put that treasure trove to work. As long as they de-identify the records — removing information like patient names, locations, and phone numbers — they can give or sell the data to partners for research. They don’t need to get consent from patients to do it or even tell them about it.

More and more healthcare groups are taking advantage of those partnerships. The Mayo Clinic in Rochester, Minnesota, is working with startups to develop algorithms to diagnose and manage conditions based on health data. Fourteen US health systems formed a company to aggregate and sell de-identified data earlier this year. The healthcare company HCA announced a new data deal with Google in May.

There may be benefits to sharing this data — researchers can learn what types of treatments are best for people with certain medical conditions and develop tools to improve care. But there are risks to free-flowing data, says Eric Perakslis, chief science and digital officer at the Duke Clinical Research Institute. He outlined the ways the system could potentially harm patients in a recent New England Journal of Medicine article with Kenneth Mandl, director of the computational health informatics program at Boston Children’s Hospital.

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https://ehrintelligence.com/news/primary-care-workforce-burnout-goes-beyond-ehr-use-to-leadership-style

Primary Care Workforce Burnout Goes Beyond EHR Use to Leadership Style

While EHR use has often been attributed to workforce burnout, organizational leadership and culture plays a large role in workforce satisfaction.

By Hannah Nelson

June 23, 2021 - A new Health Affairs study found that burnout was not associated with EHR satisfaction or the number of patients seen per clinician. Instead, researchers found that facilitative leadership centered on building relationships, enhancing communication, ensuring psychological safety, and promoting teamwork, is linked with low rates of workforce burnout.

Facilitative leadership strays from traditional hierarchal structures, allowing for practices to foster emerging leadership skills among all practice members, the study authors explained.

The findings are based on a survey of 715 small-to-medium primary care practices.

“Survey respondents who felt a greater sense of support and job control could balance known stressors – including high volume of patients – and showed lower rates of overall burnout,” Samuel T. Edwards, MD, MPH, assistant professor of medicine at the OHSU School of Medicine and the study’s lead author, said in a press release.  

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https://healthitanalytics.com/news/epic-systems-pulls-ahead-for-population-health-management-vendors

Epic Systems Pulls Ahead for Population Health Management Vendors

Arcadia, Epic, and Innovaccer receive recognition as most-well rounded leaders in population health management.

By Erin McNemar, MPA

June 23, 2021 -  In a report by KLAS Research evaluating 15 different vendors, Arcadia, Epic, and Innovaccer are highlighted as the most-well rounded leaders in population health management to date.

As provider organizations search to advance their value-based care strategies, they are turning to population health management technology to give them the confidence to move towards value-based care.

The KLAS report provides insight into the major population health management technology that is currently offered. This includes the types of organizations that use population health management systems, highlighting what the customer experience is like, which solutions are seeing the most market energy and the breadth of their population health management capabilities, all areas that Arcadia, Epic, and Innovaccer excelled in.

While Arcadia, Epic, and Innovaccer shined in the overall excellence category, other vendors were showcased in the report as well. For Customer Success, KLAS rated vendors Innovaccer, Azara Healthcare, Cedar Gate Technologies (Enli), and HealthEC with high marks.

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https://healthitanalytics.com/news/4-strategies-for-addressing-avoiding-ai-algorithmic-bias-in-healthcare

4 Strategies for Addressing, Avoiding AI Algorithmic Bias in Healthcare

The Center of Applied AI at Chicago Booth’s playbook recommends assessing risk for AI algorithmic bias and continuously monitoring.

By Erin McNemar, MPA

June 23, 2021 - AI algorithmic bias is everywhere, according to the Center for Applied AI at Chicago Booth in their recently released playbook. Through working with dozens of organizations such as healthcare providers, insurers, technology companies, and regulators, the center states that algorithmic bias is found all throughout the healthcare industry. These biases influence clinical care, operational workflows, and policy.

These algorithms are put in place to help decision makers determine who needs resources. The idea is if two people are scored the same using the algorithm, then they will have the same basic needs. This method is supposed to assist in making a more equitable and efficient method of care. According to the Center for Applied AI at Chicago Booth, the color of an individual’s skin or other sensitive attributes should not matter when determining need, and algorithms that fail this test are biased.

There are reasons behind the algorithmic bias. The first reason could be that an organization tried to hit the correct target but excludes those that are underserved in the population. This could be due to researchers being trained or evaluated in non-diverse populations.

Algorithms may also aim at the wrong target altogether.

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https://mhealthintelligence.com/news/telehealth-yields-similar-outcomes-as-in-person-hiv-treatment

Telehealth Yields Similar Outcomes as In-Person HIV Treatment

A new study finds that treating HIV with telehealth produces similar health outcomes as face-to-face treatment, presenting a potential solution for individuals in rural areas who have difficulty accessing care.

By Victoria Bailey

June 23, 2021 - The use of telehealth in HIV treatment for patients living in rural Georgia showed comparable results to in-person care, according to a study published in Open Forum Infectious Diseases. 

More than one million people above the age of 13 in the United States live with HIV. Many go for extended periods of time without treatment due to care disparities that hinder access to care, such as a lack of transportation or a lack of specialists in the area. In rural areas, those disparities are more pronounced, with patients often driving several hours to the nearest clinic or practice to receive treatment.

To test the value of a connected health platform in a rural area like Georgia, a research team from Augusta University and Massachusetts General Hospital looked at 185 individuals from the Dublin Department of Health HIV clinic database who used telehealth and compared their health outcomes with 200 individuals from the August University HIV clinic patient database who received traditional face-to-face treatment. The telemedicine participants received their treatment via two-way video conferencing with an infectious diseases physician.

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https://patientengagementhit.com/news/income-education-social-issues-leading-sdoh-limiting-care-access

Income, Education, Social Issues Leading SDOH Limiting Care Access

Researchers said understanding leading SDOH affecting care access and screening among high-risk populations can influence policy and organization-level interventions.

By Sara Heath

June 23, 2021 - New research out of NewYork-Presbyterian and Weill Cornell Medicine revealed that economic factors like income, educational attainment, and social issues like social stigma and discrimination are the leading social determinants of health limiting care access for patients.

The data, published in the journal Ethnicity and Disease, aims to inform public policy and help healthcare providers better understand the social determinants of health affecting patients. In doing so, the researchers said providers can cater their treatment plans to account for SDOH, according to Erica Phillips, MD, an associate attending physician at NewYork-Presbyterian/Weill Cornell Medical Center.

“Everyone across the country is grappling with how to address social determinants of health,” Phillips, who is also associate director of community outreach and engagement at the Sandra and Edward Meyer Cancer Center at Weill Cornell Medicine, said in a public statement. “Our study shows how we might disentangle and act on the drivers of health inequities.”

The researchers looked at populations in Brooklyn, the area of New York City with the highest rate of cancer compared to other areas served by the organization. The team utilized hospital admissions and other publicly available data to pinpoint the four neighborhoods in Brooklyn— Crown Heights, Bedford-Stuyvesant, Coney Island, and Flatbush—most affected by breast, cervix, colon, lung, and prostate cancers.

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https://www.beckershospitalreview.com/ehrs/onc-releases-framework-for-advancing-social-determinants-of-health-for-data-use-interoperability.html

ONC releases framework for advancing social determinants of health for data use, interoperability

Hannah Mitchell – 23 January 2021

The Office of the National Coordinator is prioritizing addressing inequalities that have been long driven by poverty and racism. Through documenting, reporting, accessing and using social determinants of health, the ONC expects to help eliminate health disparities and improve health outcomes at an individual and nationwide level.

The ONC is releasing a framework to launch these initiatives nationwide, according to a June 17 news release.

Here are four areas the ONC said health IT can assist in achieving these goals:

  1. Creating standards with data: Guiding the development and adoption of health IT data standards.
  2. Updating infrastructure: Supporting governments as they update their infrastructure to support social determinants of health data.

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https://www.fiercehealthcare.com/digital-health/to-debunk-covid-19-vaccine-myths-health-officials-should-turn-to-same-source-spreads

To debunk COVID-19 vaccine myths, health officials should turn to the same source that spreads them—social media

by Heather Landi 

Jun 23, 2021 10:39am

Among the many COVID-19 vaccine myths circulating on social media, one of the more persistent false rumors is that the vaccine causes infertility, according to leading doctors.

Rumors about vaccines impacting fertility have been rampant and difficult to overcome, Susan Bailey, M.D., immediate past president of the American Medical Association, told lawmakers on the Senate Health, Education, Labor and Pensions Committee.

Doctors play a critical role as vaccination ambassadors, Bailey testified Tuesday during a hearing to address vaccine hesitancy.

"Physicians need to be part empathetic counselors, part research scientists and part myth busters," she said.

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https://www.healthleadersmedia.com/technology/onc-coordinators-share-lessons-learned-including-listening-more

ONC Coordinators Share Lessons Learned, Including Listening More

Analysis  |  By Scott Mace  |   June 23, 2021

Incentives remain unaligned with the use of health IT, but 21st Century Cures Act implementation is one tool in ONC's arsenal.


KEY TAKEAWAYS

·         Ultimate EHR success still requires better ties to payment models and focus on passing functional tests.

·         Telehealth holds promise for increasing competition to consumers' benefit, panelists say.

·         Former ONC chiefs recommend listening, current chief Micky Tripathi says ONC says every comment is taken very seriously.

·         FHIR-based vaccination scheduling at the state level was a bright spot for interoperability during the pandemic, ONC chief says.

Lock-in of all sorts, ranging from the geographic lock-in of hospital consolidation to the vendor lock-in of electronic health records, was on the minds of former national coordinators of health IT during a panel last week at the virtual CHIME21 Summer Forum.

"I see telehealth as the next positive disrupter for improving care," said Rob Kolodner, MD, vice president and chief medical officer of ViTel Net, who served as national coordinator from 2007 to 2009 under former President George W. Bush.

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https://www.zdnet.com/article/microsoft-has-big-plans-for-healthcare-and-its-taking-a-different-path-to-the-rest-of-big-tech/

Microsoft has big plans for healthcare, and it's taking a different path to the rest of big tech

Common data models, a cloud just for this vertical and IoT for monitoring patients: Microsoft is taking on healthcare once again.

By Jo Best | June 21, 2021 -- 10:05 GMT (20:05 AEST) | Topic: Cloud

Healthcare seems to be top of the to-do lists of CEOs of tech's biggest companies: Amazon is launching its own healthcare business, Apple's turning the iPhone into a patient engagement and diagnostics tool, while Google's parent company Alphabet is betting heavily on healthcare through its investment arm, AI and analytics

And the other big tech giant isn't getting left behind either: Microsoft has also got big plans. It's been looking at healthcare in the hope that technology could play a role in helping to address some of the health industry's most pressing problems. 

"Some of the longest-standing challenges are around disconnectedness of data, disconnectedness of care teams, and frankly disconnectedness of patients to their own care," says Tom McGuinness, corporate VP of global healthcare & life sciences at Microsoft. 

Complaints about different parts of the healthcare world not being joined up – a separation between health and social care, or between primary care and hospital medicine and so on – isn't new. But the pandemic has intensified another emerging disconnect: between virtual care and face-to-face care. 

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https://medcitynews.com/2021/06/researchers-flag-privacy-risks-with-de-identified-health-data/

Researchers flag privacy risks with de-identified health data

Hospitals and other covered entities are striking a growing number of agreements to use de-identified patient data for research or to develop AI tools. But they should carefully weigh the risks of sharing this data, experts said. 

By Elise Reuter

Post a comment / Jun 17, 2021 at 1:57 PM

A growing number of hospitals are banding together with tech companies to create analytics businesses, or develop predictive algorithms.

These efforts are fueled by de-identified data, which gives hospitals and other covered entities the ability to share patient data without specifically asking for their consent. Patients’ names, addresses, and other potentially identifying information are removed from these datasets, which can then be shared freely under current regulations.

Even if the privacy risks to patients in sharing de-identified data might seem minute or distant, hospitals should carefully consider them when they strike data-sharing agreements, researchers wrote in an article recently published in the New England Journal of Medicine. They advocated for specific protections for patients, including seeking patients’ consent, stepping up security measures for de-identified data, and additional legislation that would protect patients in the event of a breach.

“I think the challenge in medicine is everything is benefit-risk. It’s really easy for people to imagine the benefits, and really difficult to imagine the risks,” said Eric Perakslis, chief science and digital officer at the Duke Clinical Research Institute, and co-author of the article. “Precisely what benefit is being returned to the patients from the centers that are selling their data? If the benefit is 0, then there needs to be 0 risk.”

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https://www.statnews.com/2021/06/21/algorithm-bias-playbook-hospitals/

‘Nobody is catching it’: Algorithms used in health care nationwide are rife with bias

By Casey Ross June 21, 2021

The algorithms carry out an array of crucial tasks: helping emergency rooms nationwide triage patients,  predicting who will develop diabetes, and flagging patients who need more help to manage their medical conditions.

But instead of making health care delivery more objective and precise, a new report finds, these algorithms — some of which have been in use for many years — are often making it more biased along racial and economic lines.

Researchers at the University of Chicago found that pervasive algorithmic bias is infecting countless daily decisions about how patients are treated by hospitals, insurers, and other businesses. Their report points to a gaping hole in oversight that is allowing deeply flawed products to seep into care with little or no vetting, in some cases perpetuating inequitable treatment for more than a decade before being discovered.

“I don’t know how bad this is yet, but I think we’re going to keep uncovering a bunch of cases where algorithms are biased and possibly doing harm,” said Heather Mattie, a professor of biostatistics and data science at Harvard University who was not involved in the research. She said the report points out a clear double standard in medicine: While health care institutions carefully scrutinize clinical trials, no such process is in place to test algorithms commonly used to guide care for millions of people.

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https://www.healthcareitnews.com/news/research-suggests-epic-sepsis-model-lacking-predictive-power

Research suggests Epic Sepsis Model is lacking in predictive power

A retrospective study in JAMA Internal Medicine finds that the model did not identify two-thirds of sepsis patients and frequently issued false alarms.

By Kat Jercich

June 22, 2021 12:44 PM

A new study in JAMA Internal Medicine found that a sepsis prediction model included as part of Epic's electronic health record may poorly predict sepsis.

Using retrospective data, University of Michigan Medical School researchers found that the predictor did not identify two-thirds of sepsis patients.  

"In this external validation study, we found the ESM to have poor discrimination and calibration in predicting the onset of sepsis at the hospitalization level," UM researchers wrote.   

Epic disputed the study's findings, saying that the authors used a hypothetical approach that did not take into account the analysis and required tuning that needs to occur prior to real-world deployment to get optimal results.  

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https://www.healthcareitnews.com/news/digital-health-tools-can-help-covid-19-vaccine-hesitancy

Digital health tools can help with COVID-19 vaccine hesitancy

Addressing the concerns of those reluctant to get vaccinated requires a thoughtful, complex strategy. Technology can help, but not by itself.

By Kat Jercich

June 22, 2021 09:13 AM

As the pace of COVID-19 vaccination has slowed, the priorities of decision-makers have begun to turn from managing a deluge of interest toward reaching out to those who may be reluctant to get inoculated.  

There is a range of reasons for such hesitancy, including distrust of a medical system that has historically failed vulnerable communities, especially people of color; concerns about cost or long-term effects; a lack of awareness of eligibility; and continued blocks to access.

"The increased attention and momentum surrounding the COVID-19 vaccination campaign provides opportunities to address the culture of vaccination and growing vaccine hesitancy through education and positive patient-provider encounters," said Poonam Bal, director of quality innovation at the National Quality Forum.  

Responding to such vaccine hesitancy requires a complex, thoughtful strategy. The solution will not be one-size-fits all. But some innovators and experts say health IT can play a key role in the process.  

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https://www.healthcareitnews.com/news/regenstrief-study-shows-ehrs-underperforming-primary-care

Regenstrief study shows EHRs underperforming for primary care

Electronic health records are overloading outpatient docs with info in "disparate files and folders rather than presenting comprehensive, actionable data in a context that gives meaning," say researchers in a VA-funded study.

By Mike Miliard

June 22, 2021 09:34 AM

A primary care physician may care for 2,500 or more patients in a given year, and many of their patient encounters may last only 20 minutes – much of which is often spent at a computer with a back turned to the patient.

It's become a truism by now that electronic health records are often viewed askance by primary care docs, many of whom see them as detrimental to the patient encounter. But a new report from U.S. Department of Veterans Affairs, Regenstrief Institute and Indiana University details just how outpatient EHRs are often failing the physicians who use them.

WHY IT MATTERS
The new study, Electronic Health Records' Support for Primary Care Physicians' Situation Awareness, contends that EHRs "are not rising to the challenges faced by primary care physicians because EHRs have not been designed or tailored to their specific needs," according to researchers.

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https://www.healthcareittoday.com/2021/06/22/security-exceptionalism-toxic-positivity-and-healthcare-information-security/

Security Exceptionalism, Toxic Positivity, and Healthcare Information Security

June 22, 2021

Mitch Parker, CISO

Why we need to adopt strong C-level leadership to stop the tide of exceptionalism and toxic positivity that defines organizational approaches to information security.

IN THE BEGINNING

Many organizations consider technology to be subservient to the rest of the business.  It is considered a cost center, not a valuable resource.  It gets funded last, often after the flowers and coffee.  This means that the business will make any excuse to not spend money on technology because it takes away from revenue.  Years of education in business schools of our current C-suites to minimize “overhead” expenses and focus on core business functions have left IT in an actionable position.  Nothing can go wrong because it will be seen as an excuse to further marginalize the organization and cut funding.  IT Leadership becomes risk averse, often focusing on “solutions” that promise the world and deliver little, because that is what they have budget for after the Jet Ski rentals.

WHAT ARE THE EFFECTS OF THIS?

These have the effect of creating a risk-averse culture where little gets done for fear that it will go wrong and cause people to get fired or set aside by the leadership.  You also end up driving away people who want to innovate and expand their knowledge, because nothing major will get done for fear that it will fail.  When you do not undertake major work such as an EMR implementation or upgrade, you create an environment where people who want to advance and lead just are not welcome, and they leave.  What you are left with are team members content doing the same work, ones who cannot leave, and ones who play politics to get ahead because they do not have the skills to excel in more challenging environments.  It is an employee engagement nightmare.

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https://www.healthcareittoday.com/2021/06/22/bioethics-conference-poses-twenty-first-century-questions/

Bioethics Conference Poses Twenty-First Century Questions

June 22, 2021

Andy Oram

The Center for Bioethics at Harvard Medical School recently held an online conference covering the current state of the field. All the standard ethical issues we talk about in medicine appear in the new genetic and biological research, often with greater urgency: safety and effectiveness, equitable access, privacy and informed consent, data sharing, and individual dignity. In addition, immense philosophical questions beyond the scope of medicine are raised. I’ll look at each of these issues in the article.

Safety and Effectiveness

Time-tested processes for assuring safety and effectiveness don’t always extend to new biological techniques, because the techniques potential effects are so hard to predict. As one example, Jun Wu cited research showing that the foreign cells introduced into a person for treatment might be broken down by cell-cell competition, a normal metabolic process leading to the death of cells (apoptosis). Treatments that don’t account for this process may seem to work in the lab and then have no effect in real life.

And when the techniques are not amenable to clinical trials, even more risk gets injected into the protoplasm. Dr.Timothy Yu and Jacob S. Sherkow said many modern experiments involve diseases so rare that it would be either unfeasible or unethical to set some patients aside as controls. Follow-up studies can provide a lot of useful data, but comparisons between patients in retrospect are less conclusive than a standard clinical trial. Jonathan Kimmelman said that at best, N-of-1 studies are “on the path to” Phase 1 studies.

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https://www.bbc.com/news/uk-57564355

NHS data strategy: Hancock defends data sharing plan

By Doug Faulkner
BBC News

Published 22 June, 2021

NHS patients in England will get greater control over their health and social care data under plans set out by the government, Matt Hancock says.

It means people will be able to access their medical records from different parts of the NHS through various apps.

However critics are worried that data could be misused and the system has not been properly explained to patients.

In defending the plan, the health secretary said more effective use of data would deliver better patient care.

The new strategy, called Data Saves Lives, will give patients confidence that health and care staff have up-to-date information enabling them to make quicker, more informed decisions, the government said.

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https://www.healthleadersmedia.com/technology/murky-sea-mental-health-apps-consumers-left-adrift

In a Murky Sea of Mental Health Apps, Consumers Left Adrift

Analysis  |  By Kaiser Health News  |   June 22, 2021

For tech startups looking to cash in on unmet need, that translates into more than 50 million potential customers.


KEY TAKEAWAYS

·         Venture capital firms invested more than $2.4 billion in digital behavioral health apps in 2020 — more than twice the amount invested in 2019 — touting support or treatment for issues from burnout and depression to ADHD and bipolar disorder. At least seven mental health app companies have achieved “unicorn” status and are valued at more than $1 billion.

·         But even as industry hype mounts, researchers and companies are scrambling to prove these apps actually work. Of the estimated 20,000 mental health apps available for download on personal computers and smartphones, just five have been formally vetted and approved by the Food and Drug Administration, which largely has taken a hands-off approach to regulating the space.

This article was published on Tuesday, June 22, 2021 in Kaiser Health News.

By Jenny Gold

In the eyes of the tech industry, mental health treatment is an area ripe for disruption.

In any given year, 1 in 5 adults in the U.S. experience a form of mental illness, according to federal estimates. And research indicates only about half of them receive treatment in a system that is understaffed and ill distributed to meet demand.

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https://patientengagementhit.com/news/key-steps-for-opening-the-digital-front-door-digital-transformation

Key Steps for Opening the Digital Front Door, Digital Transformation

The digital front door is anything but a door. It’s a wraparound patient journey that connects them to care across the continuum.

By Sara Heath

June 21, 2021 - The digital front door isn’t just unlocked; it’s opening wide, and healthcare organizations that want to remain competitive need to figure out how to make it an entrance to a wholly connected patient journey.

“This is an industry that has long been considered a technology laggard of sorts over the years,” Mutaz Shegewi, IDC Health Insights research director, told PatientEngagementHIT in an interview. “Healthcare has always been slow to adopt cutting-edge technology and to keep up with its peers in the other industries.”

But in recent years, mounting pressures have changed that. The rise in chronic illness, the aging of the Baby Boomer population, and the shift to value-based care have pushed many organizations to rethink the way patients engage with their care and assess the role that health IT plays in that.

There have also been emerging challenges along the way, Shegewi noted, including managing the height of the COVID-19 pandemic and the vaccine rollout processes that followed.

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https://www.fiercehealthcare.com/digital-health/amazon-launches-digital-health-accelerator-a-focus-voice-technology-virtual-care

Amazon launches digital health accelerator with a focus on virtual care, analytics startups

by Heather Landi 

Jun 21, 2021 1:03pm

Amazon Web Services wants to help incubate early-stage digital health companies that can collaborate with the tech giant's healthcare customers and partners.

Amazon's cloud division launched a healthcare accelerator to boost startups' growth in cloud technologies and enable early-stage companies to tap into AWS' technical and commercial expertise.

The program will focus on technologies such as remote patient monitoring, data analytics, patient engagement, voice technology and virtual care, according to a blog post from Sandy Carter, vice president of worldwide public sector partners and programs at AWS.

The AWS Healthcare Accelerator is a four-week program open to digital health startups based in the U.S. or ones that have existing U.S. operations and that have an established product-market fit with existing customers and revenue, according to AWS. Ten startups will participate in the inaugural program, with proposals due by July 23.

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https://www.fiercehealthcare.com/tech/past-current-onc-heads-bipartisan-industry-collaboration-yields-successful-health-it-policy

Past, current ONC chiefs: Bipartisan work, industry collaboration yields successful health IT policy

by Dave Muoio 

Jun 17, 2021 10:00am

The role of national coordinator for health IT comes with its fair share of policy constraints and budget limitations, but partisanship is one of the few Capitol Hill hurdles the office has managed to avoid over the past decade and a half.

In a recent College of Healthcare Information Management Executives (CHIME) panel convening current National Coordinator Micky Tripathi, M.D., with six of his predecessors, the health IT leaders swapped stories about the challenges that came with guiding health IT policy through major periods of change.

Rob Kolodner, M.D., who held the role for two and a half years at the tail end of the George W. Bush administration, looked back fondly on his group’s work to develop the first federal health IT strategic plan. Doing so allowed the Office of the National Coordinator of Health IT (ONC) to keep its funding and persist from administration to administration, he said, although obtaining the necessary approvals forced his team to compromise on a familiar issue.

“We mourned the loss of one of the three goals we put in … that explicitly stated that patients should be able to reliably and securely exchange electronic health information with their providers and have access to their own personal health data,” he said. “That was a bridge too far at that time.”

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https://www.forbes.com/sites/forbestechcouncil/2021/06/21/tech-has-advanced-rapidly-and-cybersecurity-needs-to-catch-up/?sh=bce94f3acba9

Jun 21, 2021,07:10am EDT|207 views

Tech Has Advanced Rapidly—And Cybersecurity Needs To Catch Up

Andrzej Kawalec

Imagine this: You've moved to a new house in a new neighborhood, and on your first night, you forget to lock your doors and windows.

Now, that doesn't mean you'll get broken into. In fact, because it's only a single night, you'll probably be fine. However, the keyword is "probably" because you're not familiar with the area or your new neighbors. Although chances are everything will be fine, there's still a chance you'll wake up without a refrigerator.

That's the situation that businesses — especially small and medium-sized enterprises (SMEs) — find themselves in today.

Technology has come a long way over the course of the pandemic. Ten years of progress in 10 weeks is a phrase I hear used, and although that's a very rough estimate, the fact is the world looks completely different today compared to the early part of 2020.

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https://www.healthcareitnews.com/news/emea/uk-government-announce-36m-ai-research-boost-nhs

UK government announce £36M AI research boost for NHS

Thirty-eight new AI projects have been announced as part of the NHS AI Lab's £140m AI in Health and Care Awards.

By Sara Mageit

June 21, 2021 07:55 AM

A share of £36 million to test 'state-of-the-art' AI technology has been invested in projects that aim to help the NHS transform the quality of care and the speed of diagnoses for conditions such as lung cancer.

At the CogX Festival last week, UK Health and Social Care secretary Matt Hancock announced the winners of the second wave of the NHS AI Lab’s AI in Health and Care Award. The 38 projects backed by NHSX and Accelerated Access Collaborative (AAC) include:

  • An AI-guided tool to help doctors and nurses to diagnose heart attacks more accurately
  • An algorithm to fast-track the detection of lung cancer
  • An AI-powered mental health app to help tackle symptoms of anxiety and depression while also identifying people experiencing severe mental health difficulties
  • Tech to help spot undiagnosed spinal fractures

WHY IT MATTERS

In September, £50 million was given to 42 AI technologies. Since then, over 17,000 stroke patients and over 25,000 patients with diabetes have benefitted from the first round of the AI in Health and Care Award.

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https://www.healthcareitnews.com/news/senators-introduce-bipartisan-bill-fight-cybercrime

Senators introduce bipartisan bill to fight cybercrime

The International Cybercrime Prevention Act would create new criminal violations for those targeting hospitals and other critical infrastructure, among other provisions.

By Kat Jercich

June 21, 2021 10:32 AM

Colonial Pipeline that led to a days-long shutdown – a bipartisan group of senators has introduced a bill aimed at shoring up the country's defenses.

The International Cybercrime Prevention Act of 2021 would create new criminal violations for those targeting critical infrastructure, including hospitals.  

"Over the last few months, we have seen the severity cybercrime attacks can have on our nation’s infrastructure, and it is time for Congress to ensure our cyber defense can withstand these attacks in the future," said Senator Thom Tillis, R-S.C., who cosponsored the bill, in a statement.  

WHY IT MATTERS  

The bill, which was also introduced by Senators Richard Blumenthal, D-Ct., Lindsey Graham, R-S.C. and Sheldon Whitehouse, D-R.I., aims to enhance the Department of Justice's authority around cybercrime.  

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https://www.healthcarefinancenews.com/news/hhs-earmarks-80m-arp-public-health-it-and-better-covid-19-data-collection

2021

HHS earmarks $80M from ARP for public health IT and better COVID-19 data collection

The effort is part of a broader push to address health and socioeconomic inequities that have been exacerbated by the pandemic.

Jeff Lagasse, Associate Editor

As part of the American Rescue Plan, the U.S. Department of Health and Human Services' Office of the National Coordinator for Health Information Technology is establishing an $80 million Public Health Informatics and Technology Workforce Development Program – dubbed the PHIT Workforce Program – in an effort to strengthen U.S. public health informatics and data science.

As part of the launch, ONC has invited colleges and universities to apply for funding through a consortium that will develop the curriculum, recruit and train participants, secure paid internship opportunities and assist in career placement at public health agencies, public health-focused non-profits or public health-focused private sector or clinical settings. 

The focus will be on Historically Black Colleges and Universities (HBCUs), Tribal Colleges and Universities (TCUs), Hispanic Serving Institutions (HSIs), Asian American and Native American Pacific Islander-Serving Institutions (AANAPISIs), and other minority-serving institutions (MSIs).

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https://www.healthcareittoday.com/2021/06/21/esignatures-and-digital-documents-matter-even-more-in-a-post-covid-world/

eSignatures and Digital Documents Matter Even More in a Post-COVID World

June 21, 2021

Colin Hung

According to a recent study, COVID-19 has raised the expectations of patients when it comes to digital health. More patients than ever are willing to switch healthcare providers over a poor digital experience. Organizations that do not invest in getting rid of paper processes risk being left behind.

Embracing Digital

The pandemic has shown patients that paperless and contact-less healthcare is possible through telehealth, electronic communications and digital documents. According to a Health Affairs study 30.1% of all visits were done via telehealth from January to June 2020 – 23 times higher than the rate of telehealth usage pre-pandemic.

A recent survey also found that patients are now placing higher value on the overall digital experience they have with their healthcare provider:

  • 65% say that they would be very likely to recommend a healthcare provider or write them a good review if they offer a great digital experience
  • 53% of consumers would consider switching doctors to get touchless paperwork and virtual care, in light of the COVID-19 pandemic
  • 41% want digital forms and communication

This trend towards a more digital healthcare experience is not new. For years we as consumers have seen digital improvements made in other industries like retail, banking, travel and even in our own workplaces that have resulted in easy, less frustrating interactions. There can be no doubt that we all want to see that same level of improvement in healthcare.

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Enjoy!

David.

Friday, July 02, 2021

It’s Wonderful To See How Even The #myHealthRecord Evangelists Hedge The Benefits They Are Seeing. They Are All Praying For Something Better!

This appeared last week:

Podcasts • My Health Record

My Health Record: General practice

Published 23 June 2021

Discover how My Health Record benefits both patients and doctors with advice from leading health professionals using this system in general practice.

Speakers: Dr Andrew Rochford (Facilitator), Dr Peter Del Fante (Clinical Reference Lead, General Practitioner, Public Health Physician), Dr Charlotte Hespe (Director, Royal Australian College of General Practitioners Board), Dr Christine Pascott (Agency Board Member) and Dr Mike Bainbridge (Agency Board Member).

Subscribe and listen to the podcast on SoundCloudiTunesGoogle Podcasts and Spotify.

Here is the link:

https://www.digitalhealth.gov.au/newsroom/podcasts/my-health-record-general-practice

I listened through and was left with the feeling that little has changed with the #myHR remaining a secondary partial system with variable data quality and lacking the capacity to really be any sort of useful tool for coordinating care.

It was also clear that many of the features that we on people’s wish lists (appointment making, referrals etc.) are simply not going to happen without a total re-conception  of how Digital Health works in Australia and whatever happens the #myHR will not be at its core.

The money spent on the #myHR would be better allocated to developing some future orientated systems that could actually do what is desired rather than nourishing a fossil!

Listen closely and you will see how the speakers all identify how central their own CISs are and the holes in the #myHR!

David.

Thursday, July 01, 2021

The Macro View – Health, Economics, and Politics and the Big Picture. What I Am Watching Here And Abroad.

July 01, 2021 Edition

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A quiet week in the US other than the awful disaster of the collapse of a large apartment block on the Florida coast. It seems about 160 people have died.

In the UK we have lost the Health Secretary for giving a passionate cuddle to a staffer. Hardly following the social distancing rules!

In OZ all the news has been about 2 things. Barnaby being back and a 2 week lockdown in Greater Sydney and the ever extending lockdowns elsewhere!. Sadly the vaccination roll out has been a mess so far - hope we can sort this out soon!

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Major Issues.

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https://www.theaustralian.com.au/business/markets/reserve-bank-may-have-to-hike-rates-sooner-as-unemployment-dives/news-story/dcbc39510ef59e56265e7957ed01c4d3

Reserve Bank may have to hike rates sooner as unemployment dives

James Glynn

Dow Jones

6:58PM June 20, 2021

A career devoted to the understanding and implementation of monetary policy has left the governor of the Reserve Bank, Philip Lowe, unfulfilled.

While in the top job, he’s not had to raise interest rates, and if current expectations play out, his term will expire before he gets a chance.

It’s a curious thing about central bankers. They muse and rehearse in their minds for the day they will get to pull the interest rate policy lever, unleashing a blunt instrument that hits every corner of the economy. RBA governors are cloaked in enormous power.

To be sure, since becoming governor in September 2016, Lowe has cut official interest rates to record lows and deployed alternative policy measures like yield curve control and quantitative easing for the first time, so his dissatisfaction is not that acute.

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https://www.afr.com/policy/economy/why-rba-s-promise-on-rates-is-potentially-dangerous-20210620-p582mp

Why the RBA’s promise on rates is potentially dangerous

The central bank’s pledge to set rates in concrete has needlessly tied its hands. And if it breaks its promise, instability follows.

Neville Norman

Jun 21, 2021 – 1.37pm

The Reserve Bank of Australia’s (apparent) promise not to raise interest rates within its control until 2024 may go down as one of the most limiting, and damaging, public-policy pronouncements, ever.

Limiting, because it ties the hands of our main maker of interest rates, constraining its policy responses to future unknown developments, for at least 2.5 years ahead, by its own (avoidable) words.

Damaging, because to either leave rates unchanged, or to break the promise and lift them sharply, before 2024, might cause concerning surges and/or slumps in sensitive asset prices – property and equity prices especially – that could have been better managed. Confidence, profits, and jobs, at the least, could be damaged.

Let’s not forget what the RBA board minutes have said, every month since earlier this year. The Reserve Bank expects no significant rate lifts until 2024. The minutes do at least make this conditional on an intermediary consideration: the annual rate of (consumer price) inflation not returning to the band of 2-3 per cent, which for some reason is propounded as a target band.

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https://www.afr.com/policy/foreign-affairs/morrison-was-naked-at-the-g7-20210620-p582mo

Morrison was naked at the G7

What Australia took to Cornwall was an object lesson in how not to handle China, and it was rewarded with lukewarm support.

Geoff Raby Columnist

Jun 21, 2021 – 4.23pm

Far from being a vindication of the Morrison government’s China policies, the G7-plus meeting highlighted the abject failure of Australia’s reckless foreign policy towards China.

Australia alone of the 11 nations that were present has no official contact with China and significant parts of its trade suspended, which others at the meeting are busily backfilling.

Certainly, Australia was an invited guest to Cornwall at the same time as the G7 leaders were meeting, along with South Africa, India, and South Korea, because Britain as chair wanted to make a statement about democracies standing up to authoritarian states. And none matters more than China, or is more challenging for democracies.

Prime Minister Boris Johnson is also keen to promote, post-Brexit, the new “global Britain”. It is a measure of the extent to which the UK feels its global position is diminished after Brexit that it is inclined to embrace Australia at almost every opportunity now – trade, immigration policy, China.

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https://www.afr.com/politics/federal/barnaby-joyce-s-return-ignites-climate-policy-chaos-20210621-p582ps

Joyce’s return ignites climate policy chaos

Phillip Coorey Political editor

Jun 21, 2021 – 7.59pm

The Morrison government’s climate policy has been plunged into uncertainty after Barnaby Joyce’s comeback as Nationals leader and Deputy Prime Minister ended any prospect of a Coalition commitment to net zero carbon emissions by 2050.

Upon deposing Michael McCormack in a tight party room ballot on Monday, Mr Joyce, who campaigned for the leadership opposing net zero, said he would be guided by his colleagues on the party’s new climate position.

But he indicated his mind was all but made up.

“If the National party room believes that the best deal for regional Australia is to make sure that we secure their jobs, is to make sure that we secure
their industries, is to clearly understand, clearly understand the
dynamics of an Australian economy as opposed to a Danish one or a
German one ... if that’s the view of the National party room, that’s the view that I’ll support.”

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https://www.afr.com/policy/economy/one-in-10-australian-adults-are-millionaires-says-report-20210622-p5833t

One in 10 Australian adults are millionaires, says report

Michael Read Reporter

Jun 22, 2021 – 9.30pm

More than 3 million Australian adults could soon be millionaires, according to a report by Credit Suisse, while Australian adults, with average net wealth of $US238,000 ($315,000), are the richest in the world.

Rock-bottom interest rates are expected to pave the way for an asset price boom that is expected to cause a dramatic increase in household wealth over the next five years.

Credit Suisse Australia head of private banking Michael Marr expects the number of US-dollar millionaires in Australia to increase “dramatically” by 70 per cent over the next five years to 3.1 million, based on trends identified in the bank’s annual global wealth report.

“This is primarily due to the ongoing performance of our two principal sources of wealth – housing and financial assets – underpinned by robust GDP growth,” Mr Marr said.

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https://www.smh.com.au/business/the-economy/who-wants-to-be-a-millionaire-almost-one-in-ten-australians-already-are-20210623-p583md.html

Who wants to be a millionaire? Almost one in 10 Australians already are

Elizabeth Knight

Business columnist

June 23, 2021 — 4.47pm

Australia has become a land of McMillionaires. We’re now top of the global rich list — at least by one measure in an annual study by investment bank Credit Suisse — with the median level wealth for adults now at $A315,380, edging out Belgium.

Twenty years ago less than 1 per cent of Australians were millionaires - today it is almost one in ten, according to Credit Suisse’s annual Global Wealth Report. In the past year alone almost 400,000 Australians joined this now not-so-exclusive cohort. With 9.4 per cent of Australian adults millionaires, the nation ranks behind only Switzerland (15 per cent) for millionaire density, and ahead of the United States (8.8 per cent).

The report forecast that in four years the number of millionaires in Australia would rise by 70 per cent to 3.1 million - only slightly shy of one quarter of the adult population. Unlike some other wealth surveys, Credit Suisse’s figures include the value of owner-occupied houses, but it also takes into account an individual’s debt and measures net (rather than simply gross) assets.

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https://www.afr.com/policy/tax-and-super/no-applause-yet-for-super-shake-up-20210621-p582ua

No applause yet for super shake-up

The government’s plan to return $18 billion in fees to superannuation members will be applauded if successful, but critics say it bears little resemblance to the review that inspired it.

Aleks Vickovich Wealth editor

Jun 22, 2021 – 4.50pm

On the morning of the delayed federal budget in October last year, The Australian Financial Review phoned some of the nation’s myriad superannuation industry lobbyists for a last-minute pulse check.

“We’re not expecting anything much in this one,” said a veteran budget watcher and retirement policy wonk. “There has been more than enough super tinkering over the past decade.”

How wrong he was.

Without warning, and amid a global pandemic, the Morrison government unveiled a four-point plan to shake up the $3 trillion compulsory superannuation system.

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https://www.smh.com.au/politics/federal/china-warning-joyce-calls-on-mps-to-prepare-for-end-of-pax-americana-20210622-p583bo.html

China warning: Joyce calls on MPs to prepare for end of Pax Americana

By David Crowe

June 22, 2021 — 6.43pm

Nationals leader Barnaby Joyce has issued a stark warning to government MPs about the risk to Australia from the waning power of the United States, calling for unity as China emerges as a new superpower.

Mr Joyce urged Liberal and Nationals MPs to unite behind the mission of making Australia “as strong as possible as quickly as possible” when it could not rely on the US to guarantee regional security.

The message resonated with government MPs who are increasingly concerned about the Chinese government’s construction of military bases in the South China Sea and provocations in the Taiwan Strait.

Liberals noted the remarks were made in Mr Joyce’s first speech to the Coalition party room after he regained the Nationals leadership on Monday and was sworn in as Deputy Prime Minister on Tuesday.

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https://www.smh.com.au/politics/federal/most-australians-blame-china-for-poor-relations-but-ambivalent-about-government-s-approach-poll-20210622-p5832e.html

Most Australians blame China for poor relations but ambivalent about government’s approach: poll

By Anthony Galloway

June 23, 2021 — 12.00am

More than half of Australians blame China for the deterioration in relations between the two countries but they aren’t sold on the federal government’s response either.

The Lowy Institute’s annual poll, to be released on Wednesday, shows trust in China has fallen to record lows, with most Australians holding little to no confidence in President Xi Jinping.

Diplomatic relations between Australia and China have fallen to their worst levels in decades over the past year after Being imposed more than $20 billion of trade strikes in response to Canberra’s call for an independent coronavirus inquiry as well as other national security decisions.

Labor has increasingly been critical of the government’s handling of the relationship, with opposition foreign affairs spokeswoman Penny Wong last month accusing Prime Minister Scott Morrison of deliberately encouraging anxiety about a conflict with Beijing.

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https://www.afr.com/policy/tax-and-super/why-the-superannuation-reforms-are-a-very-big-deal-20210622-p5834y

Why the superannuation reforms are a very big deal

The changes will divert billions of dollars from vested interests and ticket-clippers. They are the biggest reforms the Coalition has wrought so far.

John Kehoe Economics editor

Jun 23, 2021 – 12.08pm

When the Morrison government’s landmark superannuation shake-up came down to the wire in the House of Representatives last week, Transport Workers Union and industry fund representatives lobbied Barnaby Joyce and George Christensen near the whip’s office.

The Labor-aligned lobbyists warned the renegade conservatives that the “Your Future, Your Super” legislation would jeopardise super fund investments in mining and cause workers in dangerous jobs such as construction to have inadequate life and disability insurance.

Why did the unions and some industry funds oppose the new rules?

The hard-fought reforms will divert an estimated $18 billion over a decade from the super industry and other vested interests to the retirement incomes of super fund members.

The super changes narrowly passed by the Parliament arguably mark the biggest economic reforms achieved during the almost eight-year life of the Coalition government.

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https://www.afr.com/policy/economy/three-reasons-why-this-recovery-is-fragile-20210622-p5839i

Three reasons why this recovery is fragile

A region rife with infection, a recovery reliant on stimulus, and the downsides of debt could all derail the recent good economic news.

Satyajit Das Contributor

Jun 23, 2021 – 1.26pm

Reserve Bank of Australia governor Philip Lowe’s speech on June 17 was entitled “From Recovery to Expansion”. While some macro-economic indicators show welcome progress, there are three reasons for caution.

First, the COVID-19 pandemic may not be passed.

Vaccination programs are affected by supply constraints, indifferent roll-outs, vaccine hesitancy exacerbated by frequent advice changes, emerging side effects, and uncertain prophylactic effectiveness against variants. Modelling by the Burnet Institute in Australia and Institute for Disease Modelling in the US suggests that the levels of vaccination and vaccine efficacy required for herd immunity are unlikely to be met anytime soon.

As recent events illustrate, the risks of periodic outbreaks, sudden lockdowns and resultant economic interruption remain. For Australia’s less developed neighbours, first world vaccine nationalism and poor health infrastructure mean a long path out of the pandemic. Given their substantial contributions to growth, key roles in supplying essential commodities or within supply chains, Australia’s recovery will be retarded. Until the disease is contained everywhere, full opening of international borders may be difficult.

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https://www.afr.com/policy/foreign-affairs/asean-worker-plan-undermines-our-pacific-island-job-diplomacy-20210622-p5839j

ASEAN worker plan undermines our Pacific island job diplomacy

A quick fix for farm jobs robs Australia of a serious advantage in the contest with China for regional influence. There are better answers.

Jonathan Pryke

Jun 24, 2021 – 12.00am

The Nationals have dominated headlines this week with the resurrection of Barnaby Joyce. This comes a week after another National, Agriculture Minister David Littleproud, stirred controversy with the announcement that the party had secured a “seasonal agricultural workforce visa” for citizens of Southeast Asian (ASEAN) countries to come to Australia.

While here, they could work on farms for up to nine months in a year – returning home each year for at least three months – for up to three years.

This follows years of lobbying by the Nationals in response to demands from farmers to solve a labour crisis where, thanks to closed borders, they face shortages of 26,000 workers.

Things were set to get worse, with Australia losing the roughly 10,000 British backpackers annually who take up picking jobs after the new bilateral trade agreement removes requirements for them to work for 88 days on a farm to extend their visa by 12 months.

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https://www.smh.com.au/world/asia/the-insecure-superpower-a-volatile-mix-that-will-make-china-our-challenge-for-decades-20210623-p583q8.html

The insecure superpower: a volatile mix that will make China our challenge for decades

By Frances Adamson

June 23, 2021 — 8.09pm

China has been experiencing a remarkable transformation, shedding some of the rigidities of its past and becoming better integrated into the international mainstream after joining the World Trade Organisation. It has seen urbanisation, the promise of further economic reforms, the beginnings of a legal system protecting civil rights, a middle class open to new ideas, new products and new experiences.

I was there for the elevation of Xi Jinping from vice-president to President in 2013, after he became general-secretary of the Communist Party of China in late 2012 at the 18th party congress, through to my return to Australia in late 2015. Arguably, it is in that period – and the time since then – that we have seen the most consequential change.

The clock has been wound back in terms of the priority accorded to ideology, quashing voices of civil society, and erecting new barriers to external connections and the free flow of information.

China speaks of a “new type of international relations”, as if it is a fairer way, an improvement. But underneath it is the same old power politics, the raw assertion of national interests. The implication being that China’s size and strength make its interests more “special” than those of others, and that these must prevail.

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https://www.afr.com/politics/federal/pm-faces-carbon-tariffs-amid-crumbling-virus-plan-20210624-p5841c

PM faces carbon tariffs amid crumbling virus plan

Scott Morrison’s absence this week when the Coalition’s national COVID-19 response was crumbling, as was any semblance of sanity in its junior partner, was unfortunate to say the least.

Laura Tingle Columnist

Updated Jun 25, 2021 – 4.19pm, first published at 3.40pm

Politicians appreciate the value of a bit of theatre, a bit of a backdrop, to drive home the message they are delivering, or of just how in control of things they are.

So, in any other week, Scott Morrison may have been able to make a pragmatic assessment of just how bad the images of the PM sitting at the Lodge, in front of a slightly dodgy picture of Parliament House, surrounded by flags, and conspicuously reading his answers to Dorothy Dix questions.

It wasn’t just the images of course, it was the reality: the Prime Minister absent from question time, and the Parliament, and the party room, as he quarantined after all those photo opportunities in Cornwall, London and Paris.

Sure, he might have been able to sign an in-principle free trade agreement with the UK, have his say about China at the G7, and talk submarines with French President Emmanuel Macron.

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https://www.smh.com.au/national/a-wild-ride-with-the-bushwhacker-barnaby-joyce-s-return-transforms-morrison-s-easy-dominance-of-his-government-20210625-p584el.html

A wild ride with the bushwhacker: Barnaby Joyce’s return transforms Morrison’s easy dominance of his government

Peter Hartcher

Political and international editor

June 26, 2021 — 5.30am

Barnaby Joyce, the closest thing Australia has to Donald Trump, stormed back into the Deputy Prime Minister’s job this week. And the Liberal Party is anxious.

Understandably. “The Nationals will never threaten supply or confidence, of course, but there will be discussions about our aspirations,” he tells me.

In other words, the junior partner in the Coalition won’t actually bring down the government, but everything else is up for negotiation. This has transformed Scott Morrison’s easy dominance of his government.

How could Joyce tear down his leader, Michael McCormack, and make demands on the Prime Minister while the country is in the middle of a global pandemic?

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https://www.smh.com.au/national/hard-lessons-on-unis-coalition-has-embraced-howard-s-way-20210622-p583a9.html

Hard lessons: On unis, Coalition has embraced Howard’s way

By George Megalogenis

June 26, 2021 — 9.55am

In March and April 2020, Treasurer Josh Frydenberg’s phone was melting down with calls from CEOs pleading for billions of dollars in immediate relief. He drew a line in the sand by saying no to Virgin, to send a message that the government would not be negotiating handouts on a company-by-company basis. The JobKeeper scheme gave Frydenberg the leverage to resist these demands because it was generous to all firms.

Given the gargantuan sums being borrowed and spent on the safety net, no one needed to be worse off. Yet the Morrison government chose to exclude universities from JobKeeper, and also to deny JobSeeker to many of their international students. I asked ministers, former ministers, public servants and vice-chancellors: why were universities singled out? One person familiar with the government’s thinking told me: “It’s not that complicated. The government hates universities.”

“There was a sense inside government that universities also had their own financial buffers,” Frydenberg tells me. “They had become very corporatised. They had relied very heavily on international students so they had shifted their business model over time. We were willing to provide very significant support for the universities, but they also had to adjust as other businesses did.”

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https://www.theaustralian.com.au/nation/politics/gough-whitlam-on-china-and-the-us/news-story/201ed0c01439d28c1473b3de906aeb56

Whitlam on China and the US

We will never understand the Chinese unless we try to understand that above all they are determined never again to submit to humiliation.

By Gough Whitlam

June 26, 2021

‘I see no irremovable obstacles towards improved relations’, writes Labor leader Gough Whitlam in his exclusive report on his visit to Peking, published in The Australian on July 18, 1971.

The new China is Chinese first, Maoist second and Communist third. The distinction is crucial. The West’s failure to accept the difference has been the major cause of misconceptions about China and the mutual hostility between us over the past 22 years.

We should always remember that our post-war policies towards China developed in the atmosphere of the Cold War – the era of Stalin, Dulles and McCarthy. The West saw the victory of Chinese communism simply as a victory for Soviet communism. We saw the establishment of a communist government in China simply as an addition to Soviet global power and the extension of a monolithic communist empire stretching unbroken and united from East Germany to the China Sea.

To this Western view of the post-war world Australia added her own traditional racial and geographical fears, only changing the old formula by substituting Communist China for a defeated Japan as the source of menace to our security.

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Coronavirus And Impacts.

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https://www.afr.com/companies/media-and-marketing/hunger-for-news-sparked-by-the-pandemic-drops-away-20210623-p583ia

Hunger for news, sparked by the pandemic, drops away

Miranda Ward Media writer

Jun 23, 2021 – 3.58pm

The hunger for news among Australians at the start of the pandemic has dropped, while the proportion of people willing to pay for news also has not increased, a new report from The University of Canberra says.

The report, produced by the News and Media Research Centre at the University of Canberra, also found public broadcasters the ABC and SBS remain Australia’s most trusted news brands, while The Australian Financial Review is the most trusted national newspaper. News Corp’s The Daily Telegraph was the least trusted source of news.

Coverage of the pandemic has resulted in Australians becoming more trusting of news in general, with trust rising to 43 per cent, just under the global average of 44 per cent, with concerns about misinformation remaining high.

According to the report, during the early months of COVID-19, 70 per cent of Australians accessed news more than once a day, while in 2021 those who followed the news closely fell to 51 per cent, 4 percentage points lower than pre-COVID-19.

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https://www.smh.com.au/world/europe/australia-warns-world-not-to-trample-on-human-rights-during-pandemic-20210623-p583qr.html

Australia warns world not to trample on human rights during pandemic

By Latika Bourke

June 24, 2021 — 11.22am

London: Australia has warned other countries against using the coronavirus pandemic as an excuse to trample on human rights, in an intervention which advocates have likened to throwing stones in glass houses.

Australia’s ambassador to the United Nations in Geneva Sally Mansfield told the Human Rights Council this week that “governments must ensure COVID-19 response measures comply with international human rights obligations”.

“We reiterate our concerns that some states are taking advantage of COVID-19 to undermine or supplant established human rights,” Mansfield said in a statement to the 47th session of the council.

Last year the council asked United Nations High Commissioner for Human Rights, Michelle Bachelet, to report on: “the central role of the state in responding to pandemics and other health emergencies, and the socioeconomic consequences thereof, in advancing sustainable development and the realisation of all human rights.”

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https://www.smh.com.au/politics/nsw/the-horse-has-bolted-experts-warn-two-week-lockdown-may-not-be-enough-20210626-p584ja.html

‘The horse has bolted’: Experts warn two-week lockdown may not be enough

By Alexandra Smith, Lucy Cormack and Aisha Dow

June 27, 2021 — 12.00am

An explosion of COVID-19 has forced Sydney into two-week lockdown with the rest of the state of high alert for further transmission as health experts warned it could take longer than a fortnight to bring the highly contagious outbreak under control.

As the Delta strain of the virus continues to take hold across the city, residents of greater Sydney, the Blue Mountains, Central Coast and Wollongong have been issued strict stay-at-home orders.

However, leading epidemiologists warned the widespread lockdown would likely extend beyond two weeks, arguing for the NSW government waited days too long to take decisive action.

NSW Premier Gladys Berejiklian convened an urgent meeting of her crisis cabinet on Saturday, where NSW Chief Health Officer Kerry Chant recommended a two-week lockdown in a bid to contain the spread.

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Climate Change.

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No Entries This Week.

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Royal Commissions And The Like.

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No Entries This Week.

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National Budget Issues.

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No Entries This Week.

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Health Issues.

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https://www.smh.com.au/national/australia-set-to-join-the-mrna-vaccine-revolution-20210621-p582vv.html

Australia set to join the mRNA vaccine revolution

Colin Pouton

Professor of Pharmaceutical Biology at Monash University

June 21, 2021 — 5.58pm

By 2019, interest in the potential of mRNA delivery technology, for both vaccine development and other therapeutic applications, had been growing steadily for a decade. Relatively young innovator companies, including Moderna (US) and BioNTech (Germany), had embarked on clinical studies of a variety of products. But at that stage no products had progressed as far as regulatory approval for widespread human use.

Then came COVID-19. A soon as it was clear that the world was faced with a pandemic, the excitement amongst mRNA researchers was intense. Here was a perfect opportunity to demonstrate the value of mRNA as a rapid response system for deployment of vaccine against emerging viral infections.

What followed has changed the landscape of vaccine development forever. Two COVID-19 mRNA vaccines were approved within a year of the genetic sequencing of the first isolate of SARS-CoV-2 virus. The speed of development and the remarkable efficacy of the two mRNA vaccines took even the most optimistic researchers by surprise.

There are a number of reasons why the mRNA vaccines were developed so quickly. Most importantly, the time taken to identify and produce candidate vaccines using mRNA technology can be measured in days or weeks, allowing animal testing to commence almost immediately. Indeed, my team at Monash had vaccine candidates available for testing in April 2020.

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https://www.theaustralian.com.au/world/the-times/grail-blood-test-detects-cancer-among-over50s/news-story/44aae94ca1c58d7c919d3a83d916e2c6

Grail blood test detects cancer among over-50s

By Kay Lay

The Times

6:06PM June 25, 2021

A simple blood test that can ­detect more than 50 types of cancer is accurate enough to be used as a screening tool for over-50s, a trial has found.

Britain’s National Health Service will begin a trial involving 140,000 people this year, and if that is successful it will be used for millions of patients by 2025.

A paper in the journal Annals of Oncology showed that the test, created by Californian company Grail, accurately detected cancer, including in people without symptoms, and had a low false positive rate. It also predicted with a high degree of accuracy where the cancer was located. Eric Klein, chairman of the Glickman Urological and Kidney Institute at the Cleveland Clinic in the US was excited about the potential impact this approach would have on public health. “Finding cancer early, when treatment is more likely to be successful, is one of the most significant opportunities we have to reduce the burden of cancer,” he said.

The test detected 65.6 per cent of cancers involving solid ­tumours with no screening ­options, such as oesophageal, liver and pancreatic cancers. For those where screening is possible, including breast, bowel, cervical and prostate cancers, the figure was 33.7 per cent.

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International Issues.

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https://www.afr.com/policy/economy/anglosphere-dreaming-a-drag-on-our-defence-20210617-p581xj

Anglosphere dreaming a drag on our defence 

Believing that Britain is making up for abandoning us is the same kind of out of date security thinking behind the government’s handling of the American alliance.

James Curran Columnist

Jun 20, 2021 – 12.45pm

There are moments when Australia meets a challenging world with an old mind.

Revelling in the Western embrace against the backdrop of China’s assertiveness, some are even rewriting key moments in Australian history. Others recycle familiar patterns of alliance management.

Rambling through the graveyard of the nation’s British-centred past, they find new life among long forgotten tombstones. In speeches about the American alliance, their default position is to simply offer more.

Dated myths of abandonment by the “mother country” are being exhumed as question marks over US staying power persist and fear of being stranded in a Sino-centred region unsettles.

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https://www.afr.com/world/north-america/america-is-back-and-wants-everyone-to-focus-on-china-20210620-p582k5

America is back – and wants everyone to focus on China

There is little disguising the fact that the Atlantic is no longer the world’s most important geopolitical theatre in America’s eyes. That distinction belongs to the Indo-Pacific.

Edward Luce Columnist

Jun 20, 2021 – 11.33am

From Europe’s point of view, Joe Biden’s one-week visit could hardly have gone better. Having spent four years being pilloried by Donald Trump – for low NATO defence spending, trade surpluses, free-riding on US generosity and behaving like a “geopolitical foe” – Europe was craving Biden’s diplomatic balm.

The 46th US president did not disappoint. America’s friendship was “rock solid”, Biden said; Europe’s security was America’s “sacred obligation”. In addition to strategic reassurance, Biden also lifted punitive US tariffs on Europe and called off the long-running Boeing-Airbus subsidy dispute.

The relief among European officials was visible. Ursula von der Leyen, president of the European Commission, referred to America’s President as “Dear Joe” – an endearment it would be hard to imagine being used for many of Biden’s predecessors, not just Trump. “Biden’s language and tone was everything Europeans wished for,” says Jeremy Shapiro, research director at the European Council on Foreign Relations.

Long-running differences remain – not least over Europe’s low defence spending. But the larger purpose behind Biden’s trip, which began with the G7 gathering in Cornwall and wrapped up with the Vladimir Putin summit in Geneva, had more to do with the Indo-Pacific than the Atlantic.

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https://www.smh.com.au/world/middle-east/taliban-enter-key-cities-in-afghanistan-as-us-prepares-to-leave-20210621-p582ow.html

Taliban enter key cities in Afghanistan as US prepares to leave

By Thomas Gibbons-Neff and Najim Rahim

June 21, 2021 — 7.42am

Kabul: The Taliban entered two provincial capitals in northern Afghanistan on Sunday, local officials said, the culmination of an insurgent offensive that has overrun dozens of rural districts and forced the surrender and capture of hundreds of government forces and their military equipment in recent weeks.

In Kunduz city, the capital of the province of the same name, the Taliban seized the city’s entrance before dispersing throughout its neighbourhoods.

Kunduz was briefly taken by the Taliban in 2015 and 2016 before they were pushed back by US airstrikes, special operations forces and Afghan security forces.

“Right now, I hear the sound of bullets,” said Amruddin Wali, a member of Kunduz’s provincial council. “The Taliban have appeared in the alleys and back alleys of Kunduz, and there is panic all over the city.”

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https://www.afr.com/world/north-america/capital-for-the-people-an-idea-whose-time-has-come-20210621-p582ti

Capital for the people – an idea whose time has come

Rather than soaking the rich to raise revenue, California is thinking about harnessing capital the same way investors do, and then using the proceeds of the capital growth to fund the public sector.

Rana Foroohar Contributor

Jun 21, 2021 – 12.32pm

If American states are, as former US Supreme Court Justice Louis Brandeis once put it, the “laboratories of democracy”, then it’s worth watching closely what’s happening in California right now.

The threat of rising taxes and a “soak the rich” political atmosphere has led some wealthy Golden State residents, including a number of technology entrepreneurs, to leave for cheaper pastures such as Austin or Miami. This has, in turn, prompted worries of a larger migration that would have an impact not only on the state’s tax base, but on the growth and innovation that have made California the world’s fifth-largest economy.

It is an exceptionally fraught situation. While nobody these days has much sympathy for wealthy individuals or companies (witness the recent justified fury about the ProPublica leaks showing how little tax the wealthiest Americans pay), or really believes in trickle-down economics, the threat of tax and regulatory arbitrage by other states is real.

The good news is that California is applying some typically creative thinking to the problem. What if there was another way to harness company and citizen wealth for the benefit of all?

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https://www.afr.com/world/asia/how-china-broke-the-asian-model-20210622-p58335

How China broke the Asian model

Unlike Taiwan or South Korea, which turned from one-party states to democracies as they got richer, China under Xi has entrenched the dominance of the Communist party.

Gideon Rachman Columnist

Jun 22, 2021 – 9.06am

“What do you think is unique about the China model?” That was the question posed to me by a television reporter, last time I was in Beijing. My answer was that I don’t think there was a specific Chinese economic model.

There is an east Asian development model of rapid, export-driven industrialisation that was pioneered by Japan, South Korea and Taiwan. What China did was to pursue the same model — at scale.

I added that China’s one real innovation was that the country had not liberalised politically as it had grown richer. This sets China apart from the South Koreans and Taiwanese.

After we had finished talking, I asked the reporter if she would be able to use any of my answer. “No, I don’t think so,” she replied. “But it must be nice to be able to say what you think.”

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https://www.smh.com.au/business/markets/iron-fist-losing-its-grip-china-s-latest-crackdown-looks-destined-to-fail-20210621-p582sj.html

Iron fist losing its grip: China’s latest crackdown looks destined to fail

Stephen Bartholomeusz

Senior business columnist

June 21, 2021 — 11.55am

China’s latest effort to try to dampen soaring commodity prices is likely to have as fleeting an impact as its last.

Last week China announced plans to release government reserves of some key commodities – including copper, aluminium and zinc (but not iron ore) – to counter high prices and some supply shortages that are driving up raw material costs for its manufacturers.

That followed last month’s crackdown on excessive speculation, “fake news,” hoarding, price-fixing and other activities in commodities futures markets, along with efforts to lower steel production and therefore demand for iron ore and other steel-making ingredients.

In that instance, iron ore and other commodity prices fell sharply but recovered quickly to trade at levels close to their pre-crackdown peaks.

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https://www.smh.com.au/world/asia/the-contradiction-at-the-heart-of-china-s-rise-20210621-p582rl.html

The contradiction at the heart of China’s rise

Peter Hartcher

Political and international editor

June 22, 2021 — 5.30am

The Chinese Communist Party can take credit for two breakthrough events that occurred on the same day last week.

In one, Beijing launched three astronauts into the stratosphere to build China’s first space station. In the other, 500 police officers raided a newspaper office in Hong Kong to arrest five executives for allegedly endangering national security.

The first showcases the stunning ascent of China into prosperity and advanced science; the second its dismal descent into tyranny.

As China prepares to celebrate next week the 100th birthday of the Chinese Communist Party, these two events, carefully stage-managed, capture perfectly the paradox at the core of the regime.

Its economic flourishing, on a scale without precedent, has liberated vast human potential. By raising 850 million people out of poverty in the last 40 years, according to the World Bank’s reckoning, China has given its people comforts and opportunities that earlier generations had always dreamed of but never attained.

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https://www.smh.com.au/business/the-economy/keep-calm-and-carry-on-the-fed-might-have-been-right-about-inflation-20210622-p58370.html

Keep calm and carry on: The Fed might have been right about inflation

By Paul Krugman

June 22, 2021 — 7.05pm

Remember when everyone was panicking about inflation, warning ominously about 1970s-type stagflation? OK, many people are still saying such things, some because that’s what they always say, some because that’s what they say when there’s a Democratic president, some because they’re extrapolating from the big price increases that took place in the first five months of this year.

But for those paying closer attention to the flow of new information, inflation panic is, you know, so last week.

Seriously, both recent data and recent statements from the Federal Reserve have, well, deflated the case for a sustained outbreak of inflation. For that case has always depended on asserting that the Fed is either intellectually or morally deficient (or both). That is, to panic over inflation, you had to believe either that the Fed’s model of how inflation works is all wrong or that the Fed would lack the political courage to cool off the economy if it were to become dangerously overheated.

Both beliefs have now lost most of whatever credibility they may have had.

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https://www.smh.com.au/world/north-america/top-us-military-leader-on-critical-race-theory-i-want-to-understand-white-rage-and-i-m-white-20210624-p583ry.html

‘I want to understand white rage. And I’m white’: top US general

By Alex Horton

June 24, 2021 — 6.49am

Washington: The top US Army General Mark Milley admonished lawmakers over questions about critical race theory at a hearing, saying it is important for leaders to be well-versed in many schools of thought.

“I’ve read Mao Zedong. I’ve read Karl Marx. I’ve read Lenin. That doesn’t make me a communist,” Milley, chairman of the Joint Chiefs of Staff, told the House Armed Services Committee on Wednesday (Thursday AEST).

“So what is wrong with understanding . . . the country which we are here to defend?”

“I personally find it offensive that we are accusing the United States military, our general officers, our commissioned and noncommissioned officers, of being, ‘woke’ or something else, because we’re studying some theories that are out there.”

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https://www.smh.com.au/business/the-economy/unintended-consequences-china-risks-market-panic-as-it-tightens-its-grip-20210624-p583s5.html

Unintended consequences: China risks market panic as it tightens its grip

By Sofia Horta e Costa and Rebecca Choong Wilkins

June 25, 2021 — 7.45am

China’s campaign to cut leverage and instil corporate discipline is reshaping the nation’s $US12 trillion ($15.8 trillion) credit market.

One of China’s most prolific debt issuers hasn’t sold a single dollar bond in 17 months, the longest dry spell since 2013. An investment grade-rated conglomerate mostly owned by the government is facing a cash crunch in a test of state support. Analysts at UBS and Goldman Sachs now say the notion of ‘too big to fail’ no longer applies in China as defaults this year exceed $US23 billion, a record pace.

Beijing is taking advantage of a strengthening economy and stable financial markets to toughen up its corporate sector. The result is a repricing of risk that should discourage the kind of reckless debt-fuelled expansion that inflated some companies to a dangerous size. The spawning of such bloated empires created a threat to the financial system as well as a challenge to President Xi Jinping’s grip on power.

The danger for Xi is that smashing investor faith in government guarantees triggers precisely the kind of crisis he’s trying to avoid. It’s a dilemma that has frustrated Chinese leaders for decades: Ending moral hazard for indebted giants like China Huarong Asset Management and China Evergrande Group would make the financial system more resilient over the long run, but a major default would cause significant short-term pain.

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https://www.theaustralian.com.au/business/the-wall-street-journal/afghan-government-could-collapse-six-months-after-us-withdrawal/news-story/7617229815d7857e9691ced8a765f50f

US intelligence warns Afghan government could collapse six months after withdrawal

By Gordon Lubold And Yaroslav Trofimov

7:38PM June 24, 2021

The US intelligence community concluded last week that the government of Afghanistan could collapse as soon as six months after the American military withdrawal from the country is completed, according to officials with knowledge of the new assessment.

American intelligence agencies revised their previously more optimistic estimates as the Taliban swept through northern Afghanistan last week, seizing dozens of districts and surrounding major cities. Afghan security forces frequently surrendered without a fight, leaving their Humvees and other American-supplied equipment to the insurgents.

The new assessment of the overall US intelligence community, which hasn’t been previously reported, has now aligned more closely with the analysis that had been generated by the US military. The military has already withdrawn more than half of its 3500 troops and its equipment, with the rest due to be out by September 11.

On Wednesday, Taliban fighters were battling government troops inside the northern city of Kunduz after occupying the main border crossing with Tajikistan the previous day and reaching the outskirts of northern Afghanistan’s main hub, Mazar-e-Sharif. Tajikistan’s border service said 134 Afghan troops at the crossing were granted refuge while 100 others were killed or captured by the Taliban.

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https://www.afr.com/world/europe/boe-warns-against-tightening-too-soon-as-inflation-surges-20210625-p5845a

BOE warns against tightening too soon as inflation surges

Reed Landberg and Lizzy Burden

Jun 25, 2021 – 2.56am

The Bank of England pushed back against speculation that a surge in UK inflation means it’s preparing to boost interest rates, saying the economy still needs support to recover from the pandemic.

The central bank warned against “premature tightening,” toughening its language on the need to maintain stimulus. The remarks contrasted with a sharp increase in the bank’s outlook for inflation, which officials now see peaking at 3 per cent, a half point higher than their forecast just six weeks ago.

The BOE’s sanguine view follows heightened anxiety among investors and economists that consumer price increases may prove sticky. Last week, the US Federal Reserve brought forward its expectations of rate increases, while central banks in Hungary and the Czech Republic already started raising borrowing costs in recent days.

“Today’s decision reinforces our belief that the committee will continue providing monetary support through the economic restart,” said Vivek Paul, UK chief investment strategist at BlackRock Investment Institute.

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https://www.afr.com/world/middle-east/iran-bets-on-revolution-and-repression-20210623-p583kd

Iran bets on revolution and repression

Iran has a new hard-line ideological leader. That means the West’s 42-year crisis with the country is only going to get worse.

Bret Stephens Contributor

Jun 25, 2021 – 10.46am

In the summer of 1988, Iran’s supreme leader, Ayatollah Ruhollah Khomeini, ordered the secret executions of thousands of political prisoners. Iran then denied reports of the slaughter, calling them “nothing but propaganda” based on “forgeries.” It also ruthlessly suppressed efforts by the families of the disappeared to find out what had happened to their relatives, including the location of their burial sites.

More than 30 years later, the world still doesn’t know how many prisoners were murdered, although a landmark 2017 report from Amnesty International put the minimum number at “around 5000.” Other reports suggest a figure as high as 30,000.

But one point is not seriously in doubt: Among the handful of Iranian leaders most involved in the “death commissions” was Ebrahim Raisi. At the time of the massacres, Raisi, the son of a cleric and the product of a clerical education, was deputy prosecutor general of Tehran, later rising to become Iran’s chief justice. In 2018, he called the massacres “one of the proud achievements of the system.”

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https://www.afr.com/world/asia/red-power-how-chinese-communism-survived-for-a-century-20210624-p583un

How Chinese communism survived for a century

Only North Korea has an older communist movement than China, where the party is preparing to celebrate its centenary.

Michael Smith China correspondent

Jun 25, 2021 – 2.58pm

As far as historical anniversaries go in China, the warm-up for the 100th anniversary of the Chinese Communist Party has been surprisingly low-key so far.

Beijing’s Tiananmen Square was closed to the public this week as construction work started for the official celebrations. Unlike previous significant milestones where there have been extravagant military parades, the plans have been kept secret.

Still, it is unlikely the centenary of a revolutionary movement that has become one of the most powerful institutions in the world will go unmarked. President Xi Jinping is expected to take centre stage at an event that will be used to cement his decade-long reign. 

Cities have been decked out with banners and billboards reminding citizens to obey the authorities and listen to the party, as underground metro stations in Shanghai are festooned with Chinese flags and cinemas screen propaganda films several times a week.

State media says 100 rappers have been engaged to perform patriotic songs while millions of students completing university entry exams this month had to complete an essay on party history that has been revised to play down the horrors of Mao Zedong’s Cultural Revolution.

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https://www.smh.com.au/world/europe/eu-leaders-to-orban-hungary-can-exit-if-not-happy-to-uphold-values-20210625-p584bq.html

EU leaders to Orban: Hungary can exit if not happy to uphold values

By Samuel Petrequin, Lorne Cook and Justin Spike

June 25, 2021 — 4.03pm

Brussels: European Union leaders have clashed with Hungary’s Prime Minister Viktor Orban during a heated summit in Brussels, telling him a new law that bans LGBT information in schools goes against the bloc’s fundamental values.

The law prohibits showing content of any non-heterosexual sexual orientation in school sex education programs, or in films and advertisements aimed at anyone under 18. It has been widely criticised across the region and has angered human rights groups.

Its supporters claim it will help fight paedophilia.

But a majority of the leaders disagreed and insisted that discrimination must not be tolerated in the 27-nation bloc.

“Being homosexual is not a choice; being homophobic is,” Belgian Prime Minister Alexander De Croo told Orban during the meeting, according to an EU diplomat. The person spoke anonymously according to usual practice.

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I look forward to comments on all this!

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David.