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."

Thursday, July 24, 2014

Review Of The Ongoing Post - Budget Controversy 24th July 2014. It Is Sure Going On and On!

Budget Night was on Tuesday 13th May, 2014 and the fuss has still not settled by a long shot.
It is amazing how the discussion on the GP Co-Payment just runs and runs.
Here are some of the more interesting articles I have spotted this eighth  week since it was released.
Parliament has now got up for the Winter Recess we can take a breath and see where we are. Interestingly it seems so much that has been in contention is yet to even be introduced into Parliament so we will have a long wait to discover what will happen with things like the Medicare Co-payment and so on.
We sure do live in interesting times!
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General.

Health insurers make inroads into GP services

Joanna Heath
Take two 55-year-old, slightly overweight men with a niggle in their chest. One has private health insurance, and one does not. The man with private health insurance – let’s call him Simon – rings his doctor. They’re full up today, the receptionist tells him, but because he is a customer of their preferred insurance provider, they’ll fit him in. He won’t have to pay for the visit, thanks to an agreement between his insurer and the clinic.
Simon’s doctor checks him out and decides it’s nothing serious. But to be sure, he sends him down the corridor to have a scan, which will be billed straight to his insurer. The doctor suggests Simon might think about losing a bit of weight to prevent a real heart attack, and refers him to a dietitian. Again it’s the insurer that picks up the bill.
David, who doesn’t have private health insurance, also calls his doctor. He is told they can’t fit him in today.
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Aussies rank cancer highly in health priorities

Sean Parnell

Health Editor
Brisbane
AUSTRALIANS want to safeguard cancer services from ­government cuts, ranking the disease more deserving of ­additional funding than other major health conditions in an ­exclusive Newspoll.
After the federal budget cut preventive health and public ­hospital funding, and moved to impose a $7 co-payment on basic medical services, partly to pay for a new research fund, Newspoll asked Australians what areas they thought should be prioritised by governments.
Given a choice between cancer, heart disease, obesity, mental health and diabetes, Australians were more likely to give the highest priority to cancer (30 per cent), with women ranking it higher than men.
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Sports on back foot over Medicare cuts

John Stensholt
Australia’s richest and most popular football and sporting codes, such as the Australian Football League and Australian Rugby League, are used to taking big hits both on and off the field.
But an innocuous looking letter from a mid-ranking Medicare bureaucrat has flawed them and is set to cost the sports ­millions of dollars.
The letter sent in June asked clubs and sports to bear the full cost of operations and other medical procedures that were partly covered by Medicare. It sparked top-level discussions among the sporting codes’ chief executives and demands for an urgent meeting with Health and Sports Minister Peter Dutton in Canberra.
Now there is now a mounting concern that athletes may be given less than ­adequate medical treatment as costs are likely to soar for clubs and sports.
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GP Co-Payments.

More bad news on the GP co-payment: BEACH study

Michelle Hughes | Jul 15, 2014 11:58AM
In case you needed more evidence that the GP co-payment needs some further consideration, researchers at the University of Sydney have released has released a new study  on the estimated impact of co- payments, and the results provide interesting reading.
This study is of particular interest as it draws on the latest year of BEACH data i.e. GP consultations from April 2013- March 2014. The following table of examples from the paper suggests the impact for many is not insignificant.
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Survey finds cost fears delaying visits to doctor

By David Chen
Posted Thu 17 Jul 2014, 11:08am AEST
The chairman of the Townsville-Mackay Medicare Local says he is concerned people are putting off a visit to the doctor because of costs.
Data collected by the Medicare Local over the past year shows one in 12 people in north Queensland are delaying a trip to the local GP because they are worried about the cost.
Chairman Dr Kevin Arlett says the figures are higher than expected.
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Dutton commences co-payment compromise with crossbenchers

Joanna Heath

Key points

  • Peter Dutton has said there is room for negotiation on the co-payment.
  • The AMA are critical of the co-payment, saying at-risk patients should get a break.
Health Minister Peter Dutton says he has opened negotiations with the minor party senators on the $7 co-payment for doctor visits, one of the most controversial budget measures yet to be put to Parliament.
Mr Dutton has previously flip-flopped on whether the government was prepared to make adjustments to its model, which imposes the fee on GP patients regardless of their ­concessional status.
“My judgment is that there is ­certainly in my space the ability for us to negotiate on the co-payment and on the measures the government has in place otherwise,” Mr Dutton said on ­Thursday. “We’re negotiating in good faith and I’ve certainly been ­encouraged by the level of engagement from those senators so far and those ­conversations continue.”
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Parliamentary showdown over co-pay campaign

17 July, 2014 Paul Smith
Australian Doctor's Stop the Co-Pay Cuts: GPs make the difference petition caused a storm in parliament on Wednesday, with Tony Abbott claiming  many doctors support his government's co-payment policy.
Here Deputy Editor Paul Smith reports on the Question Time fracas.
The petition is being brandished in front of Tony Abbott and it doesn't look as though the Prime Minister likes it much.
It is Question Time, which in our politically turbulent age, carries a feral edge more commonly experienced in a school assembly for troubled kids.
The topic is the Federal Government's $7 co-payment plan. The petition is Oz Doc's petition signed by over 2500 GPs, and a further 600 practice staff and patients, calling for the co-payment plan to be shelved, along with the couple of billion dollars in Medicare cuts.
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Govt wants talks on co-payment: Hockey

18 July, 2014 Antonio Bradley
The Federal Government says it is open to negotiation on its controversial GP co-payment plan, but claims other political parties are not returning its calls.
In an interview on Thursday, Treasurer Joe Hockey acknowledged the resistance the controversial budget measure was likely to face when it reaches the Senate.
"Sooner or later many of our critics will have to realise that the reason why we're doing this is to strengthen the economy and help to create more jobs and greater prosperity," he told radio station 3AW.
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Medicare Locals.

Medicare Locals had no ‘clear strategy’

Sean Parnell

Health Editor
Brisbane
MEDICARE Locals, the primary care organisations established as part of Labor’s health reforms, came without a “clearly defined and measurable strategy and role”, according to an analysis for the federal government.
Consultants Ernst and Young were the key independent advisers to John Horvath for his review of the 61 Medicare Locals, which led to a budget decision to replace them with a new structure.
While the Coalition has long criticised Medicare Locals, arguing that they were an unnecessary ­bureaucracy that diverted federal funds from frontline services, the consultants and Professor Horvath found some, at least, were doing good work.
However, the Ernst and Young analysis — which includes work by the University of NSW Centre for Primary Health Care and ­Equity — reveals those successes were “in large part not due to design” and the performance varied greatly across the system.
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Rage over mental health cuts in Central Australia

  • Matt Garrick
  • NT News
  • July 18, 2014 1:44PM
THE future of a Central Australian mental health program provided by the Royal Flying Doctor Service is up in the air.
Member for Lingiari Warren Snowdon has accused the government of lies and “breaking promises to Aboriginal people” amid claims there is to be a reduction in funding to NT Medicare Local.
“This reduction in NT Medicare Local funding has meant that the service provider (of a remote mental health program) – the Royal Flying Doctor Service, is no longer able to deliver this much needed service,” said Mr Snowdon.
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Doctor shocked by health data for Mackay

17th Jul 2014 2:44 PM
TOWNSVILLE-MACKAY Medicare Local Chairman Dr Kevin Arlett is shocked by the startling reality of health data collated by the organisation during the past year that gives a snapshot of the health in the community.
He said that despite the incredible amount of education and work being done to tackle chronic and preventable disease, nearly a quarter of adults in the region are smokers and three quarters of adults are either overweight or obese.
"There is some really promising data like 80% of people in our region visiting a GP and very high percentage of indigenous children who are fully immunised but there's also some really startling numbers," Dr Arlett said.
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Pharmacy.

Facts on PBS Co-payment

A PBS co-payment has been in place since 1960, and has had the support of successive Governments since then.
Page last updated: 14 July 2014
14 July 2014
A PBS co-payment has been in place since 1960, and has had the support of successive Governments since then. But that was before Labor lost its way.
Labor should explain why they are opposing a PBS co-payment; something that has had the support of both sides of parliament over the past 50 years.
Labor increased the PBS co-payment by 100 per cent in 1986 and it was Labor who first introduced a PBS co-payment for pensioners in 1991.
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Comment:
It seems the fuss is not yet settled - to say the least. Will be fascinating to see how all this plays out.
The crucial New Senate has shown itself to be rather an extreme rabble and just where we will all wind up is rather in the lap of the gods!
To remind readers there is also a great deal of useful health discussion here from The Conversation.
Also a huge section on the overall budget found here:
Enjoy.
David.

Wednesday, July 23, 2014

A Word To The Wise In E-Health. If You Want To Shape The Future Ask Hard Questions At Consultation Sessions

We now know the Department is trying to constrain the scope of consultation re: the Future of the PCEHR - positive or negative by the questions they are asking.

There are much more fundamental issues re: this Program that need to be discussed and addressed. The initial PCEHR Review was quite inadequate and constrained, as everyone knows given it lasted only 6 or so weeks and had no genuine e-Health experts involved.

If you have a view on the future of the PCEHR etc., Deloitte needs to know, at a live session, or via e-mail!

This looks line a good place to start!

"The Department will also continue to receive any feedback on implementation issues until 1 September at pcehrreview@health.gov.au.

Get to it to get a real consultation happening!

David.

This Is An Obvious But Important Finding! Discharge Summaries Need To Arrive Promptly.

This appeared last week:

Late discharge letters frustrate GPs

16 July, 2014 Michael Woodhead
The frustration GPs feel over late-arriving hospital discharge letters is justified, according to a new study that shows tardy communication impairs patient management.
Researchers in WA have measured the additional burden created by delayed discharge letters, finding that GPs are unable to adequately manage a discharged patient's problems until they receive the all-important discharge information.
The study showed that a timely but brief discharge letter was preferable to a longer letter that arrived after a discharged patient had attended their GP.
And delayed discharge letters often meant that patients had to revisit their GP.
More here:
Here is the abstract:

BMJ Open 2014;4:e005475 doi:10.1136/bmjopen-2014-005475

A randomised trial deploying a simulation to investigate the impact of hospital discharge letters on patient care in general practice

  1. Moyez Jiwa1,
  2. Xingqiong Meng2,
  3. Carolyn O'Shea3,
  4. Parker Magin4,
  5. Ann Dadich5,
  6. Vinita Pillai1

Abstract

Objective To determine how the timing and length of hospital discharge letters impact on the number of ongoing patient problems identified by general practitioners (GPs).
Trial design GPs were randomised into four groups. Each viewed a video monologue of an actor-patient as he might present to his GP following a hospital admission with 10 problems. GPs were provided with a medical record as well as a long or short discharge letter, which was available when the video was viewed or 1 week later. GPs indicated if they would prescribe, refer or order tests for the patient's problems.
Results Numbers randomised 59 GPs. Recruitment GPs were recruited from a network of 102 GPs across Australia. Numbers analysed 59 GPs. Outcome GPs who received the long letter immediately were more satisfied with this information... see link below for details
Conclusions Receiving information during patient consultation, as well as GP characteristics, influences the number of patient problems addressed.
Here is the link:
If ever there was a clear justification for using electronic messaging to get discharge summaries into the hands of GPs this is it. They need to be done on discharge and then transmitted directly. If the patient has a PCEHR they can go there as well - but the vital step is to use the secure message transmission to the GP that is already in place for results etc. in many, many practices. We know it works so it is hard to understand why it is not happening everywhere - other than the distraction that has afflicted us with the PCEHR Program.
It is interesting to note that simple and quick is seen as better than long but slower!
David.

Tuesday, July 22, 2014

PCEHR Consultation: Here Is The Sort Of Issue We Need To Make Sure Is Discussed And Addressed!

This appeared a few days ago:

EHR Systems Falling Short in Improving Patient Safety

Greg Slabodkin
JUL 18, 2014 9:21am ET
Health information technology, such as electronic health records, has the potential to dramatically improve patient safety. Nevertheless, a majority of healthcare organizations are not using EHRs to help track adverse events, and ones that are have their own health IT–related safety risks.
“Most hospitals, even those with EHR systems, do not know their own rates of adverse events,” testified Ashish Jha, M.D., professor of health policy and management at the Harvard School of Public Health, on July 17 before the Senate Health, Education, Labor and Pensions Subcommittee on Primary Health and Aging. “They don’t know how often they harm patients. However, there are now tools available that automatically track these events and these tools are generally quite good. Yet, most EHR vendors have not put these tools into their EHR systems.”
Jha argued that if automated patient safety monitoring was made a key part of certification for the EHR meaningful use program, it would have a dramatic effect on the EHR vendor industry. “The EHR products now being built would scan clinical data and provide real-time surveillance information to doctors, nurses, pharmacists and other healthcare providers about potentially bad events that might be happening to patients,” he said. “It would allow hospitals to intervene quickly, and track their own progress over time.”
Peter Pronovost, M.D., senior vice president for patient safety and quality, and director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine, argues that “the federal government and healthcare organizations have spent hundreds of billions of dollars on health information technology with little to show for it.”
“The promised improvements in safety have not been realized and productivity has decreased rather than increased,” said Pronovost. “Moreover, the usability of most HIT is poor.” For example, to obtain the meaningful use incentives, Johns Hopkins implemented a technology approved by the Office of the National Coordinator for Health IT.
However, he said that shortly after the technology was turned on, clinicians raised concerns that it made care less safe. “After thousands of hours of work, we essentially turned all the supposed ‘safety’ functions for the tool off and had the doctors type the patient’s medications into the tool, allowing us to receive the financial incentives for meaningful use, hurting clinician productivity and failing to improve safety.”
More here:
The link to a very recent RAND report on the topic is here:
Two extracts from the Executive Summary say it all.
Discussion
The challenges and lessons identified in this pilot project point to several opportunities to  increase the safe use of health IT systems. We draw several conclusions about the current state of  health IT safety risks:
1. With few exceptions, awareness of the safety risks introduced by health IT is limited.
2. The traditional departmental “silos” between risk management, IT, and quality and safety management may impede the ability of organizations to recognize and respond to health IT safety risks.
3. External facilitation appears to be important to hospitals and practices; however, the model for providing consultation and technical assistance requires further elaboration.
4. Most ambulatory practices lack the risk management, IT, and quality and safety expertise that is available in hospitals.
5. There is an urgent need for tools and metrics to enable project teams in hospitals and ambulatory practices to detect, mitigate, and monitor health IT safety risks.
6. The current structure of the EHR marketplace, and the low awareness of the risks introduced by health IT systems, lead to weak incentives for EHR developers and providers to invest in the type of joint effort required to reduce health IT safety risks.
And here:
Conclusion
The investment that is converting the U.S. health data infrastructure into a 21stcentury enterprise has the potential to improve care for patients in countless ways. However, “digitizing” the health system also has the potential for harm. In this project, we worked with 11 hospitals and ambulatory practices to evaluate a process improvement strategy and tools developed to help health care organizations diagnose, monitor, and mitigate health IT–related safety risks. While many of the health care organizations (especially the hospitals) had expertise in process improvement, we found a general lack of awareness of health IT–related safety risks (especially in ambulatory practices) and concluded that better tools are needed to help these organizations use health IT to improve care and to optimize the safety and safe use of EHRs. The SAFER Guides provide an excellent beginning, but until health care organizations have a better understanding of the safety risks posed by EHR use, tools like the SAFER Guides may not be used to their full potential. There may also be a need for additional tools and metrics (and further usability study of existing tools and metrics) to better support the needs of health care organizations as they use health IT to improve the quality and safety of patient care.
---- End extracts (Report is 77 pages)
I raise all this to express a desire that the pathetic non-consultation we saw on the PCEHR does not recur and that we see fundamental issues discussed rather than a discussion of how best to apply the lipstick to the pig.
The PCEHR has largely failed through lack of engagement with relevant stakeholders and a ‘tin ear’ from NEHTA and DoHA as well as a failure of recognition that e-health is a lot harder than they are prepared to admit. Most who read here know a lot better.
If we are not to squander more money and effort other perspectives are crucial. If we don’t have safety definitely sorted how dare anyone plan to move forward?
Put up your hand all those who think we do!
David?

Monday, July 21, 2014

Weekly Australian Health IT Links – 21st July, 2014.

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

Another quiet week with the big news that there is to be some consultation between many stakeholders and Deloittes on the future of the PCEHR. Will be very interesting to see where this points and how deep a dive the consultation actually takes and how searching the questions asked of stakeholders will be.
Enjoy browsing the articles!
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Realising the benefits of eMM at St Vincent’s

St Vincent’s Hospital, a 320-bed facility in inner Sydney, has had significant success with its electronic medications management system, based around CSC’s proprietary MedChart software.
According to Kate Richardson, a pharmacist in eMedicines Management at St Vincents, the system has proven successful since it was installed in 2005, nine years ago.
“The main reason we put it in is because of safety,” she says. “And it’s in terms of safety that we have seen the main benefits accrue from the system. 
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Late discharge letters frustrate GPs

16 July, 2014 Michael Woodhead
The frustration GPs feel over late-arriving hospital discharge letters is justified, according to a new study that shows tardy communication impairs patient management.
Researchers in WA have measured the additional burden created by delayed discharge letters, finding that GPs are unable to adequately manage a discharged patient's problems until they receive the all-important discharge information.
The study showed that a timely but brief discharge letter was preferable to a longer letter that arrived after a discharged patient had attended their GP.
And delayed discharge letters often meant that patients had to revisit their GP.
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Novartis says Google’s smart lens is part of key growth area in health

  • Andrew Morse
  • The Wall Street Journal
  • July 16, 2014 10:10AM
GOOGLE has joined forces with drug company Novartis to work on a smart contact lens that monitors blood-sugar levels and corrects vision in a new way, the latest in a series of technology products designed to monitor body functions.
The two companies said Novartis’s Alcon eye-care division would license and commercialise “smart lens” technology designed by Google[x], a development team at the search engine giant. Financial details of the partnership weren’t provided.
The smart lenses, which Google unveiled in January, are part of a growing number of wearable technology and software products used to monitor health and fitness. Last month, Google debuted its Google Fit platform to track health metrics, such as sleep and exercise, on devices running its Android mobile operating system. Apple unveiled a similar platform called HealthKit.
The lenses contain a tiny sensor that relays data on glucose contained in tears via an equally tiny antenna. In a news release earlier this year, Google described the electronics in the lenses as being “so small they look like bits of glitter” and said the antenna is thinner than human hair.
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Start-up DoseMe adds a measure of medical safety

Fran Foo

Technology Reporter
Sydney
BRISBANE technology start-up DoseMe is on the cusp of cracking the global market for safer medical prescriptions, estimated to be worth hundreds of millions of dollars a year.
DoseMe has developed software for medical professionals that can prevent overdosing in individual patients, potentially saving lives. It is estimated that one in 10 general admissions around the world are because of adverse drug events.
DoseMe comes in the form of an iOS app but also works on the web and has a mobile site. It creates a personalised dosing profile that ensures medication is prescribed accurately by medical practitioners.
The platform can be used for 13 medications across four therapeutic areas: anti-microbial, chemotherapy, anti-coagulants and pro-coagulants.
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Guide to Health Informatics 3rd Edition

July 15, 2014
It’s now almost 20 years since I started to write the first edition, and over 10 years since I wrote the second. I’m very happy to announce that the text for the updated third edition is now completed and is being sent off to the publisher for them to do their magic.
The book will come both in paper and e-book editions, and is already available for pre-order on Amazon, and presumably other bookstores. The book is showing a September release date but I am not sure if this is going to slip or not.
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#FHIR Connectathon 7, Chicago Sept 13-14

Posted on July 19, 2014 by Grahame Grieve
We will be holding the next FHIR connectathon in Chicago on Sept 13/14 associated with the HL7 Plenary Meeting. Once again, anyone interested in implementing FHIR is welcome to attend.
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Pap smear reminder system fails

11 July, 2014 Michael Woodhead
Almost a thousand women and their GPs in Queensland are being contacted after the Pap Smear Register failed to send out reminders about follow-up tests for low-grade abnormalities.
Chief Health Officer Dr Jeannette Young said a problem with the register's automatic mailing system meant that 980 women who had a Pap smear with a low-grade abnormality did not receive a reminder letter to have a follow-up
Dr Young (pictured) said the Pap Smear Register was "merely a back-up reminder system" that only sent a follow-up letter if a test result was not received.
"GPs and other Pap smear providers have primary responsibility for following up with their patient as they are advised directly by pathology companies of the outcome of their patient's results," she said.
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Nominations for IHTSDO Standing Committees

Created on Wednesday, 16 July 2014
As the official Australian member of the IHTSDO, NEHTA is inviting expressions of interest from Australian clinical informaticians to be nominated as independent experts on the IHTSDO Standing Committees.
The four Standing Committees advise the Management Board on the development and maintenance of SNOMED CT. We are looking for candidates for the following Standing Committees this year:
  • Content 
  • Implementation and Education
  • Quality Assurance
  • Technical
For application forms and more information please email christine.borthwick@nehta.gov.au
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Practice kept medical records in garden shed

15th Jul 2014
A MELBOURNE medical practice that stored nearly 1000 patients’ records in a garden shed has escaped the threat of prosecution and heavy fines because of the timing of the offence.
The Pound Road Medical Centre (PRMC) kept the paper records of about 960 patients in a locked garden shed at its former site in Narre Warren South from around October 2012 until an intruder broke into the structure in November 2013. 
The Australian privacy commissioner opened an investigation in December 2013, after media reports revealed that boxes of medical records had been compromised at the site.
In an announcement today, Commissioner Timothy Pilgrim noted the seriousness of the breach because of the sensitive personal information in the records, including patients’ full name, address, date of birth, Medicare number and treatment details.
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Practice stored medical records in garden shed

15 July, 2014 Antonio Bradley
A practice that stored 960 patient records in a garden shed is in trouble with the Privacy Commission after burglars broke in and raided the private material.
Melbourne's Pound Road Medical Centre moved the files into the shed in 2012, so it could renovate its old premises in order to sell it.
But the records were still there a year later, in November 2013, when burglars broke into the shed, gaining access to the patients' names, addresses and dates of birth, along with the results of medical investigations, discharge summaries and correspondence with other practitioners.
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Financial System Inquiry recommends mandatory data breach notification

Report says mandatory notifications could help Australians regain control over personal information
A Financial System Inquiry has recommended the adoption of mandatory data breach notification in Australia in order to help consumers keep control over their personal and financial information.
According to the Inquiry, which was published today, the growing amount of data stored and used by firms can bring many benefits to consumers, businesses and government agencies.
“However, it also creates the risk of a data breach exposing amounts of sensitive customer information, especially given the increased sophistication and frequency of cyber attacks,” said the report.
Where data breaches involve personal information, there are no mandatory requirements to report the incident to the Office of the Australian Information Commissioner (OAIC) or notify affected individuals under the Privacy Act, the report said.
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Scientific skinful - health and electronic tattoos

Chris Griffith

Senior Technology Journalist
Sydney
THESE days we’re used to seeing the extensively tattooed bodies of our pop stars, footballers and Olympians.
In a couple of years, these stars could also be wearing tattoos of a much more advanced sort. Electronic tattoos on different areas of their bodies will collect data about their heartbeat, muscular output, breathing and hydration levels.
And it may be possible for coaches to know at an instant the condition of any player on the ground in real time.
Indeed, the human body may soon mimic the modern car, which uses on-board computers to monitor engine performance and diagnose problems.
Technology journalists invariably are asked to predict “the next big thing” in tech. While wearable devices such as the iWatch and Google’s when-will-they-ever-sell-it Glass spec­tacles are hotly anticipated, my money is on electronic tattoos. They will profoundly enhance our personal capabilities, and monitor everything about our bodies.
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Crackdown on doctors’ rorts cost millions

18th Jul 2014
MEDICARE officials have revealed there was no risk system in place to avoid the haemorrhage of millions of dollars in a loss-making crackdown on doctors’ rorts.
An Australian National Audit Office report earlier this year found an expanded four-year Medicare compliance program not only fell $128.3 million short of its savings target but was delivered at a net cost to government.
The Increased Medicare Compliance Audits (IMCA) initiative received funding of $77 million in the 2008–09 budget to step up audits of Medicare providers from 500 per year to 2500. 
While the budget projected the measure would raise $147.2 million, the Department of Human Services identified only $49.2 million in debts and recovered just $18.9 million as a result of Medicare compliance audits between 2008–09 and 2012–13.
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Cloud clues to Alzheimer’s

Chris Griffith

Senior Technology Journalist
Sydney
AUSTRALIAN researchers have developed cloud computing software that interprets brain scans and offers insights into diseases such Alzheimer’s disease, strokes and traumatic brain injuries.
Users soon will be able to upload a scan and within 15 minutes receive a one-page quantitative report showing a diagram of the brain with colour-coded values compared with what’s normal.
“By the time a diagnosis of Alzheimer’s disease can be made using current techniques, the patient is likely to be experiencing significant loss of brain function,” Australian research body CSIRO said in a blog post.
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AHA applauds cloud service

Jennifer Foreshew

Technology Reporter
Sydney
ALLIED Health Australia sought a more cost-effective infra­structure that could scale to its ­future needs and free it from the cost of in-house management of equipment.
AHA has provided workplace health and safety support and services to organisations in NSW for more than 15 years.
It works closely with organisations and their employees to ensure injured workers are supported and able to return to their role after workplace incidents. When this is not possible, the group works to find new positions where their skills can be best used.
With a large proportion of staff working in the field, having remote access to a reliable IT infrastructure for case files, medical records and administrative resources was vital.
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Allan Fels slams NBN shield

Annabel Hepworth

National Business Correspondent
Sydney
FORMER competition chief Allan Fels has slammed a key legal shield for the $41 billion ­National Broadband Network as “the biggest anti-competitive ­arrangement ever in Australia”.
In a submission to the government’s review of competition policy, Professor Fels takes aim at the high-speed network having exemption to aspects of the Competition and Consumer Act.
“This has no part in competition law,” the submission says.
“It is the biggest anti-competitive arrangement ever in Australia, as far as I can see. A competition committee needs to review this. It cannot go down in history as having turned a blind eye to this.”
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NBN: Lengthy wait for outcomes of FTTB, FTTN trials

So far no end users connected via FTTN
The outcomes of NBN Co's trials of fibre-to-the-node (FTTN) technology will shape the future of the National Broadband Network rollout, but what exactly those outcomes are won't be known for quite some time, according to the government-owned company's CEO.
No end users have been connected in NBN Co's trials of FTTN technology, the company's executives revealed today at a hearing of the Senate's NBN committee .
It's also "early days" for NBN Co's trial of fibre-to-the-building technology, according to Bill Morrow, although there are end users on the network connected via FTTB. NBN Co has been running the FTTB trial in conjunction with iiNet, M2, Optus and Telstra in eight high-rise buildings in Melbourne.
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Leaked 'Windows 9' screenshot shows new start menu

Date July 15, 2014 - 10:03AM

Pete Pachal

We know that at some point in the future, Microsoft will bring the Start menu back to Windows. What we don't know is when, but some leaked screenshots of a future version of Windows might offer a clue.
Screenshots allegedly showing the new Start menu have leaked on an internet forum. The menu looks similar, but not identical, to what Microsoft showed publicly at its Build developer conference in April.
The size and format of the menu is the same, but the tiles themselves are different, suggesting the image was generated by an early build of the new Windows.
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Enjoy!
David.

Sunday, July 20, 2014

Deloitte Have Been Engaged To Consult On Stakeholder Views On The PCEHR. Is This A ‘Claytons’ Consultation?

An e-mail came in from the Health Department a few days ago.
The gist of the e-mail is as follows.
“As previously advised, the Department will be undertaking a range of consultation activities to consider issues relating to the implementation of the Review recommendations. The Department has engaged Deloitte to support it in undertaking these consultations.
Consultation activities will include face-to-face meetings and a survey. Deloitte is currently finalising dates and venues for the meetings and will be writing to you directly to advise the details.
…..
An online survey will also be made available to capture stakeholders' views.  This survey will be made available shortly and can be accessed until 1 September via http://www.ehealth.gov.au.  These details will be included in Deloitte's letter to you.  
The Department will also continue to receive any feedback on implementation issues until 1 September at pcehrreview@health.gov.au.
----- End Extract.
Deloitte have sent out a number of e-mails which suggest what the focus of the consultation is to be:
These include:
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“It is very important that we talk to the right stakeholders to ensure that key issues are heard and understood, key ideas are incorporated and that the recommendations that arise from the consultation program are well informed. Therefore we would like to talk to members/staff of your organisation about the recommendations of the Review, with a particular emphasis on:
·         The adoption of an opt-out rather than opt-in model for consumer participation in the PCEHR – including information and education needs; security, privacy and usability issues and expectations
·         Records that should be included in the system
·         Record information access control and notification of access to the system.
The views expressed through the consultation process will contribute to advice to the Government on how best to implement the recommendations of the Review.”
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And addressed to a different stakeholder:
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“These discussions will have a particular emphasis on:
·         The adoption of an opt-out rather than opt-in model for consumer participation in the PCEHR – including information and education needs; security, privacy and usability issues and expectations.
·         The core clinical records that should be included in the system.
·         Record information access control and notification of access to the system.
·         How vendors work with Government to deliver PCEHR compliant software for clinicians
·         Recommendation 10 of the review – ‘Establish a regulatory body that monitors and ensures compliance against eHealth standards that are set and maintained by ACeH.’
The views expressed through the consultation process will contribute to advice to the Government on how best to implement the recommendations of the Review.”
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I find all this rather worrying as it seems that what has gone on here is the Deloitte have been engaged to ask around stakeholders with a set of constraining assumptions regarding what should happen next.
I really want to see the really fundamental questions asked of stakeholders - e.g. who is the PCEHR for, what is it really for, can it be made to be seriously useful for clinicians and is what we have done so far actually fixable to deliver what is intended?
Unless we can be assured that whatever is being planned will deliver quality, safety and efficiency in the health system this may be an expensive waste of time and effort.
I have a strong feeling the questions above were not asked during the initial design phase and I fear the way the Department has set this consultation up the fundamentals won’t get properly reviewed and it will be assumed that the PCEHR is a good thing that basically needs to roll on!
One gets the sense that the Department wants all this wrapped up by September 1, 2014. If this is indeed the case then this may be what is usually described as a ‘Claytons’ consultation.
It does not look good to me!
David.

AusHealthIT Poll Number 227 – Results – 21st July, 2014.

Here are the results of the poll.

How Damaging Is The Continuing Lack Of Government Response To The PCEHR Review To E-Health In Australia Overall?

Very Damaging 58% (25)

Slightly Damaging 16% (7)

Not Damaging 16% (7)

I Have No Idea 9% (4)

Total votes: 43

It seems most think the dithering is not helping anyone's interests!

Again, many thanks to all those that voted!

David.