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, October 25, 2014

Weekly Overseas Health IT Links - 25th October, 2014.

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.
-----

CDC, ONC Target EHR-Based Ebola Screening

OCT 17, 2014 7:30am ET
An initiative launched last year by the Centers for Disease Control and Prevention and the Office of the National Coordinator for Health IT to help providers meet Stage 1 and 2 meaningful use public health objectives is now focusing its efforts on Ebola electronic screening tools.
In August 2013, CDC and ONC established the Public Health Electronic Health Records Vendors Collaboration Initiative. However, with recently confirmed cases of Ebola in the United States, the initiative—which includes public health practitioners and EHR vendors—is currently aimed at trying to get vendors to configure EHR systems to support screening protocols for the deadly disease.
-----

Interoperability's 'game-changer'

Posted on Oct 17, 2014
By Bernie Monegain, Editor
Charles Jaffe, MD, CEO of standards organization HL7, came away from the joint meeting of the federal Health IT Policy and Health IT Standards committees earlier this week, thinking that the industry could move faster on interoperability. And HL7 has just the thing to change the game.
"I don't try to denigrate the success; I try to celebrate it," he told Healthcare IT News.
He blames a stuck-in-the-past approach for the slow pace of progress.
"We embrace a lot of technology that is technology for the past and ways of doing things that were important in the past rather than understanding the ideas that fundamentally change the way we achieve interoperability."
-----

EHR still in play with US Ebola case

Posted on Oct 17, 2014
By Erin McCann, Associate Editor
In a congressional hearing Thursday, a Texas Health Resources executive joined other clinical stakeholders in the U.S. Ebola crisis to shed light on myriad oversights that materialized when the Ebola virus arrived on American soil. 
Daniel Varga, MD, chief clinical officer at Texas Health Resources, who video conferenced for the hearing from Texas, appeared somber. He detailed the sequence of events and missteps that transpired at TH Presbyterian Hospital when Thomas Eric Duncan, the nation's first Ebola case, showed up at the hospital emergency room on the evening of Sept. 25. After poor communication, lacking hospital processes, EHR inadequacies and a host of other issues at play, less than two weeks later, Duncan was dead. 
What was first described by THR officials as a "flaw" in the hospital's electronic health record, which resulted in the failure of Duncan's travel history appearing in the physician's workflow, was later recanted by the health system.
-----

Global telemedicine technology market to hit $43 billion by 2019

October 17, 2014 | By Dan Bowman
Spurred by drastic growth in "telehome" technology adoption, the global telemedicine tools market will likely reach $43.4 billion within five years, according to a new report published by Wellesley, Massachusetts-based BCC Research.
The market for telehome technologies, or tools that enable outpatients to receive telehealth services, is predicted by BCC to grow from $6.5 billion in 2013 to $24 billion by 2019. To that end, telehome technologies are expected to make up 55 percent of the overall telehealth market by 2019, up from 40 percent in 2013.
The telehospital tools market, meanwhile, which represents technologies used between healthcare providers, is anticipated to increase at a compound annual growth rate of 12 percent and reach $19.5 billion by 2019.
-----

MIT, Mass General team up on health IT

Posted on Oct 16, 2014
By Erin McCann, Associate Editor
The Massachusetts Institute of Technology has teamed up with the Bay State's largest hospital in a new partnership aimed at addressing three major obstacles in clinical medicine, tapping data analytics and digital health tools.
MIT is joining with Massachusetts General Hospital to further develop disease diagnostics, create new prevention and treatment approaches for autoimmune diseases and fine-tune diagnostics for those with neurodegenerative and psychiatric diseases. Key to this will be data analytics and remote monitoring, officials say.
Both groups have pledged to fund research projects that address these three challenges by up to $3 million over a two-year period.  
-----

'Actionable' steps to interoperability

Posted on Oct 16, 2014
By Tom Sullivan, Editor, Government Health IT
The highly anticipated final recommendations from the JASON task force arrived on Wednesday afternoon.
JASON, a group of independent scientists who advise the federal government, issued a November 2013 report to the Department of Health and Human Services, the Office of the National Coordinator for Health IT and the Agency for Health Research and Quality on the matter of interoperability.
The resulting analysis, not surprisingly, was highly critical of the current state of interoperability and electronic health record systems vendors.
-----

Robert Wood Johnson Foundation program focuses on how data can improve health

October 16, 2014 | By Katie Dvorak
The Robert Wood Johnson Foundation is setting its sights on improving healthcare through data and information.
In a new initiative, Data for Health, the foundation will look at how information and data on heath can be used to help people live healthier lifestyles, according to an announcement from RWJF.
"The sheer volume and velocity of data at our fingertips today is unprecedented," RWJF President and CEO Risa Lavizzo-Mourey said in the announcement. "The Data for Health initiative will be a starting point for identifying what infrastructure is needed to turn this information into an effective tool for improving health nationwide."
-----

Federal HIT Committees OK Public API Recommendations to ONC

October 15, 2014
Language about changes to MU Stage 3 dropped
An Oct. 15 joint Health IT Policy/Standards Committee meeting approved a set of task force recommendations that the Office of the National Coordinator for Health IT and the Centers for Medicare & Medicaid Services focus effort on a public API (application programming interface) specification. But committee members asked to remove language suggesting that CMS and ONC should consider delaying or staggering meaningful use Stage 3 to accommodate an accelerated development process for an initial public API.
Meaningful use Stage 2 experience shows that overly broad and complex requirements slow progress on all fronts,” Micky Tripathi, CEO of the Massachusetts eHealth Collaborative and co-chair of the JASON Task Force, told the joint committee meeting. A focus on interoperability will send a strong signal to the market and allow providers and vendors to focus their resources, he said. “On the task force, there was consensus that this narrow focus is the way to go.”
-----

Providers Ask HHS to Address EHR Interoperability Barriers

John Commins, for HealthLeaders Media , October 16, 2014

"Strict MU requirements and deadlines [do not] provide sufficient time to focus on achieving interoperability" says a letter co-signed by eight provider organizations and large health systems.

Systemic snags and glitches around the interoperability of electronic health records are frustrating providers and doing little if anything to improve patient care or reduce costs, a group of provider organizations and large health systems says.
In a letter this week to Health and Human Services Secretary Sylvia M. Burwell, several provider groups and professional associations, including the American Medical Association, reaffirmed their support for meaningful use of EHR. However, the groups complained that stubborn proprietary barriers, the complexity of the requirements, and an accelerated timetable put forward by HHS have made it difficult to realize interoperability.
"Currently, health information stored in most EHRs/EMRs and other HIT systems and devices do not facilitate data exchange but 'lock-in' important patient data and other information that is needed to improve care," the letter says.
-----

Coalition presses HHS for MU fix

Posted on Oct 15, 2014
By Bernie Monegain, Editor
A coalition of healthcare associations today called on HHS Secretary to revamp the meaningful use program.
"Without changes to the MU program and a new emphasis for interoperable EHRs/EMRs systems and HIT infrastructure, we believe that the opportunity to leverage these technologies will not be realized," the organizations wrote.
The letter is signed by the American Academy of Family Physicians, American Medical Association, Medical Group Management Association, National Rural Health Association, Memorial Healthcare System, Mountain States Health Alliance, Premier healthcare alliance and Summa Health System.
The AMA also wrote a separate letter to CMS and ONC, pushing a similar agenda and offering a detailed "blueprint."
-----

AMA issues blueprint to improve Meaningful Use

October 14, 2014 | By Marla Durben Hirsch
The American Medical Association (AMA), frustrated by physicians' continued struggles with meeting the Meaningful Use requirements, has created a blueprint to refocus and revamp the entire Meaningful Use program.
In a 31-page letter dated Oct. 14 to Centers for Medicare & Medicaid Administrator Marilynn Tavenner and National Coordinator for Health IT Karen DeSalvo, AMA executive vice president and CEO James Madara (pictured) warns that the program is increasing costs and burdens on physicians, decreasing efficiency, interrupting access to patient information and jeopardizing patient safety; many of the Meaningful Use requirements meant to increase patient choice and quality of care were having the "opposite effect."
-----

Digital health revolution 'has failed'

October 15, 2014 | By Katie Dvorak
While the health industry is thriving, the digital health revolution has failed, according to Anna McCollister-Slipp, co-founder of Galileo Analytics and member of the judging panel for the Qualcomm Tricorder XPRIZE.
-----

Federal advisers share comments, concerns about draft interoperability road map

October 15, 2014 | By Dan Bowman
In presenting an updated version of the Office of the National Coordinator for Health IT's draft interoperability road map to a joint meeting of the federal Health IT Policy and Standards Committees on Wednesday, Erica Galvez, ONC's interoperability and exchange portfolio manager, made clear that many efforts going forward will be about balance and tradeoffs.
"We probably can't meet every need perfectly," Galvez said. "At the end of the day, interoperability is about people.
Galvez emphasized that the "device agnostic" document focuses not only on interoperability between electronic health records, but also interoperability between a number of different data sources and systems. Calling interoperability a "tremendously complex topic," she added that ONC doesn't want to be bound by a core set of use cases for fear of being stuck with guidance that doesn't meet stakeholder needs.
-----

ID System Reduces NICU Errors

Published: Oct 13, 2014 | Updated: Oct 13, 2014
By Sarah Wickline Wallan, Staff Writer, MedPage Today
Mistakes made when entering clinical orders in one hospital's electronic medical records system were reduced after implementation of a unique naming system to reduce confusion and miscommunication in the neonatal intensive care unit (NICU), researchers reported.
The use of a new naming system in the Montefiore NICU helped reduce near miss wrong-patient orders in the EMR by more clearly identifying neonates who had yet to be given a first name, Jason Adelman, MD, , Patient Safety Officer (PSO) at Montefiore Medical Center in the Bronx, and colleagues reported at the annual American Academy of Pediatrics meeting in San Diego.
Adelman presented three abstracts at the AAP meeting that build on research he published in 2013 from a randomized, controlled trial to test a related patient identification safety measure in the Montefiore EMR.
-----

Home-based connected health to overtake hospital-based by 2019

By: Aditi Pai | Oct 14, 2014
The telemedicine market, which according to BCC Research is comprised of “telehospital” and “telehome” technologies, is expected to reach $43.4 billion by 2019 with a compound annual growth rate of 17.7 percent, according to a recent report from the firm.
According to BCC, the telehospital market refers to “services that are provided within or between hospitals, clinics or other healthcare providers”, while the telehome market consists of remote monitoring devices for out patients.
“In the near to midterm, telemedicine technologies offer one of the few ways of enabling healthcare personnel to meet the increased demand for healthcare services without unacceptable delays or service rationing,” BCC Research healthcare analyst Andrew McWilliams said in a statement. “The growing adoption of telemedicine services is expected to significantly impact larger markets such as healthcare, health insurance, home care, telecommunications (telecom), networking, disease management, e-health, and healthcare IT.” 
-----

Study: EHRs decrease patient safety events

Written by Helen Gregg (Twitter | Google+)  | October 14, 2014
Advanced use of EHRs was associated with a steep decline in patient safety events, according to a new study presented at the Workshop on Health IT and Economics.
In the study, researchers gathered data from a group of Pennsylvania hospitals between 2005 and 2012 in addition to patient safety data from the Pennsylvania Patient Safety Authority.
-----

Stolen Medical Data Is Now A Hot Commodity

10/14/2014 11:00 AM
Lysa Myers
Commentary
While credit cards are selling for a dollar or less on the black market, personal health credentials are commanding as much as $10 per patient. Here's why.
This last year has been brutal in terms of breaches involving the theft of credit and debit card data. Oh sure, it’s been tough for retailers, but how has it been for criminals? With such a glut of card data on the carder market, the prices are being gutted. How are thieves supposed to turn a profit in light of this oversupply?
Fear not, gentle reader! There is plenty of valuable data out there for an enterprising miscreant to sell to make the payment on his or her beloved BMW. And it looks like they’ll be coming after your medical data next.
-----

Why we need standards-based interoperability in digital health

October 15, 2014 6:23 am by Bill Ash | 0 Comments
A vision for “e-health” is gathering around the world, in which a rich array of dependable data is seamlessly and securely shared between patient and healthcare providers, in support of breakthrough wellness care and remote monitoring capabilities. Global, open development and wide-scale adoption of interoperability standards across technology areas such as personal health device communications, cloud computing, body computing, mobility, social networking and Big Data analytics comprise a critical enabler of the vision.
In the emerging standards-based environment for e-health, caregivers are being enabled to continually maintain a comprehensive assessment of a person’s status as it evolves in making and carrying out clinical decisions. A secure stream of accurate biometric data (beat-by-beat blood-pressure monitoring, for example) would allow physicians to steadily monitor a patient’s condition in real time—wherever that individual happens to be, moment to moment as he or she goes about a daily routine.
-----

Is Geomedicine Reaching a Tipping Point?

OCT 14, 2014 7:37am ET
While other industries have leveraged geospatial data, healthcare has yet to embrace the power of geospatial information systems (GIS) and analytics to improve outcomes, quality, access to care, and lower costs.
Participants at a two-day Geomedicine Summit that kicked off Oct. 13 in Durham, N.C., argue that the technology has reached a tipping point of interest, but major barriers remain. Hosted by the Duke Center for Health Informatics, a goal of the summit—attended by health system executives and researchers—was to inform healthcare leaders to recognize the potential of geospatially-aware health data and to influence electronic health record vendors to develop supporting functionality.
-----

FTC sets sights on EHR makers

By Mike Miliard, Contributing Editor
13 October, 2014
The Federal Trade Commission fired an opening salvo of sorts aimed squarely at EHR makers unwilling to share patient data for competitive reasons.
"We are working with ONC staff to identify potential competition issues relating to health IT platforms and standards, market concentration, conduct by market participants, and the ability of health IT purchasers to make informed buying decisions," FTC officials wrote in a blog post
Healthy competition "is central to improving health care quality and outcomes, reducing costs, and improving the consumer experience," write Tara Isa Koslov, of FTC's Office of Policy Planning; Markus Meier, of its Bureau of Competition and David R. Schmidt, of its Bureau of Economics.
-----

ONC lays out HIE progress, says roadblocks remain

By Government Health IT Staff
10 October, 2014
Health IT infrastructure has made significant progress in recent years, with EHR adoption among hospitals and physicians growing. At the same time, the development of health information exchanges (HIEs) and interoperability that could deliver more effective healthcare is being held back as health care providers still don’t share patient health information electronically across organizational, vendor, and geographic boundaries.
These findings in the annual report to Congress from the Office of the National Coordinator for Health Information Technology (ONC) show decidedly mixed results, outlining steady adoption of many of the goals set out by the Health Information Technology for Clinical and Economic Health Act of 2009, while not yet achieving the interoperability that could leverage health technologies to transform the delivery of health care.
“This progress has laid a strong base for health IT adoption and created a growing demand for interoperability that not only supports the care continuum, but also supports health generally,” ONC explained in the report.
-----

If Google walks and acts like a healthcare company...

October 14, 2014 | By Dan Bowman
For a company whose founders claim they have no particular interest in healthcare, Google certainly has a lot of irons in that particular fire.
This past week, it was reported that the search engine giant is testing out a new Helpouts feature that enables users searching for illness symptoms to talk, in real time, to doctors about their concerns and to get clarity on their searches. During a trial phase, Google will cover the cost of chats for patients.
"When you're searching for basic health information--from conditions like insomnia or food poisoning--our goal is to provide you with the most helpful information available," a company spokesperson recently told Re/code. "We're trying this new feature to see if it's useful for people."
-----

ONC interoperability road map draft outlines governance, certification standards goals

October 14, 2014 | By Dan Bowman
An updated draft version of the Office of the National Coordinator for Health IT's 10-year road map to interoperability, published online late Monday, outlines goals for governance and certification standards and calls for "unprecedented collaboration" in ensuring that technology can seamlessly support the health of patients on a day-to-day basis.
Interoperability requirements, the report points out, must be consistent at all levels--federal, state and private. What's more, economic incentives should be aligned, as well, according to the report. By 2017, "explicit rules that address organizational, trust, business and technical issues" must be established, the report notes.
"With broad input from stakeholders across the health IT ecosystem" ONC will establish a voluntary nationwide government framework, according to the draft road map. The framework will define the responsibilities of different stakeholders, as well as technical standards, a governance structure and privacy and security rules.
-----

Military health review verifies a pearl: secure doctor-patient email

By Tom Philpott
Special to Stars and Stripes
Published: October 9, 2014
The recent 90-day review of the Military Healthcare System found it  “comparable in access, quality and safety to average private-sector health care,” Defense Secretary Chuck Hagel told a press conference last week.
That was disappointing to hear for a medical system that, for decades, has described itself as overall excellent and among the best in the country. 
“Overall, MHS performance mirrors what we see in the private sector: a good deal of mediocrity, pockets of excellence and some serious gaps,” wrote Janet M. Corrigan of the Dartmouth Institute for Health Policy and Clinical Practice, one of the outside experts who helped with the review.
-----

VA Healthcare: More than 2 Million Telehealth Visits in 2014

October 13, 2014
The Department of Veterans Affairs (VA) announced that its telehealth program served nearly 700,000 Veterans in fiscal year 2014. 
The total of approximately 690,000 Veterans represents 12 percent of the total VA healthcare population. The 690,000 accounted for roughly 2 million telehealth visits. A large chunk of that population were Veterans in rural areas with limited access to VA healthcare.
“We have to adapt to meet Veterans wherever their needs are,” VA Secretary Robert A. McDonald, said in a statement.
----

Telehealth Use Growing Amid Pressure for Convenient, Affordable Care Alternatives

by Lisa Zamosky, iHealthBeat Contributing Reporter Tuesday, October 14, 2014
Delivery of care remotely with the use of telecommunications is a rapidly growing segment of the health care market.
According to the American Telemedicine Association, there are about 200 telemedicine networks in the U.S., with 3,500 service sites. 
A host of private companies sell telemedicine services that offer around-the-clock access to physicians who can provide remote medical exams and prescribe medications.

Healthcare Needs an NTSB-like Agency

Scott Mace, for HealthLeaders Media , October 14, 2014

A nervous American public wasn't reassured by the absence of a crack team of patient safety experts descending upon the Texas hospital to determine the exact cause and sequence of events leading to the death of a patient with Ebola.

As we enter what may turn into the Ebola era of U.S. healthcare, the long-discussed issue of the effect health IT has on patient safety is suddenly moving from the back burner to the front.
Just last week, HHS awarded a contract to Research Triangle Park, N.C.-based RTI, a research institute, to create a roadmap for the Office of the National Coordinator's health IT safety center. It's a first step, contingent on ONC receiving funding for the center itself, on ONC's path to providing needed oversight for the variety of medical errors attributed to health IT technology and use.
-----

New Early Warning System for Health Cyber Threats

OCT 13, 2014 7:18am ET
HITRUST, a healthcare industry stakeholder coalition working to improve cybersecurity, has launched its third major service during 2014.
In March, the organization started offering free monthly healthcare cyber threat briefings in partnership with the Department of Health and Human Services. Last spring, it also pilot tested a cyber attack simulation exercise in which a third party launches real but harmless attacks on participating organizations’ information networks to assess how well they recognize and respond to the attack. That program is accelerating this month as about 750 healthcare organizations are participating and being attacked, with three levels of sophistication depending on each participant’s security readiness.
Now, HITRUST has built and is pilot testing the Cyber Threat XChange (CTX), an automated service to provide early detection and faster analysis of cyber threats that participating organizations collect and submit to CTX.
-----

Google testing telehealth waters

Posted on Oct 13, 2014
By Erin McCann, Associate Editor
Tech giant Google is trying out the telehealth waters, after reports last week confirmed the company was in the trial phase of a video-based platform that connects consumers searching online for health data with physicians. 
Google officials confirmed this in an email to Healthcare IT News.
"When you're searching for basic health information – from conditions like insomnia or food poisoning – our goal is provide you with the most helpful information available," a Google spokesperson wrote in an emailed statement. "We're trying this new feature to see if it's useful to people."
-----

Lagging interoperability stymies quality

Posted on Oct 13, 2014
By Neil Versel, Contributing Writer
Stage 2 of meaningful use is supposed to be about interoperability of data, with electronic records flowing securely between sites as needed to help hospitals and doctors provide better care. But the number of attestations to Stage 2 – just 25 hospitals and 1,277 eligible professionals nationwide had attested to Stage 2 in August, according to CMS – has been anemic, and there is plenty of anecdotal evidence suggesting true interoperability is a long way off.
Meanwhile, efficiency continues to suffer and care is not as safe as it should be.
At a Washington conference on the future of healthcare this month, national health IT coordinator Karen DeSalvo, MD, said that in the absence of interoperability, EHRs will have limited effect on care quality.
-----

VA treated 690K veterans through telemedicine in fiscal year 2014

October 13, 2014 | By Susan D. Hall
The Department of Veterans Affairs (VA) says it provided remote care to more than 690,000 veterans during fiscal year 2014.
About 55 percent of those veterans live in rural areas with limited access to VA facilities.
 "A brick-and-mortar facility is not the only option for healthcare," VA Secretary Robert A. McDonald said in an announcement. "We are exploring how we can more efficiently and effectively deliver health care services to better serve our veterans and improve their lives. Telehealth is one of those areas we have identified for growth." 
-----

5 qualities of great hospital CIOs

October 13, 2014 | By Katie Dvorak
Passion and balance are some of the keys to being a successful chief information officer, according to Stephanie Reel, vice president for information services at Baltimore-based John Hopkins Medicine.
Reel, who also heads IT for the entire university, as well, spoke with Becker's Health IT and CIO Review about several qualities CIOs need to be great. Here are five:
  1. Have passion: Being passionate about the organization and its employees is very important, Reel says. She said she respects the history, mission and vision of Johns Hopkins and that respect drives her to be a better CIO.
-----

ONC Annual Report to Congress Cites HIT Progress, Barriers

OCT 10, 2014 7:21am ET
The Office of the National Coordinator for Health Information Technology on Oct. 9 submitted its annual report to Congress updating lawmakers on the nationwide adoption of health IT and health information exchange. Though “significant” progress has been made, ONC acknowledges that key barriers remain.
As evidence of progress, ONC’s 2014 report points to widespread participation among eligible hospitals and professionals in the EHR Incentive Programs. According to the report, as of June 2014, 75 percent (403,000+) of the nation’s eligible professionals and 92 percent (4,500+) of eligible hospitals and critical access hospitals had received incentive payments under the program. In addition, ONC claims that six in 10 hospitals (59 percent) and one-half of physicians (48 percent) have adopted basic EHRs.
“This progress has laid a strong base for health IT adoption and created a growing demand for its interoperability that not only supports the care continuum, but also supports health generally,” states the report.
-----

Healthcare & Pharma Industry ICT Spending Trends and Patterns Through End of 2015 Reviewed

DALLAS, October 12, 2014 /PRNewswire/ --
MarketReportsStore.com adds ICT investment trends in pharmaceuticals - Enterprise ICT spending patterns through to the end of 2015 and ICT investment trends in healthcare - Enterprise ICT spending patterns through to the end of 2015 market research reports to its store. Published in September 2014, these research reports are spread across 57 pages and 59 pages respectively. Study the results of survey conducted in pharmaceuticals and healthcare companies regarding their ICT investment trends.
As per the pharmaceuticals industry ICT investment trends survey of 113 companies, 52% of respondents are planning to increase their ICT budgets in 2014, either slightly or significantly - witnessing an increase of 23% compared to 2013. The survey also shows that the percentage of respondents planning to retain their ICT budgets at the same level is set to reduce by 8%, to reach a value of 27% in 2014. It is also noteworthy that there is a declining proportion of respondents (a reduction of 15% compared to 2013), who intend to decrease their ICT budgets slightly or significantly in 2014.
-----

Enjoy!
David.

Friday, October 24, 2014

Medicare Locals Go As The Primary Care Networks Start Mid Next Year. E-Health Implications?

A few days ago the borders for the 30 new Primary Health Networks (PHN) which will replace the 61 Medicare Locals were announced.
Here is the link:
The most interesting part of this transition I find is this description of what these new PHNs will do.
Here is what the Department of Health says:

What will PHNs do?

The PHN name reflects the critical role they will play in networking health services across local communities so that patients, particularly those needing coordinated care, have the best access to a range of health care providers, including practitioners, community health services and hospitals.
PHNs will achieve this by working directly with GPs, other primary care providers, secondary care providers and hospitals. Care will be better coordinated across the local health system so that patients requiring help from multiple providers receive the right care in the right place at the right time. PHNs will work with other funders of services and purchase or commission high quality, locally relevant and effective services for groups of patients at risk of poor outcomes.
PHNs will assist in facilitating reform of the primary health care system. They will have a key role in trialling innovative ways of funding and integrated health service delivery models that align with national priorities and assessed regional needs.
PHNs will -
·         understand the health needs of their local communities through analysis and planning. They’ll know what services and resources are available and help to identify and plug service gaps where needed, while getting value for money for taxpayers’ dollars;
·         help general practices with support services so they are better able to provide services to patients subsidised through the MBS and PBS and help patients to avoid having to go to emergency departments or being admitted to hospital for conditions that can be effectively managed outside of hospitals;
·         support general practices in attaining the highest standards in safety and quality through showcasing research and evidence of best practice. This includes collecting and reporting data to support continuous improvement;
·         assist GPs in understanding and making meaningful use of eHealth systems, in order to streamline the flow of relevant patient information across the local health provider community; and
·         work with other funders of services and purchase or commission medical/clinical services for local groups most in need, including, for example, patients with complex chronic disease or mental illness.
PHN will be able to purchase services. This might include using local providers or seeking new providers where a market does not already exist. Where it is not possible to purchase services due to market failure, with permission of the Department of Health, the PHN may provide services. PHNs may also provide some services for a short period as part of the transition from Medicare Locals.
Here is the link to the full document:
The part I found fascinating was this paragraph:
·         assist GPs in understanding and making meaningful use of eHealth systems, in order to streamline the flow of relevant patient information across the local health provider community;
So it seems e-health is to focus on information flows between providers. Not a hint of the PCEHR anywhere!
What an excellent plan. Given how recent this document is (15 October, 2014) is DoH telling us something?
Leaks and additional info welcome!
David.

Thursday, October 23, 2014

Review Of The Ongoing Post - Budget Controversy 23rd October 2014. No Sign Of Stopping!

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. Some more this week.
Here are some of the more interesting articles I have spotted this 21st week since it was released.
Clearly Ebola and the Government Response and the new Primary Health Networks got a lot of coverage in the press this week.
The House of Reps returned a few days ago and the Senate comes back 27th October so we will see how we go!

General.

Bill Shorten says Treasurer Joe Hockey 'desperate'

Date October 11, 2014 - 10:13PM
Treasurer Joe Hockey is a desperate man, running out of time to justify his budget - but that doesn't explain why he's trying to tie Australia's intervention in Iraq to its passing, Opposition Leader Bill Shorten says.
Mr Hockey made headlines this week when, while speaking about the impact of the Iraq deployment on the budget, he said the government would "spend what we need to spend to defend our nation".
But he said the added expense was "another good reason" for Labor to back the government's controversial budget measures.
-----

Surplus continues to elude successive governments

Date October 11, 2014 - 10:00PM

Paul Malone

On the last sitting day of the House of Representatives, the former Treasurer Wayne Swan was ejected from the chamber.
Responding to a provocative jibe by the Treasurer, Joe Hockey, that in all the 400 pages of Swan's book on his time as treasurer he had not mentioned the word "surplus" once, Swan cut in.
"Madam Speaker," he said, "I rise on a point of order. That is a lie." 
Knowing full well the consequences of his actions, Swan refused to withdraw and was ordered out of the House by Speaker Bronwyn Bishop.
-----

Budget pain and senate strife

If the federal government manages to pass most of its new initiatives it will prove devastating for lower-income earners – particularly those with children. According to new research, single parents with children could see their household income cut by over 10 per cent by 2017-18.
The National Centre for Social and Economic Modelling (NATSEM) has released new modelling on the economic and distributional effects of the 2014-15 federal budget. They find that the impact of the budget “falls most heavily on low and middle income families with children.” The impact is significant but manageable in 2014-15 but blows out considerably by the 2017-18 financial year.
By comparison, higher income families with and without children are relatively unaffected by the budget in the short and long-term. In fact for this cohort, the federal budget largely leaves them better off by 2017-18 than under the previous Labor budget.
-----

Editorial - Monday, October 13: Budget proves a stinker

David Moase | 13th Oct 2014 3:00 AM
IT IS five months since Joe Hockey put forward the Federal Coalition Government's first Budget, but the bulk of the key cost-saving measures don't seem any closer to passing through parliament.
Mr Hockey was on television yesterday baiting the Opposition to pass the changes and threatening more welfare cuts to replace any savings that aren't ticked off in the Senate.
But after five months it is clear the Treasurer still doesn't get why his Budget has proven so unpopular and why he can't raise support from the crossbenches.
The Budget has failed the sniff test.
-----

Whichever way you cut it, the federal budget hurts the poorest hardest

The study by the National Centre for Social and Economic Modelling found that in this financial year, 99.8% of households are worse off after the budget
A study released last week confirms that the May budget will hit the poorest households hardest and is particularly harsh towards families. Even with the benefit of a removed carbon price, by 2017-18 the people worst affected by the government’s policies will be the poorest.
The study by the National Centre for Social and Economic Modelling (Natsem) provides a dollar impact of the budget on different households. In the past, a version of this information was provided in the budget papers, however this year such a table was left out.
Its omission could be due to the budget hitting all households and low-income households also being the worst hit.
-----

Hockey warns of massive industrial change

Shane Wright Economics Editor The West Australian October 14, 2014, 7:46 am
Joe Hockey has signalled the Government will press ahead with plans to cut taxes while warning the country faces massive industrial change over coming years.
In a speech in London, the Treasurer also defended some of his Budget measures as vital to restoring the nation's finances and putting it in position to weather future economic challenges.
It was at a similar speech two years ago that Mr Hockey claimed a coalition government would end the "age of entitlement".
-----

Tale of two cities

By Katherine Fenech

Oct. 14, 2014, 1:38 p.m.
WHEN releasing his federal budget Treasurer Joe Hockey warned that "heavy lifting" would be needed to bring the economy back to surplus.
But it seems Campbelltown is doing a lot more of that lifting than Joe Hockey's north shore seat.
The University of Canberra's National Centre for Social and Economic Modelling (NATSEM) released its report on the budget on Friday, revealing local households will be much worse off than their north shore and eastern suburbs counterparts by 2017-18.
Families in the seat of Werriwa, held by Labor's Laurie Ferguson, would lose $859.80 of their income, while those in Liberal MP Russell Matheson's electorate of Macarthur would be $494.30 worse off.
-----

Medical Research.

Melbourne’s genius medical researchers spend most of their time having to find funding

  • Brigid O’Connell
  • Herald Sun
  • October 10, 2014 9:10PM
INSIDE a nondescript annex at the end of a St Vincent’s Hospital rabbit warren, balls of cartilage are being grown.
Barely 700m down the road, the Bionics Institute is preparing to test a brain implant device on a first patient, with the aim of controlling Parkinson’s disease tremors.
Across the city in Parkville, at the Florey Institute of Neuroscience and Mental Health, Dr Kath Jackman has been lured back to Australia from the US to work on cracking the brain’s “security system”, the blood-brain barrier.
Over the road, a Royal Melbourne Hospital neurology trainee and a University of Melbourne biomedical engineer have the backing of the US military to develop a “bionic spinal cord” that would allow quadriplegics and stroke patients to control robotic limbs by thought.
-----

Ebloa.

Ebola assault sees Shorten end unity on foreign affairs

Stefanie Balogh

BILL Shorten has opened the deepest political divide in Aus­tralia’s approach to an inter­national crisis in more than a decade, ­accusing the Abbott government of sleepwalking through the Ebola outbreak.
Labor’s break from bipartisanship on the global contagion marks the most significant diplomatic fault line on foreign affairs between the major parties since former opposition leader Simon Crean refused to back John Howard on the 2003 invasion of Iraq.
The Opposition Leader yesterday swung in behind his deputy to echo Tanya Plibersek’s demands for the government to do more, including dispatching health workers to West Africa to help contain the disease before it reaches Australia and becomes “an unfolding international calamity’’.
“Doing nothing is not a recipe for a bipartisan approach,’’ Mr Shorten said. “Australia cannot sleepwalk its way through this Ebola crisis and leave dealing with it, I believe, to everyone else. That is a lack of leadership.

Queensland ramps up measures to deal with Ebola

  • Daryl Passmore
  • The Courier-Mail
  • October 17, 2014 2:04PM
QUEENSLAND will next week take delivery of three ISO-POD units to safely transport Ebola patients as health chiefs nationwide ramp up preparations to deal with any potential outbreak.
The specialist equipment will be based in Brisbane and deployed as and when necessary to fly patients to hospitals with the necessary facilities to treat cases in high-level isolation.
One ISO-POD was borrowed from the Royal Flying Doctor service in Western Australia last week following the Ebola scare involving Cairns nurse Sue-Ellen Kovack who developed a fever after recently returning from a volunteer stint in Sierra Leone.
-----

'We made mistakes,' Dallas health boss says of Ebola crisis

Date October 17, 2014

Nick Allen

Dallas: The hospital at the centre of the United States' Ebola outbreak admitted it made mistakes and has apologised, as a whistleblowing nurse described scenes of "chaos" there.
Thomas Duncan, 42, the first person to be diagnosed with the disease in the US, died at Texas Health Presbyterian Hospital on October 8 and two nurses who treated him - Nina Pham and Amber Vinson - contracted the virus.
Speaking at a congressional hearing in Washington, Daniel Varga, the chief clinical officer of Texas state health resources, the medical group that oversees Texas Health Presbyterian Hospital, said: "We did not correctly diagnose his symptoms as those of Ebola. We are deeply sorry. Despite our best intentions, and a highly skilled medical team, we made mistakes."
-----

GP Co-Payment.

Abbott's tax 'will see cancer patients pay huge fees'

Joel Gould | 14th Oct 2014 4:00 AM Updated: 6:04 AM
UPFRONT fees for cancer patients will be a hidden cost of the Abbott Government's GP co-payment package, according to an independent body.
The Australian Diagnostic Imaging Association (ADIA) says patients will be forced to pay $90 upfront for every X-ray, $380 for every CAT scan, up to $160 for every mammogram and $190 for every ultrasound.
Blair MP Shayne Neumann said the costs, "a hidden trap in the Abbott Government's GP Tax package, will force many cancer patients in Ipswich to pay extraordinary fees upfront, even those on healthcare and pensioner concession cards".
But the claims have been refuted by the office of Minister for Health Peter Dutton. A spokesman for Mr Dutton said individual diagnostic providers would decide what they charge under the government's plan, as they do now.
-----

Gosford Council to write to federal government opposing GP co-payment

  • Geraldine Cardozo
  • Central Coast Gosford Express Advocate
  • October 16, 2014 12:00AM
The  Federal Government’s proposed $7 GP co-payment has been given the thumbs down by Gosford Council.
The council voted on Tuesday night to oppose the introduction of the proposed Medicare levy.
Greens councillor Hillary Morris gave an impassioned speech urging fellow councillors to support her motion to write to Federal Health Minister Peter Dutton, ­Opposition Leader Bill Shorten, Greens Leader Christine Milne and Palmer United Party Leader Clive Palmer to express opposition to the levy.
-----

Pharmacy Related Articles.

Radical proposals to change 6CPA remuneration

13 October, 2014 Chris Brooker
Radical new sources of pharmacy revenue could be funded from the Sixth Community Pharmacy Agreement if a comprehensive new PSA blueprint is adopted.
The Pharmaceutical Society of Australia (PSA) has released a discussion paper Better health outcomes through improved primary care: Optimising pharmacy’s contribution, in which it both calls for a greater role in the 6CPA process, and advocates a realignment of the agreement towards a much greater focus on professional services.
Described by PSA sources as “evolution not revolution”, the document envisages the current Part B of the Community Pharmacy Agreement – covering professional services – “as an integrated suite of pharmacy services linked with population health objectives and primary care services”.
-----

Victorian inquiry recommends expanded pharmacist role

14 October, 2014 Christie Moffat
A parliamentary inquiry has recommended an expanded role for Victorian pharmacists in primary care, including the establishment of a flu immunisation trial and a minor ailments scheme in rural Victoria.
The Legal and Social Issues Legislation Committee released a report outlining opportunities for community pharmacists to play a greater role in taking pressure off the Victorian health system.
-----

AMA shirtfronts Vic pharmacy plans

15 October, 2014 Amanda Davey
The AMA has strongly criticised parliamentary recommendations for Victoria’s pharmacists to conduct a flu immunisation trial and treat minor ailments in rural areas.
“Doctors must remain at the centre of care, not as a second opinion,” says AMA Victoria president Dr Tony Bartone.
"Any decision which seeks to provide a substitute for a qualified doctor is a wrong decision."
Victoria’s legal and social issues committee believe pharmacists can take pressure off the state health system, and the trial could be in place before the start of the next flu season.
-----

AMA criticism won’t stop collaboration, pharmacists say

16 October, 2014 Chris Brooker
Pharmacists have responded strongly to the latest AMA criticisms of plans to expand the clinical service role of the profession.
As reported yesterday, AMA chair of general practice, Dr Brian Morton (pictured), was vehement in his criticism of pharmacy taking on additional roles, such as vaccination, as had been proposed by a Victorian parliamentary committee.
“This is not in their scope of practice, and a half day of [vaccination] training is simply inadequate,” he said. “Where will they vaccinate and treat these patients - between the toilet paper and the toothpaste?”
However, Pharmacy News readers have responded constructively to the AMA comments.
-----

Medicare Locals.

ACT Medicare Local to bid to keep its role in the new world of Health Networks

ACT Medicare Local (ACTML) has welcomed the announcement by the Commonwealth Government that one Primary Health Network (PHN) will be set up in the ACT.
ACTML Chair Dr Rashmi Sharma said it’s reassuring to consumers and health professionals that the boundary for the ACT PHN remains the same.
“We welcome the Commonwealth Government’s commitment to the importance of a strong primary health care system. As we all know, a locally coordinated and governed system of primary health care plays a critical role in containing the rapid growth of hospital and other high cost care in the face of the challenges such as avoidable hospital admissions and ED care, chronic and complex disease, an ageing population and mental health issues,” said Dr Sharma.
-----

Medicare Locals to become 30 Primary Health Networks

16 October, 2014 Tessa Hoffman
Thirty new Primary Health Networks will replace the 61 soon-to-be-defunded Medicare Locals, the Federal Government has revealed.
On Wednesday, the government finally released the boundaries for the new organisations, which will be rolled out from next year.
There is still uncertainty about how the much-hyped Primary Health Network reform will differ from its predecessor.
But the boundary shake-up, which will see one network each in the ACT, NT and Tasmania, is detailed in a map on the Federal Department of Health's website.
-----

Primary Health Network boundaries announced

15th Oct 2014
Julie Lambert
Flynn Murphy
THE government has announced 30 Primary Health Networks will replace the 61 Medicare Locals it defunded in the May federal budget.
A series of maps quietly uploaded to the health department's website today show the 17 Medicare Locals in NSW will be replaced with nine larger Primary Health Networks, and the 17 MLs in Victoria will drop to six PHNs.
WA will have three PHNs (down from eight) and South Australia will have two (from five). Tasmania, the Northern Territory and the ACT will retain a single zone each.
In Queensland, the door has been left open for the state’s largest PHN, Western Queensland, to be combined with one of three adjacent PHNs in the tender process.
-----

Primary Health Networks – an opportunity for the AMA to make some money, expand its influence?

Melissa Sweet | Oct 16, 2014 2:29PM
Now that some details about the 30 Primary Health Networks (PHNs) have been released, it might be timely to see some serious analysis of who are the winners and the losers amid the considerable upheaval and waste involved in shifting from Medicare Locals to PHNs. 
That is one warts-and-all analysis I would very much like to read.
In the meantime, the letter below – sent from AMA Victoria to all Medicare Locals in that State – shows the AMA is positioning itself to be one of the winners from the shift, offering to assist consortia pitching to become PHNs (so long as they are committed to working collaboratively with the AMA) – for the tidy fee of $10,000.
-----

Private health insurance in primary health care – what do the experts think?

Jennifer Doggett | Oct 13, 2014 11:53PM |
One of the major policy changes on the agenda of the Federal Government is the introduction of private health insurance (PHI) into primary health care.  This has been flagged by Peter Dutton in a number of speeches and media interviews and was also recommended by the Competition Policy Review.  While the exact role the Government has mind for PHI in primary health care is not clear, both BUPA and Medibank have already started to expand their activities in this sector. 
This policy direction has generated a robust debate with supporters of the Competition Policy Review position arguing that many of the intractable problems within primary health care (such as how to improve chronic disease management) could benefit from greater competition and innovation and others expressing concern about the impact of private funders on equity and access to care.
-----
Comment:
I also have to say reading all the articles I still have no idea what is actually going to happen with the Budget at the end of the day. Maybe the next few weeks of parliament will clarify this time.
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.