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, March 26, 2015

Review Of The Ongoing Post - Budget Controversy 26th March 2015. Last Sitting Week Before 2016 Budget.

Budget Night was on Tuesday 13th May, 2014 and it is still not finalised. Not much time left before 2016 Budget is upon us.
Both major health and education changes as well as pension changes seem to have been knocked back stuck and we have a new Families Package being floated for the Budget. Also we have less than no sitting weeks in Parliament before the next Budget - due to be  handed down Tuesday 12th , May 2015.
From what we have heard in the last week or so the Government has gone ‘off the reservation’ and decided all Budget issues are now pretty much solved and not even those assembling the Budget know what is going on! I wonder that Abbott, Hockey and the Fixer are thinking?

Thursday Update: Sadly the 2016 Budget confusion appears to have got worse with no one actually clear what the Budget Strategy will be - except not the 'frighten the political horses'! There is a lot of huffing and puffing from all sorts of lobbies - some who want a harsher Budget and others who want much more spending. I don't envy anyone who is involved in this - it must be a nightmare!
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Articles this week include.

General Budget Issues.

Labor will support 'sensible' budget moves

  • March 15, 2015 2:17PM
  • AAP
FEDERAL Labor has issued Treasurer Joe Hockey a note of advice for his second budget - save wisely and we'll support you.
POLITICIANS are heading to Canberra for the final fortnight of parliamentary sittings before Mr Hockey hands down his second budget on May 12.
His first budget proved highly controversial with its key planks now either dumped or stuck in the Senate, like the pension and university reforms.
Mr Hockey is now putting together his budget against the backdrop of a sluggish economy, high unemployment, falling commodity prices and low confidence.
But the budget still faces big deficits and growing debt.
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A surplus in five years? Tony Abbott's commitment is not very clever

Date March 17, 2015 - 7:02PM

Peter Martin

Comment
How's he going to do it? It's easy for the Prime Minister to say he'll get the budget back on track.
His Treasurer Joe Hockey tried it after Labor's last budget, saying that based on the numbers at the time he and Tony Abbott would "achieve a surplus in our first year in office and a surplus for every year of our first term". They've since discovered that's difficult to do.
It's not only because of the Senate, which the Intergenerational Report indicates has knocked back or delayed about half of the government's long-term budget savings.
It's also because of the collapse in commodity prices. They've slid 27 per cent since Labor's last budget, squeezing government income. Much of the slide has taken place since the Coalition took office.
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Tony Abbott's promise to balance budget in five years raises prospect of new cuts

Date March 18, 2015 - 7:44AM

Heath Aston, James Massola

Prime Minister Tony Abbott has insisted the federal budget will be be back in balance within five years, even as the government's higher education reforms were defeated in the Senate and clear signs emerged that Treasurer Joe Hockey will not pursue big structural reforms after his bruising first budget.
Mr Abbott's bullish prediction, made during a joint meeting of the Liberal and National parties on Tuesday, has raised the prospect of future deep spending cuts to replace blocked measures in the Coalition's first budget.
In the lead-up to the next budget, structural cuts and savings in areas such as health, education and the pension that were attempted in the first budget have been put on the backburner and the government is likely to seek one-off savings from changes to programs.
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Tony Abbott claims Australia was heading for a 'Greek-style future'

Date March 18, 2015 - 10:25AM

Latika Bourke

National political reporter

Labor has condemned Prime Minister Tony Abbott's claim that Australia was heading for a "Greek-style economic future" as inflammatory, irresponsible and capable of harming economic confidence.
The Prime Minister should be far more responsible than this constant scaremongering which is having a clear impact on confidence in the community 
Mr Abbott made the remark during a radio interview in which he pledged he would not fix the federal budget this year at the expense of households but predicted a "broad budget balance" within five years.
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Mixed messages on budget plans

Niki Savva

Abbott says to expect a dull budget

SEVEN weeks away from the next budget, the Abbott government is consumed not with laying the groundwork for it in any kind of coherent way but with fighting the unresolved battles from the previous one.
Joe Hockey’s second budget on May 12 promises to go the way of the first, unless the government adopts (as is sometimes suggested, depending on the time and place) a more timid approach to savings and structural reform in the hope it sinks without trace — which would create a whole new set of problems — or there is an overnight revolution in the way it goes about its business.
The frustration over the lack of signals, or more to the point their obvious incompatability, was clear when Foreign Minister Julie Bishop wondered out loud at Monday night’s full ministry meeting where the budget was headed, pointing out the Howard government’s budgets usually came with recognisable, saleable themes. It was a subtle way of saying: what the hell are we doing? While mentally concurring, fellow cabinet ministers knew as soon as she said it that it would leak, such is the climate they operate in.
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  • Updated Mar 20 2015 at 3:57 AM

Budget goes backwards by at least $80 billion since Coalition elected

The government has pushed back at suggestions it had dropped the ball on budget repair. Andrew Meares
by Laura Tingle and Phillip Coorey
The federal budget's forecast bottom line has gone backwards by at least $80 billion since the Coalition came to office, challenging the Prime Minister's promise that a tough budget is not needed this year because the nation's finances are under control.
The estimate by The Australian Financial Review covers the period to the end of last year. It therefore does not include around two-thirds of total announced cuts and tax increases of $28 billion that have have been abandoned by the Coalition, rejected by the Senate or are likely to be dumped.
Prime Minister Tony Abbott this week dumped the last remnants of tough rhetoric about budget savings, and instead promised voters they did not have to be alarmed about this year's "dull" budget "because we have got the budget situation from out of control to manageable".
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Federal Treasurer Joe Hockey rules out changes to super or the GST in the next six months

  • Jeremy Pierce
  • The Courier-Mail
  • March 20, 2015 12:25PM
FEDERAL Treasurer Joe Hockey has ruled out any changes to superannuation or the GST in the next six months as he prepares for a second budget.
Speaking at The Tax Institute of Australia Conference on the Gold Coast this morning, Mr Hockey revealed the Federal Government would release a tax discussion paper on March 30 in the lead-up to May’s budget.
He said tax reform was inevitable, as “the status quo is not an option”, but stopped short of calling for wholesale changes.
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Intergenerational report has hidden gift

Date March 21, 2015 - 9:00PM

Peter Martin

Who wouldn't want high earners to pay more tax than low earners?
It’s one thing to ensure that future generations will be no worse off than us, it’s another thing to make them much better off. 
The treasurer. It's spelled out in his intergenerational report.
The relatively low earners are most of us, today. We make an average of $58,700.
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Political Instability.

Abbott ready for poll fight on unis

Sarah Martin

PRIME Minister Tony Abbott has reaffirmed his commitment to the government’s university reform package and planned curtailment of growth in pension spending, as well as the crackdown on local Islamist extremism foreshadowed last year.
In a wideranging exclusive interview with The Australian on Sky News yesterday that included a defence of his style of government, Mr Abbott also defended his doubts on funding remote indigenous communities.
He said his Coalition government’s resolution mattered rather than its struggle for strong support as measured in opinion polls.
The Prime Minister told editor-at-large Paul Kelly and foreign editor Greg Sheridan of The Australian that the higher-education funding reforms were very important to universities, which needed regulatory strings loosened if they were to be among the best in the world.
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Scott Morrison's pension changes look set to fail as crossbenchers dig in

Date March 19, 2015 - 7:35AM

Judith Ireland

National political reporter

Another landmark policy loss is looming for the Abbott government, as Senate crossbenchers firm in their resolve to sink a $22 billion cut to pensions. 
Just days after the Coalition's defeat on its higher education reforms, Palmer United Party's Zhenya "Dio" Wang and independent senator Glenn Lazarus have signalled their opposition to Scott Morrison's fresh bid to change pension indexation - where a lowering of the indexation rate would be accompanied by regular reviews of pension adequacy. 
Senator Wang and Senator Lazarus' opposition follows that of independent senator Jacqui Lambie and strong reservations expressed by South Australian senator Nick Xenophon. 
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Broken system can’t fix nation’s problems

Paul Kelly

THE fiasco over higher education reform reveals not just chronic ­ineptitude by the Abbott government but something deeper — a failure in Australia’s political ­system born of a cultural and structural malaise.
The foundational points in this debate are that the status quo is untenable and current government funding of universities is inadequate for the needs of students, families and employers. This is the platform on which to negotiate an outcome.
While the Senate has twice voted down the reform, this is not a negotiation conducted in good faith. Indeed, there has been insufficient real negotiation. It is too easy to say the reform is unpopular. Most reform is unpopular.
The key to this defeat does not lie in public opinion but in a ­dysfunctional and irresponsible political system.
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Tony Abbott's government by shambles: something has to change

Date March 19, 2015 - 1:37PM
The government must think people are mind-readers or, worse, plain gullible.
EDITORIAL
This "being in government" business is proving to be all too hard for Prime Minister Tony Abbott and his ministers.
Too hard to frame a fair budget. Too hard to make tough decisions to place government finances on a sustainable path. Too hard to negotiate with a "feral" Senate. Too hard to be civil and constructive on policy options. Too hard to explain to voters the need for reform. Too hard to find a consistent message.
And way too hard to provide the sort of "stable, no surprises" government Mr Abbott promised just 18 months ago.
The Herald said then that voters would get to judge Mr Abbott on trust and stability "in three years or, should he prove unable to manage a democratic parliament, much sooner".
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Abbott and Hockey scramble to survive a political train wreck

Date March 20, 2015 - 12:26AM

Mark Kenny

Chief political correspondent

Surprisingly close to the last election, Tony Abbott and Joe Hockey were still promising a golden age for Australia's finances. "Our commitment is emphatic. Based on the numbers published today, we will deliver a surplus in our first year and every year after that," Hockey told the ABC's AM program in January 2013, just eight months before the poll.
Not any more. Now it's more like, "Meh! near enough is good enough".
The result is that the 2016 election (there will be no double dissolution this year) will be preceded by two pre-election budgets focused on political consolidation – unkindly called vote-buying – rather then fiscal repair. 
After dialling in some $30 billion in savings, and being blocked on measures totalling about the same amount, Abbott said on Wednesday that the nation's fiscal outlook can be viewed as a glass half full rather than half empty.
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Health Budget Issues.

Millions cut costs by dumping their health insurance policies

Sean Parnell

MORE than 2.5 million health insurance polices have been dumped or downgraded over the past three years as Australians cut costs amid premium rises and erosion of the government rebate.
While the proportion of the population with insurance has ­remained steady, data collected by industry group Private Healthcare Australia reveals 1,576,409 policies were dumped and 985,281 downgraded between February 2012 and last December.
The industry regulator rec­orded just over 5.4 million policies with ­hospital cover at the end of December.
Private Healthcare Australia chief executive Michael Armi­tage yesterday blamed the churn on the former federal Labor ­government, which introduced a means test for the rebate, stripped it from the Lifetime Health Cover surcharge and tied it to inflation, not the rate of premium increases.
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Australia too slow to approve life-changing drugs, companies say

Sean Parnell

Sid Maher

THE debate over access to new cancer drugs has escalated with pharmaceutical companies labelling Australia’s approval process one of the slowest in the developed world, while health officials accuse the companies of trying to game the system.
Industry group Medicines Australia will today release a ­report showing Australia ranks 18th out of 20 OECD countries in access to new medicines, with cancer patients waiting an average 573 days for new drugs that have received approval by a recognised regulator. “This is not good enough and I’m sure I share the same views as patients when I say access to medicines needs to be modernised,” Medicines Australia chairman Martin Cross said.
Health Minister Sussan Ley is due to speak at a Medicines Australia dinner tonight where the only other speaker, John Zalcberg, head of cancer research at ­Monash University, will join calls for reform. “We have moved past the time of incremental differences that are hard to justify,” Professor Zalcberg said yesterday. “More and more now we are seeing new drugs that are game changers, drugs that change people’s lives dramatically.”
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Members ready to dump private health insurance

Sean Parnell

HEALTH: Private health funds that have allowed members to downgrade their level of cover to cut costs may soon run out of alternatives to the policies being dumped altogether.
The Australian this week revealed industry group Private Healthcare Australia had data showing 1,576,409 policies had been dumped and 985,281 downgraded in three years.
While the Department of Health admits to not fully understanding the shift, industry regulator the Private Health Insurance Administration Council has monitored the downgrade trend since 2012. PHIAC initially noted that full cover products appeared to have “reached their price/value limit”, prompting members to choose policies with less cover, and then warned that members may be opting for exclusions and restrictions without comprehending the risks.
PHIAC subsequently noted an increase in complaints to the Private Health Insurance ombudsman about exclusions and restrictions, prompting warnings that health funds were setting members up for disappointment.
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Consumers squeezed as private health funds cut 'lifestyle' benefits while raising premiums

Date March 22, 2015 - 1:00AM

Dan Harrison

Two of Australia's biggest health insurers are cutting the amount they will refund patients for alternative therapies and gym memberships at the same time they are raising the cost of insurance.
For years, insurers have been locked in a price and service war to woo customers by offering to pay a share of the costs of many "extras", including more unconventional treatments such as reiki and Alexander technique.
But now NIB has cut the amount it will pay by $250 - from $400 to $150 - for "healthier lifestyle" benefits under its wellbeing extras cover.
The cuts come as NIB, the country's fourth-biggest health insurer, joins other funds in lifting its premiums on April 1. NIB premiums will rise by an average 6.55 per cent.
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Co-Payment Issues.

Those who visit GPs the most are old, sick and poor, new data finds

Date March 19, 2015 - 8:17AM

Dan Harrison

Health and Indigenous Affairs Correspondent

The Australians who visit the doctor most often tend to be older and poorer than those who visit their GP less, and would be hardest hit by the introduction of a "price signal", new data has found.
The data, to be released on Thursday by the National Health Performance Authority, suggests this group are twice as likely as the average to delay or decide against seeing a GP due to cost.
While Health Minister Sussan Ley two weeks ago dumped plans to cut Medicare rebates by $5 and allow doctors to charge patients this amount, she is continuing to explore options to make more people pay to see the doctor.
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Pharmacy Issues.

MEDIA RELEASE
Sunday, 15 March 2015

Minister: fix pharmacy flaws before new deal

In light of the serious deficiencies exposed by the audit into the community pharmacy agreement, the Consumers Health Forum has written to the Health Minister, Sussan Ley, urging her to overhaul arrangements for remuneration of pharmacy owners.
CHF has today (Sunday) released an overview of deficiencies exposed in the audit into the administration of the Fifth Community Pharmacy Agreement giving nine examples of the disturbing flaws in the way the $15.4 billion deal was agreed and administered.
“The Australian National Audit Office report and subsequent media reports expose how large amounts of money have flowed to pharmacy owners and the Pharmacy Guild with little apparent regard for improving the health outcomes of patients and consumers,” the CEO of CHF, Adam Stankevicius, said.
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Ownership ‘monopoly’ makes pharmacists millionaires: report

15 March, 2015 Christie Moffat
Strict ownership and location rules in community pharmacy are responsible for pharmacists making millions of dollars in profit, a new report claims.
A News Limited article has taken aim at regulations surrounding the ownership and location of pharmacies, and says that successive Community Pharmacy Agreements are allowing pharmacists to profit while “hurting consumers and taxpayers”.
The author pointed to the recent audit report, which revealed that 951 pharmacies in Australia were receiving more than $1 million in remuneration each year.
The owners of chain pharmacies such as Terry White Chemists and Chemist Warehouse were also subject to scrutiny, with the article referencing recent profits and homes owned on ‘millionaire’s row’ on the Gold Coast.
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Pharmacy taking hits over audit report

16 March, 2015 Christie Moffat
Community pharmacy continues to feel the impact of the 5CPA audit report, as a major consumer group calls for a government overhaul of the Agreement.
In a statement, the Consumers Health Forum announced it had written to Health Minister Sussan Ley, calling for changes to be made to remuneration arrangements for pharmacy owners.
To support their argument, CHF also released an overview of nine “fatal flaws” in the way that the 5CPA was agreed and administered, as highlighted in the Australian National Audit Office (ANAO) report.
The named flaws included failing to deliver on key government goals, no Health Department records of the negotiations, no competitive tenders and an inflated fees forecast.
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Drug cartel injects cash for pharmacists

Janet Albrechtsen

READING the sharply worded national audit released this month into the so-called Fifth Community Pharmacy Agreement is like reading a biting review of a really rotten taxpayer-funded Australian movie. Except that reality about this protection racket is stranger than fiction. You couldn’t make it up if you tried.
Here’s the plot so far. Imagine that a bolshie and powerful union is allowed to dictate to government the terms of its own self-serving, competition-free cartel with no input from outside stakeholders. This union calls itself a guild because that sounds more polished than a union.
Imagine that long after the country has undertaken sweeping competition reforms ending cartels in other industries, owning a pharmacy remains exempt from the realities of the market. In 2015, outdated location rules still protect the cartel, meaning an ambi­tious young pharmacist looking for a career path can’t open a new pharmacy within 1.5km of an existing one. The union and the government call the cartel deal the “community pharmacy” agreement to dispense Pharmaceutical Benefits Scheme drugs to customers, except the community that benefits the most is the tiny one of pharmacy owners in Australia. And every five years the union of pharmacy owners signs a similar cartel-enforcing agreement with the government of the day.
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Pharmacists must prepare to fail on primary care networks

18 March, 2015 Chris Brooker
Pharmacists need to proactively engage with, and take roles on, the new primary health network committees if they are to make an impact, pharmacy leaders believe.
Speaking at APP2015, Mark Booth, first assistant secretary of the primary health division of the Department of Health, outlined the latest developments in the implementation of the PHN, which are due to begin operation from 1 July 2015.
Designed by the current government to replace the ALPs Medicare Local program, there are 30 primary health networks around Australia, with each to be administered by a clinical council led by a local GP, and a community advisory committee.
Mr Booth said while the clinical council would be GP led, it was open to pharmacists and other allied health professionals to stand for election.
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Minister looks to pharmacy for PBS sacrifices

20 March, 2015 Chris Brooker
Federal health minister Sussan Ley remains adamant that the pharmacy sector will need to make further sacrifices for the sake of the health budget.
Speaking at the Medicines Australia annual parliamentary dinner, Ms Ley reiterated her comments from APP2015 that the recent PBAC approval of $2.5 billion in new medicines listings would create problems for health spending.
Coming on top of another $1.5 billion in approvals recommended in PABCs November 2014 meeting, the minister’s views have caused further disquiet among pharmaceutical industry and community pharmacy leaders. Both groups have repeatedly pointed to nearly $20 billion in PBS cuts through price disclosure.
Ms Ley told pharmacists attending the APP2015 conference last week that pharmacy and the pharmaceutical industry should prepare for some “tough decisions” in the future.
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Where are the missing employees the Pharmacy Guild should have employed with $30 million of taxpayers money?

  • March 22, 2015 12:00AM
  • Sue Dunleavy
EXCLUSIVE
The Pharmacy Guild of Australia was paid $29.3 million in administrative fees by taxpayers and refuses to say how many staff it employed with the money.
The money was to administer just $67 million worth of professional programs relating to rural pharmacy, Aboriginal pharmacy services and research under a $15 billion government agreement.
The staggering administrative costs mean taxpayers paid 43 cents for the Pharmacy Guild to administer every dollar spent.
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Doctors call for revamp of ‘unacceptable’ pharmacy agreement

20 March, 2015 Amanda Davey
Patients and not pharmacists should be the priority in any future pharmacy funding agreements, says the Royal Australian College of General Practitioners.
The group says the controversial Fifth Community Pharmacy Agreement does not have the patients’ best interests at heart and is due for a “thorough review”.
The college has joined forces with the Royal Australasian College of Physicians and the Consumers Health Forum and has written to the federal Health Minister, Sussan Ley, outlining key concerns.
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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 2015 (or the 2016) Budget (or the Government) at the end of the day. With the Co-Payment gone - but muttering about other ideas growing louder - but the continuing need for Budget savings continuing we have to ask what next?
One wonders for how much longer all this will go on and just what impact a apparently almost inevitable change of leader might have? I think that change is still coming.
It is interesting to see the Pharmacy Guild under pressure from a recent audit of the Community Pharmacy Agreement and where money was spent. It very much looks like News Limited has decided to have a serious go at the Guild’s approach to community pharmacy and its regulations.
Enjoy.
David.

Wednesday, March 25, 2015

Can We Read Anything Into This Announcement? Might Be A Straw In The Wind.

This appeared a late last week.

Australian Medicines Terminology (AMT) Support Group Meeting

Created on Wednesday, 18 March 2015
The AMT Support Group structure is changing to an open forum, an opportunity exists for interested individuals to participate in the ongoing development of the AMT.
If you have a background in medicines management and are keen to be involved, please forward an expression of interest to help@nehta.gov.au. 
The next meeting (via teleconference) is scheduled for Wednesday 29 April 2015 10 am – 12 pm AUS Eastern Daylight Time.
The Australian Medicines Terminology (AMT) is produced by the National E-Health Transition Authority (NEHTA) to standardise identification of medicines for use within Australian electronic medicine management systems. A Support Group consisting of clinicians, jurisdiction representatives and computer system vendors meets regularly to provide expert guidance on relevant terminology issues.
For more information on the AMT see http://www.nehta.gov.au/our-work/clinical-terminology or email help@nehta.gov.au 
Here is the link.
NEHTA does not have a track record of asking for expert input in forums from the e-Health Community as far as I recall so I was prompted to ask myself why now?
Might it be NEHTA is seeing major change on the way and so is beginning - after almost a decade - to change its ways or is it preparing to be shut down?
The AMT is currently a topic of hot dinner party conversation so why the AMT for volunteer input?
What do readers think is going on - other explanations?
There is an advertisement currently on Seek for a Senior Legal Counsel - and it has a contract and date of June 30, 2015.
Here is the link:
 We need to keep an eye out for other hints, given the secrecy we see around e-Health at present!
David.

Tuesday, March 24, 2015

The PCEHR Might Be A Little More Useful If It Had A ‘Blue Button’. Could Not Be Too Hard.

There have been a few mentions of the Blue Button recently.
I spotted this a few days ago.

Blue Button, PHRs gaining traction

Posted on Mar 18, 2015
By Mike Miliard, Editor
The healthcare industry is becoming more enlightened about the benefits of the Blue Button Initiative, and adoption of personal health records continues to grow, according to a new report from the Workgroup for Electronic Data Interchange
WEDI conducted its first survey on Blue Button's use for exporting patient healthcare records in 2013; as a follow-up, it conducted another poll of stakeholders – including providers, payers, vendors and clearinghouses – in late 2014.
In a letter this week to U.S. Department of Health and Human Services, WEDI offered the following takeaways from the report.
  • Electronic health record and medical device data is flowing into PHRs. "While provider respondents remained relatively consistent in their use of integrated EHRs, a significant increase occurred for government respondents from 60 percent in 2013 to 100 percent in 2014. Both of these groups saw medical device data increase, with government respondents going from zero in 2013 to 25 percent in 2014. The shift for provider respondents is likely reflective of greater participation in Meaningful Use incentive programs. "
  • Use of Blue Button still has room to grow. "The overall shift of awareness appears to have decreased, but upon further review of responses by respondent type, we found greater participation by behavioral and allied health providers in 2014. We believe the provider respondent increase of no awareness from 32 percent in 2013 to 49 percent in 2014 is impacted by the increase of more provider respondent types in 2014 that are ineligible for meaningful use incentives."
  • Offering PHRs to all patients, not just certain populations, is key. "Respondents are at varying stages in terms of PHR implementation, some have implemented, others are implementing this year and others are still in the planning stages. What remains constant is the high percentage (80 percent in 2014) of respondents that are offering the PHR to all patients/members as opposed to only making it available to select subsets of their patients/members."
More is found here:
I also noted this report:

Blue Button Awareness, Personal Health Record Usage Grows

MAR 17, 2015 7:56am ET
Awareness of the Blue Button Initiative—a public-private effort to provide patients with easy, secure online access to their health information—is slowly building, as is usage and adoption of personal health records among key industry stakeholders.
That is the finding of a new survey conducted by the Workgroup for Electronic Data Interchange, which included 274 respondents. Providers, health plans, vendors and clearinghouses were re-surveyed in late 2014 to determine Blue Button adoption compared to a similar 2013 WEDI survey.
In a March 13 letter to Health and Human Services Secretary Sylvia Mathews Burwell, WEDI provided HHS with the results of its survey conducted from Oct. 31, 2014 to Dec. 8, 2014. Key findings include: 
*Relying on integrated electronic health record and medical device data to populate personal health records (PHRs) increased. While provider respondents remained relatively consistent in their use of integrated EHRs, a significant increase occurred for government respondents from 60 percent in 2013 to 100 percent in 2014.
*Ensuring awareness of Blue Button as an industry-wide tool remains an opportunity.
More here:
The idea with the Blue Button is that the patient can download a STANDARDISED summary clinical record from their care provider and can then have it to upload to their PHR, review and correct its contents or give it to other care providers for information etc.
It seems to me that if for some reason we continue on with the PCEHR (which I do not recommend) the same functionality should exist with the PCEHR.
Its time there was something individuals could take away and share from the PCEHR if they desire!
David.

Monday, March 23, 2015

Weekly Australian Health IT Links – 23rd March, 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

Another quiet week with silence on e-Health becoming deafening. I wonder what is going on. Leaks welcome before the metadata laws pass the Senate!
I have to say I am not keen on any threat of jail related to this meta-data issue. I feel this is a bit of Governmental overreach.
Interesting to see more and more discussion on telehealth and related matters in the last few weeks.
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https://www.mja.com.au/journal/2015/202/5/implementing-telehealth-core-business-health-services

Implementing telehealth as core business in health services

Sabe Sabesan and Jenny Kelly
Med J Aust 2015; 202 (5): 231-232.
doi: 10.5694/mja14.01021
The many benefits for the rural sector suggest it is time to integrate telehealth models into routine clinical practice
The uptake of telehealth in Australia has been increasing steadily, but continued uptake relies on clinical champions. Australian telehealth models cover a wide range of medical specialties and subspecialties.1 However, most telehealth services in Australia are currently optional, which acts as a barrier to the growth and uptake of these models.
Many successful telehealth networks have been established by incorporating telehealth models of care as part of the core business of hospitals and health services, rather than as an academic activity or a pilot project. While some may argue the evidence base for telemedicine is “weak”,2 we assert there is sufficient evidence for these models to be integrated into routine clinical practice.
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Ailing eHealth system on mend

An audit of the Department of Defence's eHealth System (DeHS) has found a number of significant flaws in its implementation.
Auditor-General, I an McPhee said that overall, Defence's planning, budgeting and risk management for the system had been deficient, resulting in substantial cost increases, schedule delay and criticism within Government.
"During the initial phases of the project, Defence did not scope and cost key components of the project; validate project cost estimates and assumptions; obtain Government approval when required; follow a project management methodology; or adequately mitigate risk by adopting fit-for-purpose governance and coordination arrangements," Mr McPhee said.
Audit finds Defence implementation flawed
"Defence's planning and management of the initial phases of the DeHS project were well below the standards that might be reasonably expected by Defence's senior leadership, and exposed the Department to reputational damage."
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Canadian FHIR Connectathon

Posted on March 18, 2015 by Grahame Grieve
FHIR® North
Canada’s FHIR Connectathon

Event Details
Date: April 29th
Time: 9:00AM – 6:00PM
Location: Mohawk College, 135 Fennel Ave W, Hamilton, ON L9C 1E9
Room: Collaboratory (2nd Floor – Library)
Registration Cost: $45.00 (Entry, lunch, coffee break, pizza dinner)
Registration Site: http://www.mohawkcollegeenterprise.ca/en/event_list.aspx?groupId=3
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Australian Medicines Terminology (AMT) Support Group Meeting

Created on Wednesday, 18 March 2015
The AMT Support Group structure is changing to an open forum, an opportunity exists for interested individuals to participate in the ongoing development of the AMT.
If you have a background in medicines management and are keen to be involved, please forward an expression of interest to help@nehta.gov.au. 
The next meeting (via teleconference) is scheduled for Wednesday 29 April 2015 10 am – 12 pm AUS Eastern Daylight Time.
The Australian Medicines Terminology (AMT) is produced by the National E-Health Transition Authority (NEHTA) to standardise identification of medicines for use within Australian electronic medicine management systems. A Support Group consisting of clinicians, jurisdiction representatives and computer system vendors meets regularly to provide expert guidance on relevant terminology issues.
For more information on the AMT see http://www.nehta.gov.au/our-work/clinical-terminology or email help@nehta.gov.au 
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Call to bring Centrelink payment system ‘into 21st century’

Fran Foo

THE Abbott government has been urged to fast-track the estimated $1 billion replacement for a Centrelink mainframe system by one of its key architects who says Canberra can no longer afford to rest on its laurels.
Kevin Noonan was one of the system’s designers when Centrelink’s Income Security Integrated System was built more than 30 years ago. The antiquated ISIS, which runs on the Model 204 mainframe, is responsible for the delivery of $150bn in social security payments annually. Changes to the largely manual system are cumbersome.
Mr Noonan, now government IT lead analyst with consultancy Ovum, said the Department of Human Services was “running a 20th century system for 21st century needs”.
“The challenge is at the core; we have a system that’s built around old ways of thinking,” Mr Noonan said.
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Senior Legal Counsel

  • Fixed term contract
The National E-Health Transition Authority Limited (NEHTA) was established by the Australian, State and Territory governments to develop better ways of electronically collecting and securely exchanging health information. NEHTA is the lead organisation supporting the national vision for e-health in Australia.
NEHTA is currently recruiting people with a desire to make a difference to health outcomes, that are passionate about the use of e-health to meet these goals and who have the relevant experience to deliver solutions in a highly complex stakeholder and technical environment. In these roles you will be working with consumers and clinicians who will be defining how models of care can be improved using the PCEHR. You will be delivering the solutions that will be in place for your grandparents, parents and your children... and for you as you engage with the public and private health system.
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7 simple strategies to avoid e-health disasters

In healthcare we’re often confronted with poor quality software. Bugs and security issues are common, and the design is usually not intuitive. I spoke to Frank (not his real name), an insider in the health IT industry. Frank gives us an interesting look behind the scene and seven strategies for developing or implementing new software.

“Any industry can be a target for poor software,” says Frank, “but healthcare certainly has its fair share. Believe it or not, medical software is unregulated. Medical software that runs on a computer, mobile phone or tablet does not fit the definition of a medical device in section 41BD of the Therapeutic Goods Act 1989, as they were not intended by the manufacturer to be used for therapeutic purposes.”
“How many software developers have clinical employees? Do these employees have input into design or are they there to sell the dream?
“There is a serious gap between software design and the real-world application. Often software developers do not fully understand what is actually required by the healthcare industry to support the services that they provide.”
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Patient info stored online as NZ pharmacies connect to ePrescription repository

5:00 AM Thursday Mar 19, 2015
Nicholas Jones
New ePrescription service to keep digital record of scripts and may benefit GPs.
Details of people's prescriptions are being fed into an online repository from pharmacies across the country.
The Ministry of Health says information is encrypted and kept in a secure system only accessible by approved health professionals.
But it admits that people who aren't satisfied with those measures cannot opt out.
All New Zealand pharmacies are now connected to the ePrescription service, and nearly all general practices will be on board within months.
Pharmacy Guild chief executive Lee Hohaia said people would be unlikely to notice a change.
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Monetizing medical data is becoming the next revenue stream for hackers

The personal details in medical records fetch higher prices than stolen credit card numbers
The personal information found in health care records fetches hefty sums on underground markets, making any company that stores such data a very attractive target for attackers.
"Hackers will go after anyone with health care information," said John Pescatore, director of emerging security trends at the SANS Institute, adding that in recent years hackers have increasingly set their sights on EHRs (electronic health records).
With medical data, "there's a bunch of ways you can turn that into cash," he said. For example, Social Security numbers and mailing addresses can be used to apply for credit cards or get around corporate antifraud measures.
This could explain why attackers have recently targeted U.S. health insurance providers. On Tuesday, Premera Blue Cross disclosed that the personal details of 11 million customers had been exposed in a hack that was discovered in January. Last month, Anthem, another health insurance provider, said that 78.8 million customer and employee records were accessed in an attack.
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Virtual baby: Fly-in, fly-out worker uses Samsung Gear VR to be part of son's birth remotely

Date March 15, 2015 - 5:09PM

Hannah Francis

An Australian fly-in, fly-out (FIFO) worker has used virtual reality technology to witness the birth of his child while interstate.
Jace Larke took a contract electrician job in Queensland to feed the three mouths – and another on the way – back home in Perth, even though his four weeks on, one week off roster meant he'd miss the due date of his pregnant wife, Alison.
"Jace being the sole breadwinner, we were worried if he had put his hand up and asked for indefinite time off, with the contract coming to a close, they would have said don't bother," Mrs Larke told Fairfax Media.
"A lot of people are being laid off . . . that's the reality."
Live streaming the birth of their third son, Steele, in virtual reality three weeks ago was "the next best thing", she said.
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Virtual technology breakthrough allows WA mum to deliver world first long-distance birth

  • March 15, 2015 4:19AM
  • AMY HARRIS
  • PerthNow
NOT even 4000km could keep Jason Larke from the birth of his child.
In a world first, Mr Larke was “in the same room” as his wife Alison when she delivered their third child in a Perth hospital last month, in a breakthrough in virtual technology.
Wearing a streaming headset developed by Samsung, Mr Larke – a fly-in, fly-out electrical contractor based in Chinchilla in Queensland – experienced the birth of his son Steele in real time via cameras set up in the Perth birthing suite.
Waving to his wife and mother-in-law, Mr Larke was able to “walk” around the room and see and hear all the sights and sounds of his son’s arrival from his Queensland bedroom. The couple were selected to take part in the experiment, which could herald a breakthrough for couples who find themselves separated during childbirth.
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Journalist jail threat in metadata law

Sarah Martin

JOURNALISTS face two years in jail for reporting on a warrant system under new national security laws aimed at protecting press freedom.
After agreeing on measures to prevent the exposure of whistleblowers in the government’s proposed metadata collection regime, the Coalition and Labor yesterday gave the green light to the new laws coming into effect in 2017.
Under the legislation, which will go the Senate next week, telecommunication companies will be forced to keep encrypted information about email, phone calls and text messages — but not the content — for access by law enforcement agencies for two years.
Amid warnings from media companies that the regime would have a chilling effect on press freedom, the government agreed to establish a “public interest ­advocate” and a “journalist information warrant” to prevent the identity of confidential sources being exposed. Labor had insisted on the amendments as a condition of its support.
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'This level of secrecy is unacceptable': Senate committee slams NBN roll out

Date March 20, 2015 - 7:16AM
A parliamentary committee has accused NBN Co of secrecy over future costs of rolling out the broadband network.
The Greens-Labor dominated Senate committee tasked with overseeing the NBN has produced a damning second interim report, accusing NBN Co of releasing a glossy version of its public corporate plan by omitting forecasts for financial years after 2014/15.
It also accuses the company of manipulating forecasts for political purposes.
Additionally, NBN Co refuses to divulge names of companies that have signed contracts and the "substantial new costs" incurred, the committee claims.
"This level of secrecy is unacceptable," the report says.
NBN Co is still too "uncertain" to reveal how much technology will cost or how long it will take to build, the report states.
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'Dark web' keeps criminals out of reach of metadata retention laws

Date March 18, 2015

Liam Tung

Criminals and terrorists are taking cover in a part of the web that can't be Googled. It's called the 'dark web', it's growing and Australia's data retention law will do nothing to help police track its most dangerous users, experts say.
If you've followed the rise and the fall of the online drug store Silk Road, you know of at least one website on the dark web — a space that Google doesn't index, and that from time to time causes headaches for law enforcement and security agencies.   
The recent guilty verdict for the Silk Road's ringleader however demonstrated the dark web isn't impenetrable. And late last year Europol seized 400 websites on the dark web and arrested 17 people alleged to be selling illegal goods. 
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The truth about the rise of robots

Robots' capacity for autonomous movement and their ability to perform an expanding set of tasks have captured writers' imaginations for almost a century. Recently robots have emerged from the pages of science fiction novels into the real world, and discussions of their possible economic effects have become ubiquitous. But a serious problem inhibits these discussions: there has so far been no systematic empirical analysis of the effects that robots are already having.
In recent work we began to remedy this problem. We compiled a new dataset spanning 14 industries (mainly manufacturing industries, but also agriculture and utilities) in 17 developed countries (including European countries, Australia, South Korea, and the US).
Uniquely, our dataset included a measure of the use of industrial robots employed in each industry, in each of these countries, and how it has changed from 1993-2007. We obtained information on other economic performance indicators from the EUKLEMS database.
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Rise of the machines: is there anything to fear?

Stephen Cave
What happens when ultra-intelligent computers begin to improve themselves? We should not assume they’ll have our best interests at heart, warns Stephen Cave
Our Final Invention: Artificial Intelligence and the End of the Human Era, by James Barrat, St Martin’s Griffin, RRP$16.99, 336 pages
In Our Own Image: Will Artificial Intelligence Save or Destroy Us?, by George Zarkadakis, Rider, RRP£12.99, 384 pages
Eclipse of Man: Human Extinction and the Meaning of Progress, by Charles T Rubin, Encounter Books, RRP$23.99, 200 pages
Smarter Than Us: The Rise of Machine Intelligence, by Stuart Armstrong, Machine Intelligence Research Institute, RRP£2.99/$4.99, 62 pages
We humans have got where we are today by being the cleverest creatures in town. In the absence of claws, wings or venom, intelligence is our evolutionary special power. And it has served us well, as we have risen to dominate great swaths of this planet. But now, institutions across the world — including universities, defence agencies and internet giants — are striving to create something that will knock us off this top spot. They are working towards machines that will be cleverer than we are; towards not merely artificial intelligence, but artificial super-intelligence. As a species, we are racing to create beings that will supplant us in our own evolutionary niche. What are we thinking?
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Windows 10 embraces iris scans, facial recognition

Microsoft is embracing biometric login with a new feature of Windows 10 that recognizes faces, fingerprints and irises for authentication.
Microsoft is embracing biometric login with a new feature of Windows 10 that can recognize faces, fingerprints and irises for authentication it claims is more secure than passwords.
Windows Hello can be used to authenticate users but also applications, data and Websites without storing passwords on devices that support the feature.
The company says facial and iris recognition require infrared cameras on Windows 10 devices in order to distinguish individuals even in varying lighting conditions.
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Enjoy!
David.

Sunday, March 22, 2015

Microsoft Joins The Major A****** Category With Skype Updates

They try to have you not notice that they are re-setting defaults on the search engine and home page.

Grow up will you MS. Your endless updates are bad enough without this trickery!

David.

Now This Has To Be A Real Worry Unless A Few Important Lessons Are Taken On Board!

I noticed this rather interesting announcement a few days ago.

Health ministry to set up National eHealth Authority to develop Integrated Health Information System

Ramesh Shankar, Mumbai
Friday, March 20, 2015, 08:00 Hrs  [IST]
The Union health ministry will soon establish the National eHealth Authority (NeHA) which will be the nodal authority that will be responsible for development of an Integrated Health Information System (including Telemedicine and mHealth) in India, while collaborating with all the stakeholders, viz., healthcare providers, consumers, healthcare technology industries, and policymakers.
The Authority will act as a promotional, regulatory and standards setting organization to guide and support India’s journey in e-Health and consequent realization of benefits of ICT intervention in health sector in an orderly way.  It will be responsible for enforcing the laws & regulations relating to the privacy and security of the patients health information & records.
One of the major goals of the Authority is to guide the adoption of e-Health solutions at various levels and areas in the country in a manner that meaningful aggregation of health and governance data and storage/exchange of electronic health records happens at various levels in a cost-effective manner. It will facilitate integration of multiple health IT systems through health information exchanges.
Another mission of NeHA is to oversee orderly evolution of state-wide and nationwide electronic health record store/exchange system that ensures that security, confidentiality and privacy of patient data is maintained and continuity of care is ensured.
The NeHA has been envisaged to support formulation of policies, strategies and implementation plan blueprint (National eHealth Policy/Strategy) for coordinated eHealth adoption in the country by all players; regulation and accelerated adoption of e-health in the country by public and private care providers and other players in the ecosystem; and to establish a network of different institutions to promote eHealth and Telemedicine/remote healthcare/virtual healthcare and such other measures.
More here:
Talk about a sense of déjà vu!
All they seem to have done is drop the letter “T” from our old friend NEHTA!
One has to hope NeHA can learn from all that has gone before.

Here is another link that provides a lot of details on the plans:

http://www.dailymail.co.uk/indiahome/indianews/article-3005690/NeHA-s-helping-hand-sick-Records-government-hospital-patients-available-online.html
Reading through this article I am really worried about the level of confidence and optimism expressed. Certainly the other countries cited (UK, Aus. and Canada) have yet to make a great fist of it in countries that are much smaller and much less diverse!

All I can hope is that this new organisation takes the suggestion to do a few things as it starts up - noting that the idea of NeHA is very new and there is a very long way to go..
First it needs to have a close look at all the reports done on NEHTA over the years from Deloittes and the Boston Consulting Group etc - given the similarity of the initial mandate.
This link will provide at least a start on what is needed!
Second they need to have a look at the way the US Office Of The National Co-ordinator for Health IT operates in terms of transparency, openness, consultation, standards setting and industry engagement. The ONC has done a good job in these areas.
Third they really need to get on the ground all over the world and research what has worked (or not) and see what has the best chance to work in a huge country like India.
Fourth they need to be very clear projects like this are very hard to get right and always take a great deal longer than anyone anticipates.
All I would do is wish them luck and encourage them to work very hard to learn from history!
David.

AusHealthIT Poll Number 262 – Results – 22nd March, 2015.

Here are the results of the poll.

Should The Australian National Audit Office Look Into The PCEHR?


Yes 98% (124)

Maybe 0% (0)

Neutral 0% (0)

Probably Not 0% (0)

No 2% (3)

I Have No Idea 0% (0)

Total votes: 127

This has to be the clearest outcome ever and we can only hope someone is listening!

Good to see such a good number of responses!

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

David.