Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Thursday, January 29, 2015

Review Of The Ongoing Post - Budget Controversy 29th January 2015. Utter Disarray!

Budget Night was on Tuesday 13th May, 2014 and the fuss has still not settled by a long shot. Indeed more than a few commentators are now wondering out loud if the Abbot Government will last for a second term.
The modified Medicare co-payment plan - announced late last year  - seems to have annoyed most other than the Government and we now wait till mid February 2015 to see what the Senate thinks of Plan B. We know the AMA and RACGP are talking to the Government and the new minister about it.
Now part of Plan B is gone but some extreme nasties still remain, i.e. the rebate cut for short consults has been abandoned the freezing of rebate levels until 2018 and a plan for a co-payment are still live.
As for the rest of the Budget - who knows and Mr Hockey is threatening tax rises to repair the Budget!
See here:

Hockey: income tax burden to increase if Labor keeps blocking savings measures

Date January 24, 2015 - 7:53PM

Gareth Hutchens

Treasurer Joe Hockey has warned that if Labor continues to block savings measures in the Senate he will not be able to stop Australians' income tax burden increasing through so-called "bracket creep".
"We have been warning about bracket creep and we want to deliver tax cuts, but the Labor controlled Senate continues to block savings measures that would help pay for those tax cuts," Mr Hockey told Fairfax Media.
"If Labor continues to block our savings measures the cost burden will inevitably fall on middle Australia. We do not want this to happen."
Australia's top economists, including former Treasury Secretary Martin Parkinson, have warned that middle and low-income households will face an increasing tax burden in coming years if the government does not move to prevent bracket creep.
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Seems there are lots of broader problems also. See here:

Glenn Stevens must act fast to rescue Australia's economy

Date January 25, 2015 - 10:34AM

William Pesek

Comment
Few central bankers in modern history have had a better run than Australia's Glenn Stevens. He steered his country around the global financial crisis, drove its currency to record highs and extended its recession-free run past the two-decade mark.
That's all in jeopardy now, however, as Stevens, governor of the Reserve Bank of Australia, stands still while China's slowdown and deflationary forces close in. Markets are registering their disappointment by driving the Aussie dollar below 80 US cents for the first time since 2009. The message from traders: It's time for a rate cut. The question is, will Stevens act ahead of, or at, the central bank's February 3 policy meeting?
The odds he will are rising, but remain too low for comfort. The European Central Bank's quantitative-easing program and the Bank of Canada's surprise rate cut add to the pressure on Stevens to trim a benchmark rate he's held at 2.5 per cent for 17 months.
The most immediate danger is China, to which commodity-rich Australia has increasingly hitched its fortunes. The collapse in global commodity prices challenges Beijing's claim that its economy is growing by 7.3 per cent. Even more than the plunge in crude oil, iron ore at its lowest price in more than five years suggests China is growing slower. Such metals fuel the Chinese urbanisation trend that's been lifting world growth. As Premier Li Keqiang explained at Davos this week, China's move to a consumer-led economy from an investment-led one is real, and the fallout will be felt everywhere. China's "new normal" is particularly bad news for Australia's mining industry.
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Other articles this week.

General Budget Issues.

The black plague of finance: easy money not seen since the 14th century

Date January 22, 2015 - 2:28AM

Paul Sheehan

It is not a good sign when an internationally respected economist, one of the few who predicted the 2008 global financial crisis, invokes the black plague when discussing today's global financial markets.
"We are in a world that is dangerously unanchored … We're seeing true currency wars and everybody is doing it," said William White, a senior economist for the Organisation for Economic Co-Operation and Development.
"Sovereign bond yields haven't been so low since the black plague," he told Ambrose Evans-Pritchard, the European economics editor of The Telegraph in London. Evans-Pritchard has been a prescient (and pessimistic) observer of the eurozone.
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Health Budget Issues.

Tony Abbott should work with states to cut the cost of healthcare

AS one health minister to another, I advise new federal Health Minister Sussan Ley to pin up in her office the words “Poor quality healthcare is always more expensive than high quality care”, and remember that the US has the lowest life expectancy in the developed world, despite spending twice the percentage of its GDP on healthcare that Australia does.
The cost of providing healthcare, particularly the acute healthcare citizens have come to expect, threatens to overwhelm budgets around the world. It is understandable that the Abbott government is trying to tackle this, albeit in an ill-thought fashion. But measures which adversely affect the quality of healthcare, especially anything that discourages people from seeing their GP, will do nothing to curb the cost of healthcare.
Federal government expenditure on Medicare this year will be about $19 billion. But this is dwarfed by the $140bn state and federal governments spend on public hospitals. To change Medicare without considering the impact on public hospitals is shortsighted.

Take it from a baby doctor: cuts to GP services are a false economy

Date January 19, 2015 - 12:00AM

Benjamin Veness

At 8am on Monday, in hospitals from Wagga Wagga to Sydney to Lismore, 969 new doctors will be born. We baby doctors comprise this fertile state's newest crop of interns – the largest in the country and the most in NSW's history. We are grateful for the public's trust, and also for Tony Abbott's decision while he was health minister to increase the number of medical school places, allowing many more of us to realise a dream of caring for our fellow citizens' health.
After already spending up to six years at medical school, plus this coming year of internship, deciding on a speciality will be our next big decision.
"Are you going to specialise, or just be a GP?" is a question I am often asked, but it hasn't been possible to "just be a GP" for two decades. Once, the internship was the only impediment to a new doctor hanging his or her shingle as a GP and bulk-billing Medicare for services to patients. In 1996, new federal legislation made aspiring GPs spend several more years after internship in further supervised training and exams. General practice effectively became a specialty, just like cardiology or neurosurgery.
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Lesley Russell & Stephen Leeder: Rough road

Lesley Russell and Stephen Leeder
Monday, 19 January, 2015
THIS year will be a critical time for federally funded health care in Australia and many of us are wondering which direction we will take.
Will we see the dismantling of Medicare and health care services as we know them, or the rebuilding and restructuring of both the system of care and the way we finance it, to better meet the needs of all Australians?
In its first year, the Abbott government has torn down and cast aside policies and programs of the previous government and commitments it made in election mode. Central to these is the undermining of the financial base for acute care services, by the clawback of an estimated $50 billion over the next decade from the National Health Reform payments to the states and territories and the abandonment of activity-based hospital funding.
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Superficial debate on health policy is starting to sound like a joke

Judith Sloan

EVERYONE knows the joke about the bloke asking for directions to Dublin — I wouldn’t start from here is the punchline. When it comes to public policy, that wise Irishman has a real point.
Economists have a fancy name for it — path dependence. When considering policy options, there is no point getting a clean sheet of paper. You have to deal with what you have and tweak or modify policies, depending on your degree of political courage.
Where policy settings have been in place for long periods of time, as with Medicare, career and business decisions have been made and the electorate has built certain expectations based on their experience with the system.
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Joe Hockey raises prospect of Australians living until 150 to justify budget cuts

Date January 19, 2015 - 11:34AM

Matthew Knott

Treasurer Joe Hockey has raised the prospect of people living until 150 to explain why Australians should accept cuts to government benefits and pay a greater share of their health costs.
It's kind of remarkable that somewhere in the world today, it's highly probable that a child is being born that is going to live to 150 
Mr Hockey also refused to deny reports that he and former health minister Peter Dutton opposed a $20 cut to Medicare rebates for short consultations in a meeting of cabinet's powerful Expenditure Review Committee. The government abandoned the planned cut, which was due to take effect on Monday, after a revolt by doctors and Senate crossbenchers.
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21 January 2015, 6.25am AEDT

The AMA and Medicare: a love-hate relationship

Lesley Russell

Adjunct Associate Professor, Menzies Centre for Health Policy at University of Sydney
The Australian Medical Association (AMA) has emerged from the recent brouhaha over the Abbott government’s proposed Medicare reforms as both a winner in the protection of doctors’ incomes and an apparent champion of the affordability of health care for patients.
Medicare changes that were due to come into effect this week would have imposed a ten-minute minimum for regular (Level B) GP consultations which currently attract a A$37.05 rebate. Consultations under ten minutes would have attracted a smaller rebate of A$16.95. GPs were faced with a choice: absorb the cuts or pass them on to patients.
The AMA framed the change as a A$20 cut to patient rebates for short visits and used data to dismiss government claims of “six minute medicine”.
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Serious message behind Treasurer's 150-year aside

Date January 21, 2015 - 12:15AM
EDITORIAL
No sooner had Treasurer Joe Hockey returned from his summer holiday and attempted to shape the debate about the financial challenges facing Australia, then he was subject to ridicule. The Herald thinks those attacks were unfair, and mainly confined to the more malign influences in social media. In mentioning that some people alive today may live to the age of 150, the Treasurer was not only drawing on a considerable body of medical and scientific opinion, he was discussing, in a welcome conversational style, Australia's demographic change, its dramatically aging population, and the serious national challenge this presents.
His remarks did not deserve the kneejerk opprobrium they attracted.
While Hockey has been a forceful figure in parliamentary debate, his stewardship of the Treasury portfolio has been beset by gaffes, accidents and a poorly prepared and delivered budget message. 
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Government accused of overstating health spending growth

Date January 21, 2015 - 6:23PM

Dan Harrison

Health and Indigenous Affairs Correspondent

The Abbott government has been accused of exaggerating growth in healthcare spending to justify cuts to Medicare rebates.
Health Minister Sussan Ley has begun consulting doctors about reforms to rein in what she has called the "rapid and unsustainable" rate of growth in Medicare spending.
While her first public act as minister was to withdraw changes that would have cut rebates for short GP visits by $20, the government still plans to cut rebates for GP visits by $5 in July, and give bulk-billing doctors the option of charging patients a fee of up to $5.
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Why private health is so pricey – and what can be done

Jessica Gardner
For private health insurance customers who cannot understand why their premiums are set to rise at triple the rate of inflation, the experience of CUA Health may shed some light.
The fast-growing health fund just paid out its biggest claim ever. A patient receiving end of life care in an intensive care unit just cost the fund $270,000 over a few months. “That was unique,” chief executive Philip Fraser told The Australian Financial Review. “But utilisation across the board is rising.”
In line with other insurers, CUA Health, which has 50,000 members and premium revenue of about $118 million, is facing a rise in the cost it pays hospitals and healthcare providers of “about 6.5 to 7 per cent”, he said.
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Cost of cancer drugs rises sharply to $586 million

Date January 24, 2015 - 12:30AM

Kate Hagan

Government subsidies for high-cost cancer drugs are growing at a faster rate than for other medicines, an analysis shows.
A parliamentary research paper found spending on chemotherapy rose from $84 million in 2009-10 to $586 million last financial year.
The 63 per cent annual growth in the cost of cancer drugs far exceeded that of other medicines, including those dispensed in public hospitals to manage complex conditions such as HIV/AIDS and hepatitis.
Other high-cost drugs subsidised by the government include those used to treat infertility and rare and life-threatening diseases.
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Doctors' fees under the microscope amid accusations of over-diagnosis

Date January 24, 2015 - 12:15AM

Harriet Alexander, Julia Medew and Dan Harrison

It's not a lot of fun, picking a fight with the medical profession.
In 2009, Angela Pratt was chief of staff to the health minister Nicola Roxon when the entire ophthalmological fraternity started running at them with spinning arms.
Roxon had decided to halve the Medicare rebate for cataract surgery, which still reflected the days when the procedure was lengthy and costly, though it became simple and inexpensive. Ophthalmologists were  said to be earning up to $1 million a year.
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New funding models are a long-term alternative to Medicare co-payments

fronjacksonwebb | Jan 21, 2015 2:01PM | EMAIL | PRINT
Peter Sivey writes: The Abbott government is struggling with its Medicare co-payment reform, scrapping the latest version for a period of consultation, starting this week. The government claims it wants to make Medicare sustainable by controlling costs. However the proposed reforms are piecemeal and inequitable, antagonising Medicare’s stakeholders [...] without addressing underlying problems.
To recap, the revised Medicare co-payment policy as of December 9, 2014 was to reduce Medicare rebates by A$5 and encourage GPs to recoup this from patients; freeze the indexation of Medicare rebates for all doctors; and perhaps most controversially, impose a ten-minute minimum duration for level B appointments. This would have meant a A$20 rebate cut for short visits but the government scrapped this part of the plan.
Introducing demand restraints such as co-payments points to a lack of faith in the principles of universal health care and the preventive benefits of primary care. Hence they prompt outrage from the public and doctors alike who see the “slippery slope” to further increased co-payments, and reduction in government funding for public health care.
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Medicare Co-payment Issues.

As Sussan Ley tries to patch the cuts to Medicare, the question is: why?

If the health minister takes a good look at Medicare she’ll find it’s not bleeding profusely after all
Lenore Taylor, political editor
As the Abbott government casts around for a third version of its Medicare copayment policy, it’s surely time for it to ask the basic question: “Why are we doing this again?”
The reasons for abandoning the second copayment policy are clear: voters hated it; doctors were going to the barricades over it; it wasn’t going to pass the Senate; it was going to cause serious trouble for Campbell Newman’s Queensland election campaign.
In short, they were political. (And foreseeable, but that’s another story.)
But the policy reasons for cutting Medicare in the first place have been various and confusing – to return savings to the budget but also to provide money for a medical research fund, to reduce “unnecessary” visits to the doctor, to force payment from those who can afford it and to “save” the long-term future of a scheme with costs “ballooning out of control”.
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Repetitive Medicare backdown strain sends Sussan Ley to the doctors

The new minister needs to do things differently after previous efforts left the government looking hard-hearted and chaotic
So much much for all that nonsense last year about scraping off the barnacles for a fresh political start in 2015. The government has now backed down on last year’s co-payment backdown before it has even begun.
The new health minister, Sussan Ley – quite sensibly – says she wants to consult with doctors and the parliament to try to find a fair way to implement what she says are the government’s core aims: a price signal for patients who can afford to pay and continued bulk-billing for those who cannot.
It’s just a shame the government didn’t think of that in the first place, either when it announced the original across-the-board $7 co-payment, or when Tony Abbott and his then health minister, Peter Dutton, waited until after parliament had risen for 2014 to announce a complex series of changes to replace the original budget policy that had stalled in the Senate.
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GPs 'relieved' by backdown

By Jessica Chambers
Jan. 19, 2015, midnight
Gippsland doctors have expressed relief at the Federal Government's back-down on "unfair" Medicare changes that were meant to come into effect today.
Health Minister Sussan Ley announced on Thursday the government would take a measure "off the table" that would have seen general practitioners receive about $20 less in rebates for consultations that last less than 10 minutes.
Ms Ley said she became aware of "significant concerns and unintended consequences" and halted the proposal, but said it remained critical changes were implemented "to ensure quality care for Australians and a secure future for Medicare".
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Liberal MPs fear rebate backdown

Sarah Martin

TONY Abbott is being urged to abandon plans to cut the Medicare rebate by $5, as government MPs warn against fighting an unwinnable political battle that plays into Labor’s hands.
Last week’s backdown on a $20 rebate cut for short GP consultations has failed to quell unrest among Liberal MPs who say the “debacle” of the government’s Medicare policy had made selling a modest co-payment politically fraught.
With the opposition and the Greens resolved to block the $5 cut to the rebate in the Senate, ­Coalition MPs say the issue will dog the government for much of the year, cruelling attempts to reset its agenda without delivering any budget savings.
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Six-minute hold-up in the clinic

THE capitulation by the government to the naked self-interest of the Australian Medical Association regarding changes to GP funding not only reaffirms the premier protection racket of the AMA but is also a profoundly disappointing missed opportunity to encourage desperately needed innovation in healthcare delivery.
Instead of the commentariat blindly accepting ludicrously ­unfounded and cataclysmic rants by GPs who seek to defend their six-minute-medicine business model, the media should foster long overdue debate about the use of highly trained and talented paramedical professionals for task substitution. If medicine can be done in six minutes, it can be done by someone else.
If a history, examination, assessment and treatment (including reasonable thinking time, discussion of options with the patient, and maybe looking things up to confirm the first opinion) can be performed in six minutes, it must be a highly standard, obvious and routine clinical encounter. This could be triaged and/or performed by trained non-doctor professionals at less cost, freeing up GPs for more complex tasks.
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Knives are still out over GP rebates

  • Miles Godfrey
  • The Daily Telegraph
  • January 21, 2015 12:00AM
A PLANNED $5 cut to GP Medicare rebates could be ­restructured as the federal government gears up for crunch talks with the Australian Medical Association this week.
Health Minister Sussan Ley is scheduled to meet AMA bosses for a fresh round of consultations on the government’s vexed Medicare reforms, which the Abbott government insists are necessary to rein in the $19 billion-a-year costs.
The government still plans to introduce a $5 cut to GP ­rebates on July 1, despite opposition from Labor and the Greens who have vowed to block the reforms in the Senate amid concerns the increased cost of care will hurt the poor and increase pressure on hospital emergency rooms.
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Doctors groups expect deal on $5 co-payment

Sarah Martin

Rosie Lewis

DOCTORS groups are hopeful a fresh approach by new Health Minister Sussan Ley will see the government strike a compromise on its proposed $5 cut to the Medicare rebate.
Ms Ley had her first meetings with key interest groups yesterday as she reaches out to the sector in a bid to win support for the health reforms.
As Tony Abbott urged MPs to rally behind him and to stick to the government’s “plan”, he reiterated the case for a price signal on GP visits.
“We are going to persist with injecting some more price signals into the health system. These are all sensible economic reforms as well as important long-term savings. We have our plan,” the Prime Minister told Melbourne radio.
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Pharmacy Issues:

Pharmacy the answer to health spend crisis: Guild

19 January, 2015 Christie Moffat
Pharmacy is pitching itself to new Health Minister Sussan Ley as the answer to Australia’s health care expenditure crisis.
In the wake of the Federal government’s backdown over the controversial Medicare cuts, the Pharmacy Guild of Australia says “full utilisation” of Australia’s community pharmacy network offers the opportunity for “better and more cost-effective health outcomes.”
The Guild says it will use the health minister’s commitment to consult stakeholders for a more sustainable Medicare, and advocate for an array of “enhanced’ pharmacy services.
Some examples of these service enhancements include:
  • Enhancing access to repeat prescriptions for stable, long term conditions
  • Extending the treatment of minor ailments to community pharmacies
  • Improving access to vaccinations
  • Post hospital and transitional care medicine reconciliation support
  • Basic health checks, screening and preventative health services
  • Mental health support
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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.
As pointed out on Insiders a few weeks ago the next chance to have progress  in February, 2015 when Parliament comes back! Right now there is a lot of planning going on behind the scenes.
One wonders for how much longer this will go on?
Enjoy.
David.

Wednesday, January 28, 2015

I Wonder Is Mr Turnbull Planning To Kick Of Another Australia Card Style Debate?

This appeared a few days ago.

Tony Abbott promotes Malcolm Turnbull to take charge of e-government

Date January 23, 2015 - 3:29PM

James Massola

Political correspondent

Prime Minister Tony Abbott has bolstered Malcolm Turnbull's ministerial duties, handing him greater responsibility for e-government in a push to expand the use of a single digital identity for Australians.
Mr Turnbull and Mr Abbott on Friday announced the creation of a new Digital Transformation Office, made up of developers, designers, researchers and content makers.  It will work like a start-up and look to expand the use of the MyGov site across federal, state and local governments and potentially deliver big savings for the budget bottom line.
The establishment of the new digital office is designed to resolve the messy division of responsibilities between several departments, including Finance and Mr Turnbull's Communications Department, for e-government services.
In an interview with Fairfax Media, Mr Turnbull said he was keen to establish a digital mailbox or platform that could be used by people to interact with every level of government.
Lots more here:
Clearly what is being talked about here is an identifier of some sort which can be used to ‘join up’ services from a range of layers of Government.
Does this remind anyone of the Australia Card, the Human Services Card and the Individual Health Identifier Service?
Clearly there is a long way to go but it will be interesting to see how the single digital identity will be constructed to be useful and widely used while addressing the various privacy concerns which will inevitably arise.
I will be watching closely to see what comes next!
David.

Tuesday, January 27, 2015

Article Draft : Government And The Bureaucracy Are Making Progress In E-Health Harder Than It Should Be. The Need To Simply Get Out Of The Way!

Looking back at 2014 it seems to be clear that as far as e-Health is concerned it has been largely a wasted year as far as the national initiatives - such as the Personally Controlled Electronic Health Record  (PCEHR) - have been concerned. It seems to me there is at least some small hope things might just be a little different in 2015.
Despite all the propaganda that tends to be encountered from Government and its agents the goal of ‘e-Health’, or what might be better termed Health Information Technology Deployment and Use, is to safely and securely provide relevant health information to those who need it for decision making in the care of and support of patients. This can be via the provision of record keeping systems for patient information as well as a range of information communication and sharing systems which make available at health information where it is needed with security, integrity and privacy.
In 2010 ,for reasons best known to Ms Nicola Roxon, the then Health Minister, set out to create a national centralised system of patient records, and this system was to operate in parallel with the record keeping systems that were being used by doctors in their practices. The benefits of such a national system was to have a patient’s record available wherever and whenever needed via the internet. The system began operation in June 2012, and when the Government changed in late 2013 one of the first acts of the new Health Minister (Mr Dutton) was to commission a review of what had by then become a $1Billion program.
The Review was completed in December 2013 and released publically in May 2014. At the time of writing (late January, 2015) there has yet to be a Government response to the Review which, among other things recommended that there be a radical shake up in the leadership and governance of the sector, a change in the law to have an electronic patient record created for every citizen unless they specifically opted out of a record being created, rename the system MyHR, oblige doctors to upload clinical documents to the system and the disbanding of the National E-Health Transition Authority (NEHTA).
You can read the summary of all the recommendations of the review here:
All this was intended to happen by 1 January 2015 - but clearly most of the recommendations have not been actioned and, as far as I know, there is no time line for action.
The situation has now been further complicated by the Governmental re-shuffle just before Christmas 2014 where Ms Sussan Ley became Federal Health Minister and has found herself deeply embroiled in the public debates around the sustainability of Medicare and Co-Payments.
The hiatus in strategic direction for e-Health in Australia since the change of Government (Sept. 2012) has not been without consequences. Among these has been, with an abiding and single minded focus on the PCEHR / MyHR, a total lack of Government decision making in other important and related matters and deep frustration on the part of private providers of services in the sector who have had, essentially, no idea what is coming next as well as a series of demands for system changes in their systems to suit the needs of the MyHR with little, if any, financial compensation.
Having now seen two and a half years of operation of the MyHR system it is pretty plain the system is an expensive failure despite all the claims of Government. What is now needed, in my view is a five point action plan to be implemented.
The action points are:
Action One:
We need an updated National E-Health Strategy that consults all stakeholders properly and provides the  governance, leadership, strategies, technical standards and managerial pathways to actually achieve the goals needed by those working in the health sector and their patients.
This Strategy needs to consider and review both the PCEHR Review and the input of all other relevant stakeholders. Both private and public sector need to be fully involved.
We then need the Strategy to be properly funded and led - as did not happen with the 2008 version.
Action Two:
We need to recognise that there are two distinct clients for e-Health systems and services and that their needs are not by any means the same - meaning that different systems are required for each. The professional clients (doctors, nurses, allied health etc.) need systems that enhance their clinical capabilities, improve record keeping and facilitate their secure sharing of clinical information to improve patient care and safety.
The consumers need systems to allow them to record their own information while at the same time having access  to, ideally, the live clinical systems so they can better engage with and understand and contribute to their care.
It is obvious the present PCEHR/MyHR  does neither of these things well.
Action Three:
We need to recognise we don’t need a single monolithic System but that we need an e-Health ecosystem where health information flows efficiently, accurately, securely and privately between appropriately credentialed actors within the health system and to and from consumers.
Action Four:
Before anything more is done or spent actually undertake a proper in depth peer-reviewed evaluation of what e-Health in all its guises has achieved in Australia and what has been achieved in the rest of the world that might be applicable to Australia. This research should inform what comes next.
Action Five:
We need to understand that no-where in the world has a transition to e-Health been easy, uncomplicated, pain free or without missteps. As we increasingly realise, getting this right is a very considerable and some might suggest near impossible challenge that takes lots of time, lots of money and dedication - as well as quality leadership and governance for success. E-Health is not something for generalist bureaucrats and technicians to have repeated goes at and repeatedly fail at!
Crucial to fixing the Government created mess we are now in is that the actions listed above are treated as an indivisible action plan and that the Minister is fully involved and supportive. The bureaucracy also needs to grasp they have a very imperfect grasp of what is needed and listen much more closely to experts and other stakeholders and get out of the way!
I can see no other realistic way to provide direction and give stability and certainty to all involved in E-Health so that they can move forward, invest and innovate with confidence. To just wander on as we are presently doing is just not an option. It is clear that there needs to be major change so the Government stops being part of the problem and becomes part of the solution and this change really needs to happen soon!
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Comments welcome:
David.

Monday, January 26, 2015

Weekly Australian Health IT Links – 26th January, 2015.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

The holidays are about the end and things will start to return to normal next week. Soon after that Parliament will come back and the bun-fight can resart.
Interesting that Mr Turnbull is pushing for a ‘single digital identity’ for Australians - I wonder just exactly he means by that - thinking IHI etc. Time will tell I guess.
Clearly Microsoft's Window 10 is going to have some considerable impact when it appears later in the year.
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Tony Abbott promotes Malcolm Turnbull to take charge of e-government

Date January 23, 2015 - 3:29PM

James Massola

Political correspondent

Prime Minister Tony Abbott has bolstered Malcolm Turnbull's ministerial duties, handing him greater responsibility for e-government in a push to expand the use of a single digital identity for Australians.
Mr Turnbull and Mr Abbott on Friday announced the creation of a new Digital Transformation Office, made up of developers, designers, researchers and content makers.  It will work like a start-up and look to expand the use of the MyGov site across federal, state and local governments and potentially deliver big savings for the budget bottom line.
The establishment of the new digital office is designed to resolve the messy division of responsibilities between several departments, including Finance and Mr Turnbull's Communications Department, for e-government services.
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The full story...

E-health helping young people in distress

Lexi Metherell reported this story on Wednesday, January 21, 2015 08:13:33
ASHLEY HALL: As the Federal Government contemplates reforming the mental health sector, experts in the field are urging it to invest more in e-mental health services. They say the use of technology to help people with mental health issues is not only cheap, but it's effective as well.
Lexi Metherell has taken a look at a pioneering online service which began in Australia.
LEXI METHERELL: Sophie Sauerman was in high school when her life turned upside down as her sister developed an eating disorder.
SOPHIE SAUERMAN: I found myself getting really frustrated because I just couldn't understand why she just wouldn't eat food. I was like, it's so simple, you know, just eat food. It's not a big deal.
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Health advocates call on Federal Government to utilise technology to fight mental illness saying digital services are 'vastly underused'

By Lexi Metherell
January 21, 2015, 4:00 pm
Mental health advocates are urging the Federal Government to make better use of technology-based mental health services, saying they are cheap, effective, but vastly underused.
The Federal Government is considering reforms to the sector and is soon expected to deliver its response to the National Mental Health Commission's review of programs and services.
Mental health professionals have called for e-mental health services to be made a core part of the system.
The Black Dog Institute estimates that while e-mental health services could benefit 600,000 Australians, just 30,000 use them.
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eHealth Workshop Series

The NTML is pleased to announce the roll-out of a series of eHealth workshops hosted in Darwin.
Delivered both face-to-face and online, the six free workshops provide an overview of national eHealth systems, as well as cover in detail all of the phases of implementing the Personally Controlled Electronic Health Record (PCEHR) system, including the importance and value of quality clinical records in everyday practice.
The face-to-face workshops are designed to offer practical demonstrations and training using the PCEHR and the PEN Computer Systems Clinical Audit Tool (CAT) in each relevent workshop. There will also be opportunities to engage one-on-one with the eHealth team should there be any specific support required during or after the workshops.
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IT shops grapple with new healthcare codes for hurled turtles, fiery water skis

The OCD-10 medical coding system triples the number of codes hospitals and doctors use for billing and describing diagnoses and treatments
While much of the media's focus of late has been on electronic medical records (EMRs), what is proving to be a more daunting task is a new medical coding system affecting healthcare provider and insurance backend systems.
ICD-10, which represents the 10th edition of the International Classification of Diseases (ICD), will be used for classifying diagnoses and medical procedures.
The codes will dictate how the more than $2.8 trillion that Americans spend each year on medical care is paid out.
The new coding system is so complex that the mandate requiring it has been delayed twice. Its current deadline is Oct. 1, and there are industry rumblings that it may be delayed again.

HTSDO Conference Report October 2014

Created on Friday, 23 January 2015
The IHTSDO Conference Report October 2014 Meeting has been published.
The International Health Terminology Standards Development Organisation (IHTSDO) Business Meeting Report provides summary information on the international activities and areas of work as discussed at the IHTSDO October 2014 Business Meeting held in Amsterdam, The Netherlands. The report includes an update from the Content, Implementation & Education, Quality Assurance, and Technical Committees, as well as the General Assembly and Member Forum.
Download IHTSDO Conference Report October 2014 PDF (145.41 KB)
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CDA Validator v2.1 Available for Download

Created on Friday, 23 January 2015
This release includes an updated version of the CDA Validator which supports the PCEHR R5 documents Pathology Report and Diagnostic Imaging Report as well as providing the latest terminology databases.
The following new features and improvements have been introduced in version 2.1 of the CDA Validator:
  • Terminology code validation now supports AMT version 3.
  • Users can import AMT versions 2 and 3, SNOMED CT-AU and PBS clinical terminology codes.
  • More types of CDA documents can be validated.
  • CDA documents and CDA packages to be validated can be selected using ‘drag and drop’ onto the CDA Validator user interface.
  • Various usability improvements have been made.
Download the releases below:
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Australia's New Hospital Opens with Success

Summary:Fiona Stanley Hospital of Perth, Australia is projected to lead in health research and education. The building, which opened successfully at the end of 2014, was staffed in part by Serco Group using SAP SuccessFactors.
By Christine Donato for ÃœberTech | January 19, 2015 -- 18:55 GMT (05:55 AEDT)
Perth, the fourth most populous city in Australia, is home to about 1.97 million people and serves as a cultural hub to the western coast of the continent.
The newly opened Fiona Stanley Hospital right outside of Perth in Western Australia is the third major hospital and the State Government's largest building project (to date) weighing in at $2 billion.
The facility contains 6300 rooms and 783 beds, 83% of which are single occupancy. The institution is committed to leading in research and education as well as delivering comprehensive clinical services. It includes an intensive rehabilitation service and mental health unit, and is also designed to have a healing and therapeutic effect on patients. There are five hectares of natural bush-land, landscaped parks, and internal gardens on campus.
Click here for a virtual tour of this incredible hospital:
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Mario lives: researchers inject artificial intelligence into Nintendo's leading man

Date January 20, 2015 - 1:00PM

Tim Biggs

Technology reporter / producer

Super Mario's newest adventure is not about saving a princess, conquering Bowser or even completing a round of golf. It's about being empowered to break free of the shackles of player control, become self-aware and sate his endless hunger for coins and monster-stomping.
The University of Tubingen in Germany has built a custom clone of the timeless video game which it uses to teach and converse with an artificial intelligence (AI) version of Mario, who in turn develops a personality and behaviour of his own.
The Mario Lives! project, created as an entry for the annual AI Video Competition, shows the chubby mushroom-lover coming to grips with the mortality of his enemies ("If I jump on Goomba, then it maybe dies", he says after being instructed to obliterate the enemy and report on what he learns) and analysing potential future scenarios to plot jumps without falling to his death.
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Microsoft goes for broke with Windows 10

Microsoft’s latest presentation on Windows 10 has been a revelation, not just for all the bells and whistles the software giant had on offer, but the fact that it has managed to turn a routine Windows software upgrade event into a media spectacle.
The HoloLens and its grand visions of holograms and augmented reality may have something to do with that, but there are also some signs of improvement across the board here from Microsoft.
The company has never been short of ambition but with Windows 10 its CEO Satya Nadella just might be hoping to exorcise the ghosts of everything Microsoft has done after Windows XP.
The software giant has had its struggles in reconciling its PC-centric side with the mobile world and Windows 10 is its best attempt yet to unify the two worlds, a world where the device type doesn’t matter, only Windows does.
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MUST SEE: Windows 10 free upgrade for Win 7 to 8.1 plus HOLOGRAMS

As predicted, Windows 10 will be a free upgrade for Windows 7, 8 and 8.1 users, but Microsoft’s holographic vision is far grander and very real.
At an event held in Microsoft’s visitor centre at its Redmond campus, Microsoft unveiled much more information about its next-generation not only of Windows, but of computing.
Windows 10 will be a free upgrade for Windows 7, 8 and 8.1 users for one year, which will create a new ‘Windows as a Service’ to keep all Windows users updated and create one massive platform for developers.
It will deliver Cortana so you can talk to your computer, in a natural voice, saying ‘Hey Cortana’ and asking it to do various things for you.
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Enjoy!
David.

Sunday, January 25, 2015

Good To See More Positive Evidence and Publicity On E-Mental Health.

This appeared a few days ago:

Health advocates call on Federal Government to utilise technology to fight mental illness saying digital services are 'vastly underused'

By Lexi Metherell
January 21, 2015, 4:00 pm
Mental health advocates are urging the Federal Government to make better use of technology-based mental health services, saying they are cheap, effective, but vastly underused.
The Federal Government is considering reforms to the sector and is soon expected to deliver its response to the National Mental Health Commission's review of programs and services.
Mental health professionals have called for e-mental health services to be made a core part of the system.
The Black Dog Institute estimates that while e-mental health services could benefit 600,000 Australians, just 30,000 use them.
E-mental health programs include services delivered through digital mechanisms - such as phones and computers - which allow users to prevent, treat and recover from mental illness.

E-mental health services cost as little as $2 per user

It is estimated 300,000 people a month use the website Reach Out, which provides advice on mental illness at a cost of just $2 per user.
Professor Helen Christensen from the Black Dog Institute - a pioneer in the field - said e-health services cost a fraction of traditional mental health therapies, and could be used at any stage of mental illness.
"To give you an example, people who have a small number of symptoms, who would never meet diagnostic criteria, could easily benefit from some of the automated e-health psychological techniques that are available," Professor Christensen said.
"Somebody with psychosis, whilst not being cured of all of their psychosis, by an e-mental health intervention, can learn to manage their condition better."
Professor Christensen said while Australia had been a leader in developing e-mental health services, it had failed to commercialise them and embed them in the health system.
"I think policymakers recognise that they should be integrated with face-to-face services - it's just how you get there," she said.
"I think the sector, which consists of most of the organisations who provide this, would like to see leadership on how we can all work together.
"We have lots of ideas about to do that, but at the moment Australia is a country where a lot of innovation stops once you've actually had the initial proof of concept.
"We don't actually go the next step and we'd really like to see that happen now for e-mental health services."
More here:
There is also an interview on ABC AM here on the topic:

E-health helping young people in distress

Lexi Metherell reported this story on Wednesday, January 21, 2015 08:13:33
More here:
There is little to add to this. The important thing here is that all those who might be helped by such technology get to know about it so they can be helped!
An unambiguous piece of good news going into Australia Day - have a good one!
David.

AusHealthIT Poll Number 254 – Results – 25th January, 2015.

Here are the results of the poll.

Following The Back-down On Medicare Rebate Cuts, With A Promise Of Consultation, Do You Expect More Consultation On The PCEHR And E-Health This Year?

For Sure 3% (2)

Probably 6% (4)

Neutral 3% (2)

Probably Not 32% (21)

No Way 53% (35)

I Have No Idea 3% (2)

Total votes: 66

A pretty clear response with large majority believing that it is unlikely E-Health consultation will be stepped up any time soon.

Good to see a clear outcome with a lot of responses over the time of the holidays.

Again, many, many thanks to all those that voted!

David.