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, November 29, 2014

Weekly Overseas Health IT Links - 29th November, 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.
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CommonWell broadens data sharing efforts

Posted on Nov 21, 2014
By Mike Miliard, Editor
CommonWell Health Alliance is marching toward "a new phase" of its vendor-driven interoperability efforts, extending its availability to providers, signing on new corporate members and eyeing new opportunities for nationwide expansion.
Earlier this year, CommonWell's services were launched at more than 10 provider sites representing four different geographies. Since then, more than 20,000 people have opted to connect their records via CommonWell through their participating providers.
Now, CommonWell members have the option to enter into service agreements that offer a broader range of providers and their patients. Additionally, the alliance has locked in its relationship with founding member RelayHealth, whose health information exchange technology underpins CommonWell's efforts.
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Digital health records: Toss them out and start over?

November 21, 2014 | By Susan D. Hall
Despite the millions they've spent on digitizing medical records, many hospitals would be better off just scrapping their systems, according to an article at Hospitals & Health Networks.
"Poorly designed and poorly implemented information systems are worse than useless, worse than a waste of those millions and billions of dollars," writes Joe Flower, a healthcare futurist and CEO of The Change Project Inc., and its healthcare education arm, Imagine What If.
"As we go through rapid, serious changes in health care, poor information systems will strangle your every strategy, hobble your clinicians, kill patients and actually threaten the viability of your organization," Flower says.
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2015 healthcare predictions: Growth in analytics, mobile, security risks

November 21, 2014 | By Susan D. Hall
Big data continues to dominate the 2015 predictions for health IT from IDC Health Insights, though security plays a major role as well.
Among the predictions in the IDC FutureScape for Health Insights report:
  • By 2015, half of healthcare organizations will have experienced one to five cyber attacks in the previous 12 months, with a third of those attacks successful.
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3 reasons for provider moderation in health IT use

November 21, 2014 | By Dan Bowman
While digital tools enhancing communication between physicians and patients has been proven an effective method for boosting medication adherence for some patients, their use should be approached with caution, according to Esther Choo, an assistant professor at Warren Alpert Medical School in Providence, Rhode Island.
Choo, in a commentary for Quartz, warns that while email and text messaging can be helpful for engaging patients, there are a number of challenges associated with using such tools. Here are three:
  1. Impersonal relationships: Particularly when it comes to discussing serious or terminal conditions with patients, plans and reassurances primarily should be delivered in person, as opposed to via text message, for example. "[H]ave we arrived at an age when everything--even professional sympathy and support--can be conveyed electronically?" Choo asks.
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Glow adds postpartum-focused tracking to its pregnancy app

By: Aditi Pai | Nov 19, 2014
Fertility tracking app maker Glow has added a new feature to its app for pregnant women, called Glow Nurture. The app will now offer postpartum support.
The postpartum period refers to the time immediately after the birth of a child and lasts for about six weeks. According to Glow, the emphasis during this time is generally on the baby, but the mother is also recovering. Postpartum depression affects 10 to 20 percent of women, the company said, but resources for women during postpartum are lacking.
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Study: Health IT Use Could Affect Physicians' Capacity To See Patients

Thursday, November 20, 2014
The increased use of health IT among providers could reduce the number of patients physicians are able to see, according to a study published in the American Journal of Managed Care, FierceHealthIT reports.

Study Details

The study was based on survey responses from primary care physicians in Michigan (Hall, FierceHealthIT, 11/19). The survey -- by the Center for Healthcare Research & Transformation and the University of Michigan Child Health Evaluation and Research Unit -- was conducted between October 2012 and December 2012 and included a total of 739 respondents.
Responses from physicians who were not practicing at the time were not included.
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Highlighting generic drugs in EHRs boosts generic prescribing, cuts care costs

November 18, 2014 | By Marla Durben Hirsch
The simple act of listing generic drugs first in a physician's electronic health record can substantially increase generic prescribing and lower the cost of healthcare, according to a new study in the Annals of Internal Medicine.
The researchers, from the University of Pennsylvania and the Philadelphia VA Medical Center, evaluated two family medicine ambulatory clinics and two internal medicine ambulatory clinics between June 2011 and September 2012, reviewing 8,934 prescriptions pre-intervention and 12,443 during the intervention period for beta blockers, statins and proton-pump inhibiters. 
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Research based on EHR data needs to account for, remove bias

November 19, 2014 | By Marla Durben Hirsch
Screening analyses using electronic health record data need to be refined to reduce the risk of bias and prevent "spurious" findings, according to a new report in eGEMs (Generating Evidence and Methods to Improve Patient Outcomes).  
The researchers, from the Group Health Research Institute in Washington state, noted that EHRs increasingly are being used to facilitate research and quality of care, such as in the review of cancer screening rates. However, the EHR data for cancer screening, such as colon cancer, is inaccurate because there is no separate code for screening; to that end, the data would include diagnostic colonoscopies, as well as screening colonoscopies. This bias can range in overestimation of colon cancer screening by 11.6 percent, according to the study's authors.
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DeSalvo keeps focus on EHRs, usability

Posted on Nov 20, 2014
By Neil Versel, Contributing Writer
In case anyone was still wondering about a leadership vacuum at the Office of the National Coordinator for Health Information Technology, Karen DeSalvo, MD, is still national coordinator – a fact that was in evidence Wednesday at the close of the American Medical Informatics Association's annual conference.
DeSalvo – who was named acting assistant secretary of health at the Department of Health and Human Services this past month, to lend her public health expertise to the response to the Ebola outbreak – spent her entire keynote address talking not about Ebola or epidemiology, but about ONC and health IT.
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Alert overload could prompt physician turnover

November 20, 2014 | By Susan D. Hall
Primary care physicians who are dissatisfied with electronic health record-based alert notification systems may throw up their hands and quit if those systems are too intrusive, according to a study published at the American Journal of Managed Care.
Previous research had determined that providers using these systems receive 56 to 63 alert notifications a day, and most doctors do little to customize their alert interface to help them be more effective. As a result, many providers become overloaded with alerts they see as unnecessary and feel create more work.
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Surgery outcomes data published on MyNHS

19 November 2014   Sam Sachdeva
NHS England has published the latest surgery outcomes data for ten specialties and will release information on three more soon as part of a push for greater transparency around clinical performance.
The surgeon-level data has been published on the MyNHS website this morning, as well as on individual websites for each specialty.
The publication has been driven by Sir Bruce Keogh, NHS England’s medical director, who has been a long-term advocate of making outcomes data public.
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Are seniors ready for digital health?

Posted on Nov 18, 2014
By Eric Wicklund, Editor, mHealthNews
The general consensus that older Americans aren't comfortable with new technology means that many are not accessing the Internet for health information or using electronic health records. This low health literacy rate, according to a study from the University of Michigan, might also demonstrate that seniors aren't ready to reap the benefits of digital health.
At the mHealth Summit 2014, in fact, there will be no shortage of solutions or sessions focused on the senior market. But if they're not looking up health issues on the Internet or accessing their records, just what are they doing?
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Democratizing Medicine: Eric Topol Pushes a Patient-Centered Healthcare

November 17, 2014
Topol notes that digital health tools can help the patient "come alive"
As the healthcare industry moves into an era of accountable care, new digital tools can help democratize medicine, Eric Topol, M.D., director at the La Jolla, Calif.-based Scripps Translational Science Institute, said in a keynote at the New York eHealth Collaborative's (NYeC) 2014 Digital Health Conference.
In a crowded room full of conference attendees, who at times seemed mesmerized by the examples of how far digital health tools have come, Topol said that these new technologies will allow providers to move to individualized medicine. "You can have multilayers of information about someone,"  he said. "It's almost like a Google Maps for each patient."
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Global PACS market will keep growing

By AuntMinnie.com staff writers

November 19, 2014 -- The global PACS market is expected to increase in value this decade, but there are still challenges ahead, according to a new report from medical intelligence company GBI Research.
GBI projects that the worldwide PACS market will increase from $2.9 billion in 2013 to more than $5.3 billion by 2020, achieving a compound annual growth rate (CAGR) of 9%.
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Can the U.S. Health Care System Realize the Promise of Digital Health?

by Kate Ackerman, iHealthBeat Editor in Chief Thursday, November 20, 2014
NEW YORK -- Embracing digital health is key to curbing out-of-control health care costs, increasing access to care, improving care quality and encouraging patient engagement. But the current regulatory and policy landscape could get in the way of the U.S. realizing the full potential of health IT.
That was the message from speakers and attendees at the New York eHealth Collaborative's fourth annual Digital Health Conference in New York City
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A fall standards update

Source: John Halamka, MD Date: Nov 19, 2014 e-mail to a friend
The November HIT Standards Committee focused on "asynchronous bilateral cutover," the compatibility of different CCDA payloads, healthcare IT that supports long term services and support, an update on the Standards & Interoperability projects, a discussion of data provenance efforts and the HITSC workgroup organization.
We started the meeting by thanking Jacob Reider, Deputy National Coordinator, for his chairmanship of the Standards Committee. He’s leaving ONC at the end of the month. He will be missed.
Charles Parisot provided an analysis of Consolidated-Clinical Document Architecture (C-CDA) Version Migration and Cutover Findings. The good news—many vendors can successfully generate and parse different CCDA versions. We discussed two key takeaways. When new versions of standards are introduced attention needs to be paid to backwards compatibility. A bit of planning now can save significant EHR engineering complexity later. Also, at some point, certification will need to codify what it means to be backward compatible. Are older versions stored as human readable documents instead of structured data? The HITSC members recommended to ONC that they seek the input of the EHR vendors as to the appropriate path for historical CDA variants (CCD, C32, CCDAr1, CCDAr2).
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Paradigm shift coming for digital health

Posted on Nov 19, 2014
By Erin McCann, Managing Editor
Digital healthcare is no longer a reality of the future. It's happening now. And, as the industry moves toward full digitization, previously resistant clinicians are slowly, but gradually, getting on board with embracing new digital technologies. 
At least that's according to a new report put out by the folks at PwC, who highlight a telling shift in clinicians' attitudes toward digital technology, especially when it comes to connecting with patients. 
In the report, PwC officials surveyed 1,000 industry clinicians – including physicians, nurse practitioners and physician assistants – to gather a sense of how they perceive digital health nowadays. And the takeaways? In many arenas, most clinicians are on board. 
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Parsing the paradox of underused PHRs

Posted on Nov 19, 2014
By Neil Versel, Contributing Writer
Rather than just getting more cheerleading for a technology that has been disappointing for years, attendees at the AMIA annual conference on Tuesday heard a refreshingly frank assessment of the slow uptake of personal health records.
But they also heard about strategies informaticists can use to better employ PHRs to engage patients and clinicians alike. And they got to hear from activist patients and caregivers for an often-overlooked perspective.
Noting that the meaningful use regulations to date have not specified a preference for PHRs or patient portals when it comes to making records available to consumers or engaging patients, Joseph Kannry, MD, lead technical informaticist at Mount Sinai Health System in New York City, said no institution wants to put up multiple portals.
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RingMD launches global-focused telemedicine app

By: Jonah Comstock | Nov 18, 2014
Singapore-based RingMD launched its first app this week, an Android app designed to connect patients anywhere in the world to doctors anywhere in the world — although for now the doctors are mostly based in Singapore.
“Basically, when it comes down to healthcare and really just the world in general these days you have to think global from day one,” CEO Justin Fulcher told MobiHealthNews. “And we’re one of the only companies that are really taking that to heart as a core part of our philosophy. From there, being based in Singapore, we have the best opportunity to leverage the huge growth in the Asia region, but still given our management team — a lot of them come from the US — leverage our knowledge of the American market and accomplish that remotely.”
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Social Media Analytics Tracking of Infectious Diseases

NOV 17, 2014 9:42am ET
The recent outbreak of the Ebola virus has focused public opinion on the analytical methods used by institutions such as the Centers for Disease Control and Prevention (CDC) to manage infectious diseases. In a recent opinion piece on CNN’s website, Sen. Rob Portman wrote that the CDC should get “proactive” about Ebola by switching from “passive” monitoring to “active” monitoring of the outbreak. The media’s attention on Ebola has highlighted the fact that epidemiologists can be limited not only by the data they capture, but also by the traditional methods of analysis available, especially when trying to function in real time.
Generally speaking there are two forms of data capture (i.e., surveillance) when studying the spread and prevalence of an infectious disease: active and passive tracking. Active tracking is where researchers “capture” observation subjects from the “wild” (in the US this might be from the shopping mall or a phone list) with targeted instruments in a timely fashion. With passive tracking, researchers must wait until someone chooses to report information (e.g., a patient chooses to go to the doctor), and therefore they’re potentially unable to influence what or when information is shared.
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New Effort to Strengthen EHR-HIE Sharing of Patient Data

NOV 17, 2014 10:26am ET
In an effort to better connect electronic health records to health information exchanges, the New York eHealth Collaborative’s EHR/HIE Interoperability Workgroup has formed a strategic relationship with HIMSS and Integrating the Healthcare Enterprise (IHE) to streamline the process for achieving connectivity between EHR and HIE systems.
According to the organizations, the effort affects more than half the U.S. population and their healthcare providers, with the goal of secure sharing of patient data across multiple states and health IT systems. Specifically, the new alliance is designed to strengthen the EHR/HIE Interoperability Workgroup’s current program to test and certify EHRs and HIE vendors to enable reliable transfer of data within and across organizational and state boundaries.
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Pros and cons of pulling behavioral and social data into EHRs

By Mike Miliard, Contributing Editor
Should more types of health data figure into electronic health records?
On the one hand, the Institute of Medicine put out a call for doing just that on the grounds that behavioral and social data can benefit population health practices to ultimately improve the care of individual patients. For physicians who already complain that EHRs are burdensome and distract from care delivery, on the other hand, the idea of making electronic records more complex, perhaps even cluttered, will inevitably be unwelcome news.
"Patient electronic health records provide crucial information to providers treating individual patients, to health systems addressing the health of populations, and to researchers uncovering valuable details on determinants of health and the effectiveness of treatments," IOM officials wrote in the report. "Over the past few decades, substantial empirical evidence points to the contribution of social and behavioral factors – such as living conditions and physical activity levels – to functional status and the onset and progression of disease."
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Does encryption cover all HIPAA bases?

Posted on Nov 18, 2014
By Erin McCann, Associate Editor
What are the responsibilities of covered entities when an encrypted laptop or device is stolen, but the pass codes are handed over in the theft as well? A recent robbery reported by Boston's Brigham and Women's Hospital may shed some light on these tricky situations.
Hospital officials on Monday announced that an encrypted – not unencrypted – cellphone and laptop containing patient medical data were stolen this fall after a BWH physician was robbed at knifepoint and forced to disclose the laptop's pass codes.
The two devices contained the names, medical record numbers, ages, medications, clinical diagnoses and treatment data on 999 patients, officials said. The specific set of patients were those who received treatment at BWH's neurology and neurosurgery programs from October 2011 to September 2014, in addition to a group of individuals who participated in research studies.
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Public APIs getting ready for prime time

Posted on Nov 18, 2014
By Neil Versel, Contributing Writer
At the American Medical Informatics Association's annual symposium today, developers and backers of public application programming interfaces talked about how the standard could speed interoperability with add-on apps to enterprise EHRs, and help make those bulky systems more nimble.
In a recent draft of its 10-year roadmap toward interoperability, the Office of the National Coordinator for Health IT adopted a recommendation from its JASON task force that Stage 3 of meaningful use include public APIs. The first such API likely would be Fast Healthcare Interoperability Resources, or FHIR (pronounced "fire"), a standard being developed by Health Level Seven International.
On Tuesday at AMIA's annual conference, fans of FHIR discussed a federally funded test implementation of the standard, and what it might mean for moving the needle on interoperability.
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PwC: Provider, consumer views on healthcare tech closely align

November 18, 2014 | By Katie Dvorak
Healthcare providers' and consumers' views closely align when it comes to the promise digital technology holds for care, according to a new report by PricewaterhouseCoopers.
"Digitally-enabled care is no longer nice-to-have, it's fundamental for delivering high quality care," Daniel Garrett, Health Information Technology Practice Leader at PwC, said in an announcement.
PwC's Health Research Institute surveyed 1,000 physicians for the study.
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Data breaches 'should lead to jail time'

18 November 2014   Lyn Whitfield
A leading privacy watchdog has called for tougher penalties for breaches of the Data Protection Act, arguing that present legislation is not enough of a deterrent.
Big Brother Watch says courts should be given the option of imposing custodial sentences on those who breach the act, and that the “worst offenders” should be left with a criminal record.
It also argues that staff should be given better training in a report that identifies 7,255 breaches of the DPA in the NHS over three years.
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Why Patient Engagement is Key to Improving Health, Reducing Costs

The Engelberg Center for Health Care Reform recently hosted “The State of Accountable Care: Evidence to Date and Next Steps” to discuss the development, challenges, and potential future for accountable care efforts across the country.  Sean Cavanaugh, Deputy Administrator & Director of the Center for Medicare at CMS, kicked off the event, and highlighted progress and challenges of the Medicare ACO program and potential regulatory changes that could be included in the soon to be released Medicare Shared Savings Program (MSSP) proposed rule.
A Key Takeaway: Patient Engagement is Critical to the Success of ACOs
The need for greater patient engagement was a prevailing theme of the day for ACOs at Brookings.  Patient engagement is viewed as a key to improved health outcomes and lower costs; well-designed patient engagement strategies can also improve patient experience by allowing individuals to become more active participants in their care. For example, shared decision making and patient activation are proven strategies for engaging patients at the direct care level. These approaches help providers and patients to recognize that a clinical decision is necessary, understand the evidence on best available interventions, and ensure patient preferences are built into treatment decisions and plans. A recent study by Jennifer Sweeney and colleagues highlights some successful examples.
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Brigham and Women's opening access to the medical record

Nov 13, 2014, 4:54pm EST Updated: Nov 17, 2014, 4:03pm EST
Jessica Bartlett
Reporter- Boston Business Journal
Dr. David Bates clicked through the app's many functions – test results, care team, medications, food – each a snapshot into a patient's needs and status.
But the program, unlike most electronic medical records, wasn't designed for the doctor. This platform was created for patients.
"The notion is to change the way care is delivered," said Bates, senior vice president for quality and safety at Brigham and Women's Hospital.
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Healthcare's cloud poised for a shakeup

Posted on Nov 17, 2014
By Erin McCann, Associate Editor
Healthcare industry: Get ready for some serious growth of the cloud market. Due in part to evolving regulatory and health IT landscapes, the cloud market is poised for a double digit growth phase, new analysis suggests. Don't be fooled, though. Some big time barriers remain and have ultimately stymied the industry's shift over to the cloud.
The new data, published by Frost and Sullivan, underscores serious growth slated for both the U.S. and European healthcare cloud market, with analysts projecting that average penetration rates over the next decade will increase anywhere from 10 to 30 percent. As the industry further invests in healthcare IT and government regulations are updated to make cloud solutions more cost efficient, the numbers will only increase, analysts say.  
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How To Improve Hospital Emergency Department Communications

11/17/2014 01:20 PM
For better patient outcomes, start by improving communications among staff members, departments, and patients.
A growing body of evidence indicates quality medical care in the emergency department may be enhanced or eclipsed by patients' experiences with their medical providers.
For example, the Joint Commission performed a study to find root causes for all reported sentinel events between 1995 and 2005. Its findings indicate poor communications was the most common cause of negative events in the United States (68%). Meanwhile, lack of technical competence was responsible for only 20% of events.
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How Simple Data Analytics is Driving Physician Incentives

Scott Mace, for HealthLeaders Media , November 18, 2014

Easy-to-digest reports and data dashboards may be an easier pill for physicians to swallow than trying to get clinical data into their EHR workflows. Especially if their pay depends upon population management performance.

My latest HealthLeaders magazine cover story on big data started on its journey to publication with the notion that big data is only a sideshow in the healthcare analytics space. During the course of my reporting however, it turned out to be the main event of 2014.
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ONC Provides Vision for HIT-enabled Quality Improvement

NOV 14, 2014 1:48pm ET
The Office of the National Coordinator for Health Information Technology has released its vision for health IT-enabled quality improvements over the next 10 years.
“Leveraging health IT adoption and improving the exchange of health information through the use of health IT will be integral to supporting the essential building blocks of a quality improvement (QI) ecosystem,” states the ONC document. “This paper will illustrate ONC’s ten-year vision for advancing health IT capabilities in a manner that will combine, at a minimum, both clinical decision support (CDS) and clinical quality measurement (CQM) to enable robust and continuous quality improvement.”
Currently, ONC is in the process of developing a 10-year interoperability roadmap that is due to be released for public comment in January 2015. According to the just-released QI vision document, the nationwide interoperability roadmap will be interdependent with the quality initiative.
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5 steps toward a learning health system

Posted on Nov 17, 2014
By Neil Versel, Contributing Writer
Without good data, patient-centeredness is just a buzzword. And without a patient-centric focus and proper organization, data can be rather useless.
That was the message Sunday from Amy Abernethy, MD, a hematologist/oncologist and palliative care physician, who delivered the opening keynote address at the American Medical Informatics Association's annual symposium.
"Patients are the anchor for our work," Abernethy, the CMO of Flatiron Health, a New York City-based oncology analytics company, told this gathering of mostly academic medical informatics specialists. Patients' stories help clinicians work better with data, she said.
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ONC sees 10 years of quality improvement

Posted on Nov 17, 2014
By Mike Miliard, Managing Editor
In tandem with its 10-year interoperability roadmap, ONC has developed a decade-long vision for ensuring health information technology is deployed to "enable robust and continuous quality improvement."
"Dramatic advancements have been made in digitizing the care delivery system during the past decade," ONC notes in its report – not least the fact that all 50 states have some form of health information exchange services to enable care coordination.
In addition, more than half of U.S. hospitals can electronically search for patient information outside their own walls, with six out of ten electronically exchanging health information with outside providers.
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Why ICD-10 is necessary for big data success in healthcare

November 17, 2014 | By Katie Dvorak
While ICD-10 might have codes that seem excessive--like injury via turkey--without its comprehensive codes, doctors will "never detect the one-in-a-million disease when it matters," according to resident physician in family medicine William Rusnak.
With advanced computing power that can record human behavior in vital healthcare situations, we should be able to capitalize on that, Rusnak writes in a recent post for HIT Consultant.
"If a patient suffers the rarest of occurrences or undergoes an abstract procedure, there should be a code for it," Rusnak says. "Likewise, when a physician performs a specific procedure, a code should represent it in detail, including any variations."
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Wikipedia tracking helps with disease prediction

November 17, 2014 | By Dan Bowman
First, Google Flu Trends was touted as a potential epidemic detection tool. Then researchers at Johns Hopkins School of Medicine developed a Twitter screening method for delivering real-time data on flu cases to determine which publicly available tweets were linked to actual infections.
Now, researchers at Los Alamos National Laboratory in New Mexico say that tracking Wikipedia page views can forecast the spread of influenza and dengue fever. In a study published this month in PLOS Computational Biology, researchers show that through use of an algorithm, they can connect relevant Wikipedia searches with information from the Centers for Disease Control and Prevention for real-time disease prediction.
The researchers say their algorithm allows them to overcome challenges such as weak scientific peer review and underdeveloped forecasting capabilities that hamper the reliability of other similar data surveillance methods based on Internet information.
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Electronic Data Enables Care Evaluation at Individual Nurse Level

NOV 12, 2014 7:06am ET
Researchers from the University of Michigan, the University and Colorado, and Marquette University have demonstrated differences of individual nurse performance in quality of care, based on individual nurse level data linked to patient-specific outcomes.
"This groundbreaking research, released in a the new issue of Health Services Research featuring the Best of the 2014 Academy Health Annual Research Meeting, lays an empirical foundation for recognizing individual nurses as each being a unique and integral component of care delivery," said University of Michigan officials. "Achieving high-quality patient care and reducing costs will require that high-performing nurses are identified, recognized, and rewarded."
Using electronic data extracted from the 854-bed study, hospital electronic patient records and human resources databases on 1,203 staff nurses were matched with 7,318 adult medical-surgical patients discharged between July 2011 and December 2011. The study employed retrospective observational longitudinal analysis using a covariate-adjustment value-added model with nurse fixed effects.
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6 Fitness Trends for 2015 That Have the Experts Buzzing

Posted: 11/13/2014 8:27 pm EST Updated: 11/13/2014 8:59 pm EST
As 2014 starts to wind down, the fitness industry is hotter than ever. We got together with industry thought leaders in New York City for a Talk Sweat roundtable series, hosted by Sweaty Saturday. The panel was stacked with fitness and wellness leaders from all areas of the industry: Marcus Antebi -- founder of Juice Press, Alexia Brue -- co-founder of Well+Good NYC, Joyce Chang -- editor in chief at Self, Erin Corcoran -- brand lead at Nike, John Foley -- founder & CEO of Peloton Cycle and Mark Grabowski -- partner at Catterton Partners all took the stage to discuss the latest topics and trends. The result was an incredibly thoughtful and well-informed discussion about what healthful living looks like today and what it will look like tomorrow. Here are some key themes to look out for in 2015 according to the experts:
1. WHAT'S NEXT FOR WEARABLES?
Is this the end of wearables or a 2.0-style rebirth? This is a theme that far too many of us can relate to: You buy a new Fitbit, JawBone, FuelBand, etc. and track your sleep and steps religiously for three weeks only to figure out what you average, get bored with charging it and throw it in a drawer. Many find that wearables simply don't offer enough information to keep them interested long-term, and we're still quite a ways from technology that will intuit calories consumed. Should we expect to see a decline in this space, even with the arrival of the iWatch?
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AHIMA: ICD-10 Costs Lower Than Previously Reported

November 14, 2014
New data published online in the Journal of AHIMA suggests that the estimated costs, time and resources required by physician offices to convert to ICD-10 are “dramatically lower” than initially estimated.
The evidence also suggests that physicians and their office staff, vendors and health plans have made considerable progress on ICD-10 implementation with fewer resources than previously estimated.
The article estimates that the ICD-10 conversion costs for a small practice are in the range of $1,900-$5,900. This is in stark contrast to a 2014 update of a widely referenced 2008 report by Nachimson Advisors to the American Medical Association (AMA), which estimated the cost for a small practice to implement ICD-10 was in the range of $22,560-$105,506.
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Now or Later? Hospital Electronic Clinical Quality Measure Reporting

By Anantachai (Tony) Panjamapirom, Naomi Levinthal and Ernie Hood Monday, November 17, 2014
Hospitals participating in the Medicare Electronic Health Record Incentive Program must stay nimble to the constant changing nature of the program as CMS uses multiple regulatory channels to modify and update the meaningful use requirements. CMS releases an annual Inpatient Prospective Payment System rule, which stipulates the available meaningful use quality reporting requirements for hospitals.
In the 2015 IPPS final rule, CMS finalized two clinical quality measure reporting options -- similar to those available in federal fiscal year (FFY) 2014 --for hospitals:
  1. Attestation; or
  2. Electronic submission.
Both options are available for all eligible hospitals (EHs) and critical access hospitals (CAHs) regardless of stage and year of participation. However, there are slight operational differences depending upon a hospital's given year of meaningful use attestation. The figure below summarizes the CQM reporting options and associated reporting details by year of meaningful use participation. 
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CIOs, CMOs Share EHR, Telehealth Adoption Experiences

Cheryl Clark, for HealthLeaders Media , November 17, 2014

At the first annual HealthLeaders Media Health IT & Quality Exchange, executives discuss the challenges of implementing electronic medical record systems and telehealth technologies.

It hasn't been an easy year for Linda Butler, MD, or her colleagues at Rex Healthcare in Raleigh, NC.
As vice president of medical affairs as well as CMO/CMIO, she and her team have had to help manage the hospital's Magnet status reaccreditation, Ebola preparedness, and its three-year review by The Joint Commission.
They've also had to assist with the delicate implementation of Rex's electronic medical record system, an Epic installation. "You replace an EMR maybe once a decade, you go through Magnet accreditation every four years, and TJC every three years. We did all of that in about six months," she says.
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Enjoy!
David.

Friday, November 28, 2014

The Issue Of Taking Digital Images In Health Care Certainly Needs Care and Rules.

This appeared last week.

Promoting a 'Clinical' Approach to the Taking and Transmission of Clinical Images

Targeted News Service
BARTON, Australia, Nov. 21 -- The Australian Medical Association issued the following news release:
The AMA today released a new guide for medical students and doctors on the proper use of personal mobile devices - including smart phones, cameras, tablets, laptops, and portable music devices - when taking and transmitting clinical images.
The guide, Clinical Images and the Use of Personal Mobile Devices, was developed jointly by the AMA and the Medical Indemnity Insurance Association of Australia (MIIAA), with specialised input from the AMA Council of Doctors in Training (AMACDT) and the AMA Council of Salaried Doctors (AMACSD).
AMA President, A/Prof Brian Owler, said the guide outlines the key ethical and legal issues that doctors need to be aware of before using a personal mobile device to take or transmit clinical images for the purpose of providing clinical care in the Australian health care system.
"Medical professionals routinely take clinical images while caring for patients," A/Prof Owler said.
"These images form part of a patient's medical record, so are subject to the same privacy and confidentiality principles as the rest of the record.
"With an ever-increasing range of portable devices available to the medical profession, it is important that doctors and medical students are aware of the benefits and risks associated with the use of this new technology in clinical settings.
"The guide outlines the professionally appropriate processes of informed consent, documentation, capture, secure storage, disclosure, transmission, and deletion of clinical images, including de-identification and privacy legislation."
A/Prof Owler, said the guide is in keeping with the AMA's commitment to uphold the principles of medical professionalism.
"Sharing clinical images is extremely valuable for teaching, research, and advice - but there are also associated legal, professional, and ethical responsibilities," A/Prof Owler said.
"The guide will inform doctors of the obligations associated with the capture and use of clinical images, particularly when using a personal mobile device.
Lots more here including some very sound basic advice for all clinicians.
Obviously the advent of digital photography and camera phones has really changed the game in this area over the last few year.
Given there can be risks to privacy and inadvertent harm it makes good sense to think carefully how images are handled in the clinical environment.
Respect, professionalism and common sense will go a long way here!
David.

Thursday, November 27, 2014

Review Of The Ongoing Post - Budget Controversy 27th November 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 26th week since it was released.
Tony Abbott is still complaining just how hard it is being to make budget progress and reports of huge budget blowout also featured - said to now be $40B.
The Government response to Ebola seems to be finally lifting off with the new hospital in Africa to open in a week or so.

Late Note: The co-payment story has become very, very blurred in the last 24 hours and no one knows what is going on! There are only 4 sitting days left before Parliament rises till February 2015! 

General.

G20: Tony Abbott 'whingeing' about domestic agenda on world stage

Opposition leader Bill Shorten says Australian PM made ‘weird and graceless’ opening address on the carbon tax, asylum seekers and budget problems
Tony Abbott has highlighted his domestic political agenda during an opening address to world leaders in Brisbane, citing the abolition of carbon pricing, the hardline stance on asylum-seeker boat arrivals and “massively difficult” budget measures.
The Australian prime minister conceded his counterparts could raise any topic they wish in the G20’s closed-door leaders retreat – despite his wish that it remain economics-focused – after intense pressure from Europe and the US for stronger action on climate change.
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Tony Abbott talks Senate woes in front of world leaders

Phillip Coorey Chief political correspondent
Prime Minister Tony Abbott has bemoaned his budget woes to the leaders of the world’s richest nations, telling them the Senate won’t pass his higher education reforms or Medicare co-payment.
In an opening address to G20 leaders, which the opposition has slammed as “graceless and weird’’, Mr Abbott said it was proving “massively difficult’’ to get the budget under control.
The G20 leaders have signed off on a commitment for each country to grow its economy by 2.1 per cent over five years. The government’s budget measures are part of Australia’s plan to achieve this.
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Australia suffers another cringeworthy moment during G20 summit

Date November 17, 2014 - 6:40AM

Robyn Dixon

The adolescent country. The bit player. The shrimp of the schoolyard.
For Australians it's not so bad - most of the time - to be so far away, so overlooked, so seemingly insignificant as to almost never factor in major international news. The lifestyle makes up for it.
But occasionally, there's an awkward, pimply youth moment so embarrassing that it does sting. Like when 19 of the world's most important leaders visit for a global summit and Prime Minister Tony Abbott opens their retreat on Saturday with a whinge about his doomed efforts to get his fellow Australians to pay $7 to see a doctor.
And then he throws in a boast that his government repealed the country's carbon tax, standing out among Western nations as the one willing to reverse progress on climate change - just days after the United States and China reached a landmark climate change deal.
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Briefing to the incoming Minister of Health 2014

Link to Resource:

12 November 2014
Executive summary
This briefing provides you, as the incoming Minister, with information on challenges and opportunities facing the New Zealand health and disability system, and how the Ministry can advise and support you to implement your Government’s priorities for health. The Ministry looks forward to discussing with you how to progress your health policies, including: providing high-quality health services; healthy communities; a strong and engaged health workforce; quality aged care and mental health services.
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Some Australians to pay more for health

  • November 18, 2014 3:11PM
SOME Australians will pay higher Medicare levies and more for private health insurance from next year.
LEGISLATION to freeze income thresholds for three years for the Medicare levy surcharge and private health insurance rebate passed parliament on Tuesday.
The freeze will be in place from July 2015.
Australians not yet paying the Medicare levy surcharge could rise over the threshold as their incomes increase, and have to pay it for the first time.
Others may move into a higher bracket.
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Budget deficit heads for $40bn

David Crowe

GLOBAL pressures are driving the federal budget towards a $40 billion deficit this year, as Joe Hockey confronts plunging iron ore prices that will wipe out revenue, just as he fights to legislate his agenda.
With iron ore prices tumbling faster than some of the gloomiest forecasts prepared for the federal budget, the Treasurer is preparing to issue an economic update within weeks, including new savings measures.
The government is also dealing with a splintering of Senate alliances that will make it more difficult to pass controversial changes such as university funding cuts and savings on family tax benefits.
While the May budget tipped an “easing” of the iron ore price over the next few years, those forecasts have now been rendered obsolete by a halving of the price over the past year.
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ABC budget cuts a story about lying, not money

5:00pm, Nov 20
Patrick Smithers Senior Editor
Don’t be distracted by the size of the cuts to the ABC. The headline story is the rolled-gold election promise that has been broken by the Prime Minister.
The Abbott government’s cuts to the ABC are neither savage nor indefensible.
Compared with decisions to charge people to go to the doctor, or to withdraw financial support for the young unemployed, they are a mere pimple on the policy landscape.
If, in the pursuit of a balanced budget, pensioners will have to make do with less and families will have to pay more at the petrol bowser, it is at least arguable that the ABC should take a trim.
Yet the cuts are important politically because they are the clearest example of an unpalatable, unavoidable truth: Tony Abbott lied to Australians to help win his way into office.
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19 November 2014, 11.38pm AEDT

An unexpected win for consumers of financial advice comes out of PUP implosion

Michelle Grattan
Australia’s financial services industry has been thrown into turmoil by the spectacular implosion of the Palmer United Party (PUP) and an independent stand by its supposed ally, Motoring Enthusiast Ricky Muir.
Wednesday night’s disallowance, by a 32-30 vote, of the government’s regulations that unwound Labor’s Future of Financial Advice measures reinstates a range of protections for consumers.
But it also means many financial advice institutions don’t have systems in place to meet what they will now be supposed to do, and thus could be in breach of the law. They’d been confident these wouldn’t be needed, thanks to the government’s watering down of Labor’s phased-in measures.
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ABC and SBS cuts are not cuts, and five other great political evasions

Date November 21, 2014 - 3:00PM

Rose Powell

Journalist

One might assume the freshly announced multimillion-dollar budget reductions to our government-funded national broadcasters would render Prime Minister Tony Abbott's pre-election promise of "no cuts to the ABC or SBS" utterly broken. But apparently not.
Both Finance Minister Mathias Cormann and Communications Minister Malcolm Turnbull stepped into the breach to explain.
Senator Cormann said Mr Abbott's promise did not refer to cuts but to "efficiency dividends", from which he said the ABC had been exempted for the past 20 years.
"The Prime Minister absolutely told the truth. We are not making cuts. What we are making sure happens with the ABC is what happens with every other taxpayer funded organisation across government."
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Sale could hurt Katya’s normal life

By NIGEL MCNAY

Nov. 22, 2014, midnight
KATYA Haynes headed to Canberra this week for testing of her hearing and cochlear implant.
The Albury girl, 5, has profound hearing loss, but the implant and plenty of family support have her keeping pace with kids her own age.
Crucial to her development, her mother Jana Kyte said, was the work of the Albury office of Australian Hearing.
But the family is concerned at federal government moves to privatise the service.
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Medicare Co-Payments.

Health Minister's Medicare claims not supported by facts

dburdon | 17th Nov 2014 6:00 AM
ARGUMENTS that the Medicare system is costing more due to patients "overusing" subsidised visits to GPs are not borne out by the facts of a major study showing how doctors are working longer hours to deal with more complex problems, according to one health policy expert.
The study by the University of Sydney's Family Medicine Research Centre last week revealed the system cost some $2.1 billion a year more in 2013-14 than it did 10 years ago.
But, the centre's Associate Professor Helena Britt said, the data showed taxpayers were actually getting a lot more bang for the buck - through an extra 35 million more GP services (36% more than in 2003-04), managing an extra 68 million health problems (a 48% rise on 2003-04).
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Victoria election 2014: Clive Palmer says election is a vote on GP co-payment, education

Posted yesterday at 2:12pmSun 16 Nov 2014, 2:12pm
Clive Palmer says the Victorian election is a referendum on the Medicare co-payment and the future of education in the state.
The leader of the Palmer United Party (PUP) outlined the party's policies at its official campaign launch in Melbourne.
The outspoken Queensland Federal MP spruiked his Victorian connections, saying he was born in the state and lived there until he was 10.
"For most of the time since federation, Victoria was Australia's premier state and it can be again," Mr Palmer said.
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Politicians dispute impact of Medicare co-payment

Nov. 17, 2014, 6:24 p.m.
MEMBER for Wagga Daryl Maguire says there will be no co-payment in NSW, slamming Labor's claim 9200 extra patients would flock to Wagga's sole public hospital.
Country Labor candidate Dan Hayes spruiked NSW Labor's new hospital data model that showed a 27 per cent increase in emergency department admissions, under the proposed $7 Medicare co-payment plan.
The region's sitting member refuted the claim.
"They will be no co-payment," Mr Maguire said.
Mr Hayes and shadow minister for health Walt Secord said the $7 GP payment cost would be too high for many Australians, who would forgo seeing a general practitioner and instead seek free, hospital services.
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Jacqui Lambie: Palmer United Party implosion creates uncertainty

THE implosion of the Palmer United Party has created a new level of uncertainty in an already obstructionist Senate which casts further doubt on the Abbott government’s ability to pass outstanding contentious proposals such as the Medicare co-payment.
Indeed, the conglomerate decision of the newly liberated Jacqui Lambie with Ricky Muir, the Greens, Nick Xenophon, John Madigan and Labor to move to disallow financial reforms already passed with PUP support signals uncertainty for existing government legislation.
An already unpredictable and fractious Senate, arguably the most difficult since Federation, has become even more unpredictable and fractious.
After chalking up a series of legislative victories in the Senate, largely with the help of bloc votes from Palmer United Party Senators dictated to from Palmer in the Lower House the Government faces a new and even more daunting challenge.
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Ebloa.

Ebola threatens global security, says Julie Bishop

  • AAP
  • November 23, 2014 12:45AM
FOREIGN Minister Julie Bishop has expressed concern about the Ebola virus outbreak at a UN Security Council meeting she chaired on the disease.
“The Security Council reiterates its grave concern about the unprecedented extent of the Ebola outbreak in Africa, which constitutes a threat to international peace and security, and the impact of the Ebola virus on West Africa, in particular, Liberia, Guinea and Sierra Leone,” Ms Bishop said yesterday in New York.
She also warned that gains made to date could easily be reversed.
The debate came as an Australian company prepared to open a treatment facility in Sierra Leone, with doctors likely to treat their first patients within weeks.
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Medical Research.

Vision for high-performance bionic eye jeopardised by lack of funds

Date November 23, 2014 - 12:15AM

Bridie Smith

Lack of funding may force Australia researchers to drop their promising work on a bionic eye.
Australian bionic eye researchers fear a lack of funding will force them to drop one of the most promising research projects in their quest to restore vision to the blind.
As the federal government calls for submissions on how to improve the country's commercialisation of research, Bionic Vision Australia has had to prioritise its focus. It will now concentrate on low-vision prototypes.
Their holy grail - a high-acuity bionic eye that would allow the blind to read large print and recognise faces - is likely to be shelved within months as there is not enough funding to get through trial stage.
"We're just about to fall into the valley of death," said Melbourne University physics professor Steven Prawer, head of materials development for the high-acuity bionic eye.
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Pharmacy Related Articles.

Profession divided over variable dispensing fees

17 November, 2014 Christie Moffat
Pharmacists are divided over whether a dispensing fee should be linked to the level of patient consultation, a Pharmacy News poll reveals.
The 2014 UTS Pharmacy Barometer, released in October, found that many pharmacists supported a consult-linked dispensing fee, with similar numbers of employed pharmacists and owners in favour of dispensing fee differentiation.
In light of the interest, Pharmacy News recently ran a poll, asking our readers whether they supported different levels of fees for dispensing based on the amount of patient interaction.
The outcome of the poll indicated that pharmacists are significantly divided on the issue – which reflects the wider trend among professional groups such as the Pharmacy Guild of Australia and the Pharmaceutical Society of Australia.
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Proposed S3 oral contraceptives 'totally inappropriate': AMA

17 November, 2014 Chris Brooker
Proposals have been tabled for a range of medicines to be downscheduled, including a number of oral contraceptives.
Among the proposals, which have already drawn condemnation from the AMA, are to move a number of oral contraceptives – including oestradiol, levonorgestrel, dropsirenone and others – to Schedule 3.
Another proposal would see herpes treatment acyclovir downscheduled from S4 to S2 in muco-adhesive tablets containing 50mg in a pack of two.
The TGA is currently calling for submissions on these and other proposals by 11 December, ahead of the March 2015 meeting of its Advisory Committee on Medicines Scheduling.
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Chemist Warehouse faces accusations of misleading discount advertising

By consumer affairs reporter Amy Bainbridge
November 18, 2014, 7:44 am
Two major pharmacy bodies say Chemist Warehouse is misleading consumers in the way it advertises its discounts on some of its products in store, as well as on dockets given to customers.
The Pharmacy Guild and National Pharmacies have each written to the Australian Competition and Consumer Commission (ACCC) and asked it to investigate, with the Guild describing it as a "matter of urgency".
But Chemist Warehouse has denied any wrongdoing.
In his letter to the ACCC, the president of the Victoria branch of the Pharmacy Guild, Anthony Tassone, pointed to two examples he believed misled consumers.
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Most GPs opposed to pharmacy consultation role: poll

17 November, 2014 Chris Brooker
The strident opposition of doctor’s groups to any extension of the clinical role of pharmacists has been borne out by a recent poll conducted by the Royal Australian College of General Practice.
The poll, which is still ongoing on the RACGP website, asks College members to vote on whether they “Support the expansion of community pharmacists’ roles to provide basic patient consultations?”
To date, the response has been an overwhelming no. In fact, of the first 100 voters, 84 voted “No, pharmacists are not medically trained and have a conflict of interest because they dispense medication”.
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Guild analysis finds deregulation call ‘deeply flawed’

19 November, 2014 Christie Moffat
Recommendations by the Competition Policy Review panel to remove pharmacy ownership and location rules have been labelled “deeply flawed” in a detailed submission by the Pharmacy Guild of Australia.
The 123-page document was commissioned in response to the Harper Review’s draft recommendations, and contains a three-pronged analysis from a range of leading consultants on whether removing ownership and location rules would advance the welfare of the Australian community.
Criticisms levelled at the Review included that it was based on a “poorly formulated public interest test”, was not based on robust or transparent evidence, did not recognise the success of the current regulations, and was developed without a clear understanding or formulation of alternatives.
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Community pharmacy passes the test

This week the Guild has lodged a significant submission to the national Competition Policy Review, responding to the Panel’s draft report released last September.
I am very proud of the Guild’s submission because it breaks new ground in establishing a range of objective measures of the true value of community pharmacy and the model under which it operates in this country.
The submission is based on a new three-pronged analysis of the community pharmacy model which confirms that it is delivering a high level of access, choice and equity for consumers.
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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 things this time but I doubt it. The Reps come back on soon, along with the Senate. Both rise until the new year on Dec 4, 2014 until February!
As pointed out on Insiders this week - if the Budget is not sorted in the next week or so - then the next chance is in February, 2015 - and after MYEFO - and then we are into the next Budget!
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.

It Seems There Is Opportunity For Remote Telehealth To Make A Bigger Positive Difference.

This appeared last week:

Doctors call on government to expand Medicare for Telehealth

Delegates gather for annual telehealth conference
Brian Karlovsky (ARN) on 17 November, 2014 09:48
The Australasian Telehealth Society has called on the Government to expand medicare for telehealth ahead of its annual meeting.
Delegates are gathering in Adelaide today for SFT-14, the "Successes and Failures in Telehealth" conference, and the fifth Annual Meeting of the Australasian Telehealth Society, which will be opened by the South Australian Health Minister, Jack Snelling.
Telehealth is the delivery of health care services at a distance, using information and communication technology.
This conference will showcase the achievements of doctors, nurses, psychologists and all healthcare providers in using telehealth to bringing healthcare to rural and remote areas and into people’s homes, to achieve better access to healthcare and improved health outcomes.
In 2011, the Australian Government put video consultations by specialists to rural Australia on Medicare.
This means that people in the bush can see a specialist by simply going to their local general practice, rather than having to travel to the city.
This initiative has supported around 230,000 telehealth consultations. More than twice this number was predicted, so the funding set aside has been underspent, and this gives capacity to extend telehealth to a broader range of health services.
"It is still only available in some areas and needs to be put into practice much more widely to make health outcomes more equal," according to the Society.
"More than 30 per cent of Australians live in rural and remote areas, but less than 1 per cent of medical specialist consultations are by telehealth.
"Improvements in broadband communication need to be harnessed to bring more health services to these areas."
In far west NSW, remote Western Australia and in the Northern Territory, life expectancy is more than 10 years below average, and suicide rates are more than double.
The Society has called for a list of reforms to be implemented.
Lots more here:
The requests from the Society all seem sensible to me and could make a real difference at  a very reasonable cost.
Interesting the usage to date has been lower than predicted. I wonder why that was?
David.