Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
General Comment
It seems it was all about the States and Territories this week and not in a good way!
Other than that – a plea to notice the computer less and the patient more!
Lots more as you browse down!
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The practice of medicine is a subtle art. Doctors need to give patients their undivided attention.
By Caleb Gardner and John Levinson
Sept. 21, 2016 6:50 p.m. ET
Of the many problems facing modern medicine, the deterioration of the patient-doctor relationship is one of the most pernicious. Today our health-care system is losing its humanity amid increasingly automated and computer-driven interactions between doctors and patients.
The signs and symptoms of this pathology are everywhere and have been described in these pages: Primary-care appointments are now as short as five minutes, and the physician must spend much of that time typing instead of attending to the patient and performing a physical examination. Medical students and residents are spending more time with screens than with patients. A 2013 study from Johns Hopkins showed that first-year physicians spent a meager eight minutes a day with each of their hospitalized patients while spending hours at the keyboard describing and quantifying those fleeting moments. Meanwhile, fewer doctors would like to see their children enter a career in medicine, and escalating health-care costs are crippling families and the economy without improving public health.
The electronic health record (EHR), once a promising new medical technology, is a major cause of this disconnect. Not long ago, doctors dreamed of a time when unwieldy paper charts would be replaced by streamlined computer systems, freeing them up for more direct patient care. But now these computer systems are distracting and burdensome. Senior physicians are retiring early because of the EHR, while young doctors feel the humanity draining from a profession to which many were drawn because of a desire to interact and connect with people.
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Miles Kemp, The Advertiser
September 20, 2016 8:30pm
AN elderly dementia patient’s death was not reported to the Coroner because paperwork was “lost” in a controversial hospital computer system, an inquest has found
Gordon Smith, 91, had been subjected to a “treatment order” and shackled to a bed after he was found wandering in the Repatriation General Hospital carpark.
This meant his subsequent death from multiple organ failure must be reported to the Coroner and investigated by his office because he was technically “in custody”.
But the treatment order was lost among 200 other computer entries, Deputy Coroner Anthony Schapel found in an inquest into Mr Smith’s death.
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September 21, 2016 9:30pm
OUR state’s public-health system is being buffeted by unprecedented change – and that’s led to waves spreading across some of our most important institutions.
The latest is an elderly dementia patient’s death going unreported to the coroner because paperwork was “lost” in a controversial hospital computer network, the new Enterprise Patient Administration System, or EPAS.
Deputy Coroner Anthony Schapel has found a treatment order was lost among 200 other entries in the EPAS, which meant his office was told of the death only a month after the error was realised.
The coronial report draws the issue to the attention of Health Minister Jack Snelling. It will be added to his in-tray of political hot potatoes, which include a chemotherapy underdosing scandal and the continued saga of the new Royal Adelaide Hospital opening date.
Perhaps ironically, the EPAS’s smooth operation is critical to the new RAH, which has been designed as a paperless hospital. Clearly, the EPAS did not cause the 91-year-old man’s death but Mr Snelling concedes that the system is being changed as a result of the coronial recommendations.
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When is a device not a device? When it’s an app
Australia’s drugs and devices watchdog has spent years grappling with the issue of how to regulate smartphone apps.
At present, the TGA has no overall mandate to regulate apps, as they are rarely devices in the true sense of the word.
However, last week, the need for more robust regulation came to the fore after a problem was found with the Accu-Chek Connect Diabetes Management app that is used in conjunction with Accu-Chek Aviva Connect and Accu-Chek Guide blood glucose meters.
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23 September 2016
THE 21st century is well upon us, and the scientific and health landscape is rapidly changing, yet there are still new horizons to conquer. The final frontier does not lie in a distant galaxy. It is much closer to home. Look no further than the place where men fear to tread: Men’s Health.
The prostate gland, which rarely sees the light of day, is suddenly in the spotlight and cancer is the focus. Prostate cancer is not just a disease of men, but a disease of couples, especially when issues of manhood and masculinity are at stake. Surgery for prostate cancer may result in erectile problems and urinary incontinence. These make up the very fabric that constitutes masculinity, wherein lies the reluctance to contemplate prostate screening. Can men learn to address this difficult topic, or are they too often reluctant to discuss it until it is too late?
New Advances
Advances in technology have been the driving force to further advances in medical treatments. The slow trickle of progress in newly found horizons of information has suddenly become a torrent of new information. Advancements in new ways of thinking and solving the reluctance of men to undergo prostate screening and treatment are major steps forward for all men. All of which is good news for managing the medical problems facing an ageing population in the future.
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COMMENT
- September 20 2016 - 7:30PM
· Stephen Crook
ACT Health has told the managers at Canberra Hospital that they have to save $96 million over the next three years starting this year. Clearly they want to save money, but at what cost? Is the plan that services should be reduced or is it that staff should "simply" do more with less?
Front-line staff are already stretched – something as simple but vital as recording patient medications requires endless duplication as patients move from one speciality area to another.
Millions have been spent on an increasing number of electronic record systems. But, despite gold plated prices, these systems often fail to communicate with each other or even be available to doctors outside a particular specialty. This siloing of information wastes time and risks vital information not reaching doctors as they treat patients. With the increasing levels of documentation staff are removed from patient care frequently during the day to attend pointless paper-shuffling meetings, is it any wonder less time is spent treating patients?
And yet, while seemingly happy to spend vast sums on ineffective computer systems, ACT Health is considering saving money by reducing or terminating the attraction and retention incentives that brought many senior medical staff to Canberra. Affected staff have been given no guarantees of a fair hearing or appeal process if decisions are unfavourable. This morale-sapping process risks major effects on staff retention and performance.
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Stephen Crook is the executive and industrial officer of the Australian Salaried Medical Officers Federation (ACT)
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Inquiry doesn’t mince words over Department of Health centralised computing services contract
An inquiry by a committee of the WA Legislative Assembly has called for the state’s health minister to report to parliament on why the Department of Health failed to utilise the government’s Gateway review process, in the wake of a major contract bungle.
“The Department of Health has been inconsistent in its use of the Gateway review
process for major ICT procurement projects, which reflects a disregard for the value of the process in improving project delivery performance,” the report by the Legislative Assembly’s Education and Health Standing Committee said.
The committee's inquiry focused on a damning audit of the department’s management of its centralised computing services contract.
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Adrian M. Reodique | Sept. 20, 2016
The telehealth market in Asia Pacific (APAC) region - including telemedicine, mobile health (mHealth), and remote patient monitoring (RPM) - is expected to reach US$1.79 billion in 2020, according to the report by Frost & Sullivan titled "Asia-Pacific Telehealth Outlook 2016-2020".
The forecasted value indicates a 12 percent Compound Annual Growth Rate (CAGR) from its estimated value of US$1.02 billion in 2015.
The report said the growing usage of mobile and broadband Internet service across the region pushed the adoption of new healthcare delivery models to address the challenges in the industry, including rising cost of services, and increasing incidence of chronic and infectious diseases.
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20 September 2016
IN the evolving culture of healthcare, actively involving patients is seen as increasingly important. Written communication is a useful tool, yet most Australian patients don't receive copies of the correspondence between their specialist and GP.
Should they?
To test the question, a team of Victorian gastroenterologists randomised 70 patients referred for endoscopy to the Royal Melbourne Hospital. They gave 36 patients copies of the clinic correspondence and an endoscopy report. The remaining 34 received neither.
When the researchers asked the groups to fill out a survey a month later, they found those who received correspondence had similar levels of satisfaction, understanding and anxiety as those who didn't.
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Tim Catley, Chris Robson, Aaron Liu, Tim Hume and Dr Zoran Bolevich discuss current and future IT works in their agencies.
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Zoran Bolevich, CEO and CIO, eHealth NSW
Established in July 2014, eHealth NSW is the dedicated organisation within NSW Health to deliver technology-led healthcare to the state. The agency launched its ten year plan in May this year, which includes the development of core clinical systems, integrated care solutions and workforce and business management systems.
Bolevich was appointed as CIO and CEO of eHealth NSW in March, after acting in both roles since July last year.
“Our vision is a one of digital enablement and transformation of health services and we are well under way in achieving that,” Bolevich said. “For us cloud-based technologies are a very important part of ehealth’s strategy, and a key vehicle towards great innovation.”
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Just before the last election the Government announced that it had awarded Telstra a $220 million five year contract to run national cancer registries. Concerns were raised at the time about both the process and the timing of this decision and many stakeholders questioned whether the telecommunications giant was the best choice for an organisation to collect and protect sensitive persona health data.
Four months later, without responding to these questions and concerns, the Government has introduced the legislation to establish the National Cancer Screening Register (which will be responsible for the collection, storage, analysis and reporting of cancer screen program data for the National Cervical Screening Program and the National Bowel Cancer Screening Program) into Federal Parliament.
This legislation has been referred to the Senate Community Affairs Committee by Labor, which also tried to introduce amendments into the legislation which could potentially make the contract with Telstra invalid.
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- September 22 2016 - 2:20PM
Tim Biggs
A new virtual reality app that puts users in the position of a person living with dementia has been released for Google's Cardboard VR platform.
Called EDIE (pronounced Eddy put standing for Educational Dementia Immersive Experience), the app was launched on Thursday by Alzheimer's Australia Vic, and is available free on Android and iPhone.
Dr Tanya Petrovich, manager of business development at Alzheimer's Australia Vic, says the app was designed to build empathy and make people more aware of the issues faced by those living with Dementia.
"The idea is you step into the shoes of a person named Edie, who's living at home with his wife, and who is living with dementia", Petrovich says. When Edie gets up in the middle of the night and has to go to the bathroom, players see the world through his eyes.
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22 September 2016
THE RACGP is calling time on the era of the fax machine and the letter, officially telling the government and other health services to catch up and integrate with the electronic communication systems of general practices.
The shift should happen within three years, the college says in a new position statement, citing cases where a lack of timely communication between general practice and other health services have put patient safety at risk.
In one well-known case, a South Australian coroner found that a specialist's "archaic" practice of sending a letter by ordinary post contributed to the warfarin-related death of an elderly Adelaide woman.
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Peninsula Health is part of Australia’s My Health Record system so please register prior to or during your admission so your doctors and health care professionals can have access to your health information for your hospital stay and treatment.
What is a My Health Record?
A My Health Record is an online summary of your health information. You control who can see each piece of your information. Peninsula Health currently uploads discharge summaries to the My Health Record, going forward it is proposed to contain other personal health information such as your current medications, immunisations, allergies, adverse reactions, advanced care directives and emergency contact details.
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Created on Friday, 16 September 2016
Dr John Aloizos, Clinical Advisor to the Australian Digital Health Agency, discusses how the My Health Record and digital technologies are helping his team at Garden City Medical Centre develop clinical pathways for patients with chronic and complex illnesses, and provide comprehensive care and service for their patients.
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The FHIR trademark system is operational. There are 2 kinds of license to apply for:
You can use the name “FHIR” without applying for a trademark license in 2 circumstances.
Fair Use
You don’t need trademark permission to make use of the name “FHIR” to refer to the specification HL7 publishes, or the community that builds it. You can use “FHIR” as you like as long as you are referring to one of those things. That’s covered clearly under the “fair use” provisions of trademark law in most jurisdictions. HL7 asks that you mention that FHIR is a registered trademark, and provide attribution to HL7, but you don’t need to do those things under fair use law.
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20 September 2016
MEDICAL software has become an integral tool in general practice.
One of the more commonly used systems is Best Practice, developed by former GP Dr Frank Pyefinch in 2004.
The two main components are for front-desk management and clinical management. But a practice can opt for only the clinical functionality and link to existing billing software.
The nature of Australian general practice requires software to be able to do online bulk billing claims, DVA claims, private claims as well as charging for products such as immunisations, all of which Best Practice caters for.
Appointment bookings are easy to use and allow for notations such as new patient, as well as reminders for a particular patient.
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- The Australian
- 12:00AM September 19, 2016
Annabel Hepworth
The Australian Taxation Office is pushing for a review of confidentiality rules that restrict the sharing of personal data across government, warning some of the laws are decades old.
In a move that has reignited privacy concerns, the tax office has declared there should be efforts to “broaden the social licence for the increased sharing of confidential government data-going forward”.
The call comes as the Australian Securities & Investments Commission has also pushed to widen the scope of sensitive data it secures from other government agencies, insisting it would benefit from “rapid access” to bankruptcy records, travel movements and criminal history.
In a submission to a Productivity Commission inquiry into data ordered by Scott Morrison, the tax office has argued for modernised rules on confidentiality as a way to deal with the rapid changes to technology.
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Paul Craven to lead new division
Wavelink, a value-added distributor of enterprise mobility and unified communications solutions has launched a new division focussed on the health industries markets in Australia and New Zealand and has named Paul Craven to lead it.
Wavelink said Craven would “focus on bringing together solutions for Wavelink’s partners targeting public hospitals, private healthcare groups, and aged care facilities across Australia and New Zealand.”
It said the establishment of its health practice would provide a level of specialisation to its partners by providing end customers with comprehensive solutions, not just hardware. “The premise of the practice is to build solutions from use cases that improve patient care and drive operational efficiency.”
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Orion Health says it is looking to hire the best analytics talent in New Zealand.
NZX-listed health technology company, Orion Health (NZX: OHE) says it is investing significantly in new analytics and machine learning applications and looking to hire the best analytics talent in New Zealand.
Orion Health CEO Ian McCrae said: “We are now focussed on boosting our ability to provide data insights that will help our customers improve their delivery of healthcare. We already have a talented analytics team based at our US headquarters in Arizona, but we need a team in Auckland where the majority of our research and development team of over 500 people are based.”
The company has appointed Peter McCallum, the former head of data & insights at Spark’s data solutions company, Qrious, to lead its analytics team and says he has over 15 years’ experience working exclusively in the business intelligence, data warehousing and data analytics domains.
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- Updated Sep 20 2016 at 11:45 PM
by Philip Ball
Late last year, an experiment carried out by scientists at the Delft University of Technology in the Netherlands appeared to demonstrate that one object can affect another from afar without any physical interaction between the two. The finding confirmed an idea so extraordinary that, nearly a century ago, Albert Einstein had rejected it with the dismissive phrase "spooky action at a distance". In quantum theory this phenomenon is known as "entanglement", and many physicists now regard it as the most profound and important characteristic of the physical world at the smallest scales, which quantum theory describes.
Quantum entanglement is a deeply counterintuitive idea, which seems to contradict human experience of the physical world at the most essential level. In the everyday ("classical") physical realm, objects affect one another via some kind of contact. The tennis ball flies from the racket when struck, and when it hits the window the glass will smash.
Sure, "invisible forces" seem to act across space – magnetic and electrical attraction and repulsion, say. But in quantum theory these interactions arise from the passage of a particle – a photon of light – between the two interacting bodies. Meanwhile, Einstein showed that the sun's gravity corresponds to a distortion of space, to which distant objects such as Earth respond. It's generally believed that in a quantum theory of gravity (which doesn't yet exist), this picture will prove to be equivalent to the exchange of "gravity particles" or gravitons between the sun and Earth.
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- Tom Whipple
- The Times
- 12:00AM September 22, 2016
Generations have watched Captain Kirk say the words “Beam me up Scotty” and dreamed of a future in which teleportation is possible. Now, at last, it is. Provided, that is, the thing you are beaming is a precisely entangled unit of quantum information, and Scotty isn’t too concerned about a high probability of it getting lost along the way.
For the first time, scientists have successfully teleported quantum information over a significant distance using a city’s fibre-optic infrastructure. Two separate teams of researchers achieved the feat, considered a prerequisite to building a secure “quantum internet”, and broke the distance record for fibre-optic teleportation in the process.
Quantum teleportation does not, alas, involve the science fiction-style transfer of objects. Instead, it involves moving information securely, using a phenomenon by which particles can be “entangled”, so that a change on one affects another, even when they are separated.
This weird property of particles so discombobulated Albert Einstein that he referred to it as “spooky action at a distance”.
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Enjoy!
David.
