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, May 07, 2015

2016 Budget Watch. Parliament Closed Until Budget Day. It’s Coming Very, Very Soon!

Last Budget Night was on Tuesday 13th May, 2014 and it is still not finalised -apparently $27Billion still unresolved! I think we should forget about all that and now look forward. Will be interesting to see what the Budget Papers say about all the failed ideas etc.
We now look forward to see what we might see next time - less than a week. I am sure this will be fun.
It’s now getting down to the wire. Good to see Mr Hockey has called to bottom of the iron ore slump by planning on the price going to $35. Since his call it seems to be going up again!
Apparently the Budget is now in such good shape millions of dollars can be thrown at the PCEHR!
Budget Night is May 12, 2015.
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Articles looking forward and back this week include.

General Budget Issues.

Tony Abbott and Joe Hockey look to use the budget to hold onto their jobs

Date April 25, 2015 - 9:30PM

Paul Malone

Junior iron ore miners are on a roll.
It was September 2011 and The Australian's front-page headline left no doubt about where we stood: "Decades of wealth from boom – report forecasts 750,000 new jobs as commodities exports hit $480BN."
Inside the paper financial "experts" voiced their joy at the expected transformation revealed in a "landmark" report released exclusively to The Australian and prepared by the ANZ Bank and economic consultants Port Jackson Partners.
We were told that a new economy, based primarily on mining, would be formed and that the number of workers employed in the sector would rise rapidly over the next two decades.
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Govt to inject 'integrity' into budget

A new package of tax and welfare integrity measures will be put at the heart of the federal budget next month as cabinet ministers prepare to sign off on a new strategy to counter the damaging campaign against “unfair” savings.
Welfare cheats will be targeted in a new program to cut the nation­’s social security bill while global companies will face tighter laws on shifting profits to foreign tax havens, adding billions of dollars to the budget bottom line.
Fighting back at attacks on last year’s unpopular spending cuts, the federal government will use the integrity measures to assure voters that its second budget not only passes the “fairness” test but also prevents some taxpayers from shirking their obligations.
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Seniors group hits out on bank levy

Seniors have a blunt message for the federal government: leave savers alone.
Over-50s lobby group National Seniors Australia has joined the opposition to a bank deposits tax, saying people who save are an easy target for governments.
"They're low hanging fruit for governments who are keen to grab money," chief executive Michael O'Neill told AAP.
The tax - a 0.05 per cent levy on deposits up to $250,000 first proposed by Labor - is expected to be unveiled in the May 12 budget in a move that would raise about $500 million a year.
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Hockey might need to flip his budget thinking

Opinion
April 27, 2015
A fortnight out from the federal budget - and with last year's effort still in tatters - the storm clouds are looming and a choice needs to be made about how to cope, writes Ian Verrender.
The insurgency has been halted, the counter-revolutionaries are gaining ground and both Joe Hockey and Chris Bowen have been caught somewhere in between.
A fortnight out from the federal budget - and with last year's effort still in tatters - Australia increasingly is attracting global attention in a decades old battle over the most effective way to drive an economy.
Australia is a member of a relatively exclusive club; a developed nation with minimal debt where interest rates - while at a record low - are still well above zero.
And here's where it gets interesting. While we have an enviable record of almost a quarter of a century of unbroken growth, storm clouds are looming. And a choice now needs to be made about how to cope.
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Why the government is in big trouble

  • April 27, 2015 11:54AM
  • Malcolm Farr
  • News Corp - National Political Editor

Budget 2015: What we know so far

PRIME Minister Tony Abbott and Treasurer Joe Hockey are dealing with old issues and new problems as they put together their second Budget in an atmosphere greatly different to their first last May.
They will again have to manage the bills coming in from a big-spending government. But this time it’s not Labor’s, it’s their own.
When spending is expressed as a proportion of GDP — economic output — the Abbott Government is the most profligate for two decades. All this at a time when the tax revenue stream is becoming shallower.
Here are six problems the Prime Minister and the Treasurer will have to manage, and which were not a bother last May.
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Few surprises expected in budget as Coalition avoids fights

Judith Sloan

Tony Abbott and his lieutenants are absolutely determined to avoid the mistakes of last year’s budget. The key guiding principle will be to avoid picking any fights — especially with groups that count politically.
Fearful that the government’s fiscal credibility may be on the line, however, there will be plenty of references to establishing a “credible trajectory” to surplus, which will occur (if it ever does) well ­beyond the period of the forward estimates.
The Treasury convention of bunging in trend figures for economic growth and other key parameters in years three and four of the forward estimates will make the out-years look better, even if it is the assumption driving this outcome rather than the likely reality.
Expect the Treasurer to highlight repeatedly the fiscal impact of the low iron ore price, even if the impact is being exaggerated. Just think about it: lower mining company tax revenue and lower PAYE tax receipts from what is a relatively small number of workers may add up to hill of beans, just not a very high one.
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Tony Abbott says his second budget will be 'measured, responsible and fair'

Date May 2, 2015 - 4:50PM

Adam Gartrell

Prime Minister Tony Abbott has declared his second budget will be "measured, responsible and fair" but he won't publicly confirm a backflip on pension indexation.
Reports say the government has decided to dump its deeply unpopular plan to reduce the rate of indexation for the age pension and will make up the lost revenue by changing eligibility criteria for the part-pension.
But Mr Abbott was tight-lipped when asked about the reports on Saturday.
"I want to assure people this is a budget that will be measured, responsible and fair," he told reporters in Sydney.
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Apparent Budget Leaks.

Millions in savings as over-the-counter drugs now off script pad

Sid Maher

Labor looks set to back a government move to strike from the Pharmaceutical Benefits Scheme medicines that are available over the counter, a development that should produce significant savings for the federal budget.
Common over-the-counter pain­killers such as paracetamol, antacids and aspirin will be removed from the PBS, meaning doctors will no longer write prescriptions for the medicines and they will no longer be counted towards the PBS safety net.
The safety net kicks in after 60 scripts: after that time, patients receive free medicine.
While the move is aimed at saving the budget money, it is also part of negotiations for a new pharmacy agreement aimed at increasing efficiency in the system.
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Budget 2015: rewards for seniors to stay at work

David Crowe

Older Australians will get new ­rewards for finding work and strong incentives to put off their retirement as the federal government recasts its controversial pension savings in a wider budget reform aimed at boosting the workforce at the same time it helps to cut the deficit.
Federal cabinet has agreed to make faster payments of up to $10,000 to employers who hire older Australians as part of an overhaul of job programs to help tens of thousands of people back into the workforce.
A separate budget measure will give people approaching ­retirement a new incentive to stay at work for a few more years in the knowledge they could collect a bonus when they choose to claim the Age Pension.
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Tougher eligibility rules for childcare rebate set to hit stay-at-home mums

Date May 1, 2015 - 4:23PM

Matthew Knott

Communications and education correspondent

Social Services Minister Scott Morrison has confirmed the Abbott government will introduce tougher rules on the number of hours a parent needs to work each week to receive subsidised childcare, a move expected to hit stay-at-home mothers.
Parents can currently access the childcare rebate - which covers 50 per cent of out-of-pocket expenses up to $7500 a year - if they work, volunteer or study, but there are no minimum hours required. This has led to to concerns that some stay-at-home parents are taking on very small jobs to qualify for childcare benefits.
Mr Morrison flagged on Friday that a new form of activity testing will be introduced to ensure the highest subsidies go to parents who contribute the most to the workforce.
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Ley to announce multimillion-dollar 'rescue package' for Labor health scheme

Date May 2, 2015 - 11:42PM

Adam Gartrell

The costly electronic health scheme is a white elephant and should be scrapped, expert says.
EXCLUSIVE
The Abbott government will spend hundreds of millions of dollars trying to salvage a Labor's electronic health scheme that has been branded an irredeemable failure.
Five hundred days after receiving a review into the e-health system – a scheme that has already cost taxpayers $1 billion over the last five years – the coalition still has not publicly announced whether it intends to save it or axe it.
But Fairfax Media has learnt the government has decided to try to save the system and will make the announcement in the May 12 budget. The rescue package is set to cost hundreds of millions of dollars over the next four years.
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Health Budget Issues.

Health savings should go back into the system, says Labor

Date April 26, 2015 - 4:52PM

James Massola

Political correspondent

Labor health spokeswoman Catherine King says any savings found in a review of the Medicare system should be re-invested in health care, not used to repair the budget bottom line.
Ms King has also welcomed a review of the Pharmaceutical Benefits Scheme – which could see access to some common pain killers curtailed while also seeing some common painkillers such as Paracetamol that are currently subsidised struck off the register to save money – as a sensible measure.
Health Minister Sussan Ley said on Sunday there was a strong argument for over-the counter-drugs such as Paracetamol, which costs taxpayers $73 million a year when accessed under the PBS, to be taken off the scheme.
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  • Apr 26 2015 at 10:00 PM
  • Updated Apr 27 2015 at 5:40 AM

Government targets subsidies medicine as part of $7b budget savings

A radical overhaul of the Pharmaceutical Benefit Scheme appears set to contribute about $3 billion of savings to a total health-cut target of $7 billion in next month's federal budget, in changes that would also see a long-awaited overhaul of competition among pharmacies.
Health Minister Sussan Ley confirmed on Sunday that the federal government was looking at removing subsidies from several over-the-counter medicines and allowing pharmacies to discount the co-payment patients pay on pharmaceuticals, a measure that is argued will boost competition among retail chemists.
Both measures are being examined as a way of dramatically reducing the burgeoning cost of the pharmaceutical safety net – under which patients get free medication when they have spent more than $1453.90 for general patients, and $366 for concession card holders.
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Medicare review set up by Health Minister Sussan Ley shows costs can be cut

Date April 26, 2015 - 10:10PM

Jeffrey Braithwaite

There is a huge opportunity to do more in the health system, and do it better, without spending more.
The decision of Health Minister Sussan Ley to set up a three-part review of Medicare does two important things. First, it gets her and the government out of the jam that the GP co-payment plan, introduced in last year's budget, got them into. And second, and more important, it gives the government, the medical profession and health management at all levels a chance to look at the places within the health system where real savings can be made.
Everyone knows the costs of healthcare are rising quickly while government revenues are constrained, exacerbated by the end of the mining boom. Everyone acknowledges, too, that health spending must be efficient as the demand for services rises with an ageing population. The co-payment was such a bad decision because, simply put, we do not need to impose additional costs on the public to meet our future healthcare challenges. It would have inflicted a lot of pain without gaining much.
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The 25 medical tests and medicines doctors say you don’t need

  • April 29, 2015 6:00AM
  • Sue Dunlevy
  • National Health Reporter
DOCTORS have identified 25 wasteful tests and treatments they say shouldn’t be given because they are costing Medicare billions of dollars each year — without improving patient outcomes.
Five specialty groups will on Wednesday unveil the “Choosing Wisely” list which tells doctors not to prescribe long term medicines like esomeprazole and omeprazole to beat heartburn and gastric reflux.
These medicines cost taxpayers $450 million last financial year with more than 6.9 million scripts written for esomeprazole.
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Climate change will significantly affect Australians’ health, report finds

Report by the Australian Academy of Science warns extreme weather events will contribute to the spread of disease and disrupt food and water supplies
Climate change will have significant repercussions for Australians’ health as warming temperatures fuel extreme weather events, help spread disease and disrupt food and water supplies, according to a report backed by the country’s peak scientific and medical bodies.
The Climate change challenges to health report, released by the Australian Academy of Science, warns that vulnerable people, particularly the sick, elderly and poor, will “suffer disproportionately from the worst impacts of climate change.”
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No explanation for huge disparity in hospital costs

Sean Parnell

Medical treatment in some public hospitals has cost on average almost twice as much as in others, with no explanation for the difference, according to a landmark report from the National Health Performance Authority.
For the first time, the federal agency has charted the significant disparity in the cost of delivering hospital services in Australia, taking into account whether the facilities do more complicated work or treat sicker patients.
In examining more than 60 per cent of costs in acute admissions and emergency department in 2011-2012, amounting to expenditure of more than $16 billion, the authority found the notional average cost of a service ranged from $3100 to $5800.
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Medical Future Fund.

Ley revives Medical Research Future Fund

28th Apr 2015
HEALTH Minister Sussan Ley has vowed to pour savings from a comprehensive review of the MBS into the $20 billion Medical Research Future Fund (MRFF).
The announcement on Tuesday marks the revival of the fund policy. Its future was in doubt after the co-payment package that was to pay for it was scrapped.
That co-payment link saw the fund dogged by claims it was a “budget sweetener”, but Research Australia head Elizabeth Foley told Medical Observer that while “in a few people’s minds it was tainted”, the new announcement meant it was “a very genuine offer in the first place”.
Speaking on Sky News, Ms Ley declined to say how much the MBS review expected to save.
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Medical Research Future Fund: Cure for cancer delayed

  • April 30, 2015 9:37PM
  • Sue Dunlevy
  • News.com.au
TREASURER Joe Hockey said it was going to find a cure for cancer but nearly 12 months after it was announced the government’s $20 billion Medical Research Future Fund has not been set up.
And now doctors are at war with Health Minister Sussan Ley over whether new savings in health to be announced in next month’s budget should go into the fund.
Ms Ley told Sky News earlier this week any savings from her recently announced review of Medicare rebates would go into the fund.
“If there are savings it will go into the Medical Research Future Fund, as we promised in the last budget,” Ms Ley told Sky News.
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Medicare Co-payment.

  • Apr 29 2015 at 3:02 PM

Peter Gregg, new Primary Health Care CEO, says GP co-payment inevitable

New Primary Health Care chief executive Peter Gregg says if the government does not remove its freeze on rebates paid to doctors, bulk billing GPs will be forced to charge a co-payment to cover their costs.
However in a change of approach for the healthcare company, Mr Gregg has said that Primary will be more collaborative and work with governments to ensure they are getting the most bang for their healthcare buck.
Mr Gregg started at the $2.6 billion medical centre, pathology and imaging provider in March, after founding managing director Edmund Bateman stepped down in January due to illness. Dr Bateman, who established Primary in the 80s with a medical centre on Sydney's northern beaches, has been a strident critic of government health policies.
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Pharmacy Issues.

Painkillers and antacids may be removed from subsidised medicines list

Pharmaceutical Benefits Scheme review told stripping out paracetamol, aspirin and antacids would save budget millions
Paracetamol and aspirin could be taken off Australia’s Pharmaceutical Benefits Scheme (PBS) in a proposed budget measure designed to save millions of dollars.
The pharmaceutical benefits advisory committee is reviewing the PBS and the proposal to remove medications such as paracetamol and antacids has the cautious support of the opposition. Labor’s health spokeswoman, Catherine King, has called it “sensible”.
Moving paracetamol off the PBS would stop pensioners using such prescriptions to get the 60 scripts a year required for all subsequent scripts to be free, the Sunday Telegraph reports.
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Aspirin, Panadol to get cut from PBS

  • April 26, 2015 4:56PM
  • By Rashida Yosufzai
  •  AAP
PARACETAMOL, antacids, aspirin and other basic medicines could soon be removed from the list of subsidised medicines.
BUT the budget measure to strip some over-the-counter drugs from the Pharmaceutical Benefits Scheme will mean a better deal for consumers, the federal government says.
Health Minister Sussan Ley said the government was paying too much for people to access basic drugs on script at their chemist.
The government wanted to make way for expensive, new-generation cancer and other life-saving drugs on the scheme.
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Sussan Ley confirms Pharmaceutical Benefits Scheme crackdown in May budget

Date April 27, 2015 - 8:59AM

Matthew Knott

Communications and education correspondent

Health Minister Sussan Ley has confirmed the government will tackle "perverse incentives" in the health system by removing over-the-counter medications - such as Panadol, aspirin and antacids - from the Pharmaceutical Benefits Scheme in the May budget.
A responsible fiscal approach across the health portfolio demands that we do this 
The change will mean that pensioners and other concession card holders can not receive pain killers and other products, such as anti-dandruff shampoo and laxatives, for free with a doctor's script once they reach the annual PBS safety net.
After receiving around 60 scripts a year, concession card holders can currently access over-the-counter medications for free even though they are available cheaply and without a prescription at supermarkets. 
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Subsidy cuts will hurt pharmacists and change prescribing habits

27 April, 2015 Meg Pigram
The federal government plan to remove paracetamol, aspirin, antacids and other over-the-counter medicines from the PBS will devalue pharmacist advice, says consultant clinical pharmacist Debbie Rigby (pictured).
A consulting pharmacist says the health minister’s plan has been tried before and did not work
The federal government plan to remove paracetamol, aspirin, antacids and other over-the-counter medicines from the PBS will devalue pharmacist advice, says consultant clinical pharmacist Debbie Rigby.
“I am surprised this is happening, because it has already happened before and it didn’t work,” Ms Rigby says.
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Bitter pill to swallow as budget surgery continues

9:11pm, Apr 27, 2015
The Health Minister has common medicines and chemists in her sights. While the Opposition appears to be open-minded about it, the real opponents are ready for a fight.
Fresh from healing the deep wounds left after last year’s budget battle with the nation’s doctors, Health Minister Sussan Ley is scrubbing down for some radical surgery on the country’s chemists.
The stakes are high.
The referring doctor is Treasurer Joe Hockey, who is looking for savings of $3 billion in the new pharmacy agreement over four years and a huge $7 billion across the whole health sector.
The patient is already being prepped. Ms Ley’s campaign began on the weekend when she confirmed she’s looking at savings in the Pharmaceutical Benefits Scheme. That’s the one that heavily subsidises expensive but lifesaving medicines. The trouble is, readily available over-the-counter drugs like paracetamol are also included.
So a 100-pack of Panamax Paracetamol costs $1.89 off the shelf, but when it’s prescribed by a doctor for an eligible pensioner the price shoots up to $8.66. Included is a chemist’s dispensing fee of $6.76. The cost to taxpayers is $73 million a year. This would more than cover the cost for the anti-melanoma drug Ipilimumab at $65 million.
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Plan for OTC drugs to be taken off PBS

28 April, 2015 Michael Woodhead
GPs will no longer be able to prescribe over-the-counter medications such as paracetamol and antacids on the PBS as part of plans being considered for May's budget.
Citing "perverse incentives" and a need to make the PBS more sustainable, Federal Health Minister Sussan Ley said there were potential savings of hundreds of millions of dollars a year to be made from removing products such as paracetamol from the PBS.
The plan will also cover products such as loperamide, laxatives and anti-dandruff shampoos, which are currently available on the PBS.
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These cuts will hurt

1 May, 2015 Meg Pigram
Three national health groups have joined forces with the PSA to urge the Federal Health Minister to assess the health and economic impacts of changes to pharmaceutical subsidies before implementing new measures.
The Consumers Health Forum, Arthritis Australia, Painaustralia and the PSA say changes, as currently proposed, would significantly disadvantage more than one million Australians living with arthritis and other chronic conditions requiring frequent medication.
Health Minister, Sussan Ley, has foreshadowed significant changes to the PBS including the introduction of a discount of up to $1 on the co-payment for prescription medicines and the removal from the PBS of a range of OTC including analgesics.
This comes when there is a separate move to introduce doctors’ prescriptions for some pain killers currently available over the counter at pharmacies. There is also continuing speculation about a possible increased co-payment for prescribed medicines.
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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 2016 Budget but there has been a good deal ruled out (Super changes, dividend imputation changes and a new Medicare Co-payment).
It does seem the Pharmacy Guild are taking a little water however and might be in for a fright. The rumours of major change are pretty strong!
Nonetheless I am sure there will be lots of fun to observe over the next week.
Enjoy.
David.

Wednesday, May 06, 2015

It Looks Like The South Australian Implementation of EPAS Is Going Pretty Badly. An External Expert Review Is Really Needed and Egos Parked At The Door!

This appeared last week.

E-health system ‘halved appointments’ at Repat

Bension Siebert | 30 April 2015
ADELAIDE | The number of outpatient appointments available to older people and veterans at the Repatriation General Hospital has been halved because of the state’s troubled $422 million electronic patient records system, senior doctors have revealed.
The minutes of this year’s annual general meeting of the Medical Staff Society, given to InDaily by an SA Health employee, say that the Enterprise Patient Administration System (EPAS) has severely slowed patient care at the Repat.
“To accommodate the needs of EPAS, the Repatriation General Hospital has reduced outpatient appointments by 50 per cent,” the document says.
Outpatient services provided at the Repat include general medicine, surgery and rehabilitation, cardiology, mental health, neurology, psychiatry and urology services, among others.
SA Health was unable to confirm or deny the reduction in appointments before deadline this morning.
The document also says that “it is now expected that EPAS won’t be operational at the new Royal Adelaide Hospital until July 2017″.
In December last year, a report by the Auditor-General revealed that SA Health was drawing up contingency plans in case EPAS were unable to function properly at the new hospital.
According to an SA Health spokesperson, the department is “working to implement EPAS directly into the new Royal Adelaide Hospital in 2016″.
…..

More than 200 EPAS ‘incidents’

The SA Health spokesperson told InDaily that 231 adverse incidents directly related to EPAS had been recorded since August 2013.
The spokesperson said only one of those incidents, involving a delayed referral, caused harm to a patient. The incident is being investigated.
“The implementation of EPAS has led to improvements across a range of safety functions, such as ensuring the correct drugs are ordered and right dosage is given to patients,” a statement from SA Health reads.
“In total, there are around 44,000 incidents reported each year in the Safety Learning System used across South Australia’s public hospitals.”
Lots more here:
Oh dear. This all suggests that a fundamental re-think of what has gone on to date and just how progress can be made is vital. This project has been growing on for years - you would have thought the rough edges would have been addressed long before this.
An independent, external and expert view is clearly vital here!
David.

Tuesday, May 05, 2015

Medical Director White Paper Shows We Have A Little Way To Go With Using E-Health. PCEHR Not All That Favoured.

Medical Director released a white paper on e-Health usage and a range of other matters last week.

The survey was titled: 2015 Survey: Practice pressures and eHealth realities

You can download the white paper from this link:
The summary of the findings - made by the authors - is as follows.

SURVEY QUICK FACTS

  • 48 per cent of health professionals surveyed are worried government changes could have a negative impact on patient outcomes
  • 38 per cent of respondents said their practices are under pressure to cut costs or increase bookings, while 14 per cent have already seen a drop in bookings
  • 17 per cent of health professionals use an online booking system, while 10 per cent are planning to implement one within a year
  • 28 per cent use an automated reminder system to notify patients of upcoming appointments, and of those, 70 per cent find it reduces the number of no shows or late patients
  • 42 per cent prefer to send records via paper methods - post and fax
  • 44 per cent think sharing records electronically has potential to accelerate the referral process and possibly improve patient care, while another 30 per cent think it will streamline work and reduce administration time
  • 26 per cent think health related phone or tablet apps have the most opportunity to benefit health professionals and patient outcomes, followed by telemedicine at 21 per cent
There are a couple of reports on the paper in the press:
First here:

Health professionals missing the e-Health bandwagon

Despite feeling the pressure to increase bookings and cut costs, many health professionals are missing opportunities presented by e-health technology that would be of benefit to patients a new whitepaper says.
According to the Practice pressures and e-health realities whitepaper, prepared by MedicalDirector, almost 40 per cent of health professionals think speculation over government changes to Medicare has put their practices under pressure to cut costs or increase bookings.
14 per cent had already experienced a drop in bookings.
Only 17 per cent had used an online booking system however, which would make it easier for patients to secure appointments, and less than a third used an automated reminder system to notify patients of upcoming appointments – even though of those who did, 70 per cent found it reduced no shows and late patients.
Lots more here - with a good infographic as well.
Also there is coverage here:

GPs still opting for snail mail

1 May, 2015 Amanda Davey
GPs are slow to embrace e-health technology with many still preferring to send medical records by post and fax, finds a survey of 423 practices.
While more than three-quarters of those surveyed think sharing records electronically has the potential to reduce administration burden and enhance the sharing of patient information, almost half are continuing to use post and fax.
The survey, by clinical and practice management software vendor Medical Director, shows few practices are using online booking systems and just over one-quarter have adopted automated reminder systems to notify patients of upcoming appointments.
Furthermore, despite initial enthusiasm for the government’s Personally Controlled Electronic Health Record (PCEHR) System that was launched in 2012, uptake is low, with only 12% of city-based and 9% of regional practices using the system.
Rural and remote doctors are slightly more enthusiastic than the city dwellers, with a 16% take-up rate of PCEHR.
More here:
I loved the GP who said that he occasionally sent a record to the PCEHR but that he had never found anything useful on it - but felt it was a great idea!! In the survey on 17% felt the PCEHR had the largest potential for benefit.
Overall what we see is that the migration to use of electronic communications appears to be lagging use of local electronic records after at least 20 years since the software as first introduced.
Thanks to MD for doing the survey work and pointing out just how many other useful things GPs and Practice Managers see ahead of the PCEHR.
David.

Monday, May 04, 2015

Weekly Australian Health IT Links – 4th May, 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

Only one topic this week - the fate of the PCEHR!
The budget on the 12th will be very interesting to see just how much is planned to be spent!
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Ley to announce multimillion-dollar 'rescue package' for Labor health scheme

Date May 2, 2015 - 11:42PM

Adam Gartrell

The costly electronic health scheme is a white elephant and should be scrapped, expert says.
EXCLUSIVE
The Abbott government will spend hundreds of millions of dollars trying to salvage a Labor's electronic health scheme that has been branded an irredeemable failure.
Five hundred days after receiving a review into the e-health system – a scheme that has already cost taxpayers $1 billion over the last five years – the coalition still has not publicly announced whether it intends to save it or axe it.
But Fairfax Media has learnt the government has decided to try to save the system and will make the announcement in the May 12 budget. The rescue package is set to cost hundreds of millions of dollars over the next four years.
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Blowout fears for $1bn Centrelink IT system overhaul

Fran Foo

Centrelink’s new $1 billion-plus IT system could be doomed if ­politicians don’t heed lessons of the past, cave in to public pressure and rush to deliver undercooked projects, analysts warn.
An analysis by The Australian shows that taxpayers have been saddled with billions of dollars in additional costs for bungled IT projects over the years.
One of the biggest bungles in history — Queensland Health’s payroll debacle — will cost 900 per cent more, or an additional $1.1bn, until 2017 — from $98 million to a projected $1.2bn.
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Health, fitness apps and devices worry privacy experts due to data mining issues

Posted about 4 hours ago
As mobile health and fitness apps and wearables gain popularity in Australia, privacy experts have raised concerns that companies are monetising personal medical information.
There are many very clever data scientists who know exactly how to access open information that people voluntarily upload to the web.
Professor Deborah Lupton
There are thousands of health and fitness devices and apps on the market, but it is not always clear if users' data is kept confidential.
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GPs still opting for snail mail

1 May, 2015 Amanda Davey

Latest News

GPs are slow to embrace e-health technology with many still preferring to send medical records by post and fax, finds a survey of 423 practices.
While more than three-quarters of those surveyed think sharing records electronically has the potential to reduce administration burden and enhance the sharing of patient information, almost half are continuing to use post and fax.
The survey, by clinical and practice management software vendor Medical Director, shows few practices are using online booking systems and just over one-quarter have adopted automated reminder systems to notify patients of upcoming appointments.
Furthermore, despite initial enthusiasm for the government’s Personally Controlled Electronic Health Record (PCEHR) System that was launched in 2012, uptake is low, with only 12% of city-based and 9% of regional practices using the system.
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Health professionals missing the e-Health bandwagon

Despite feeling the pressure to increase bookings and cut costs, many health professionals are missing opportunities presented by e-health technology that would be of benefit to patients a new whitepaper says.
According to the Practice pressures and e-health realities whitepaper, prepared by MedicalDirector, almost 40 per cent of health professionals think speculation over government changes to Medicare has put their practices under pressure to cut costs or increase bookings.
14 per cent had already experienced a drop in bookings.
Only 17 per cent had used an online booking system however, which would make it easier for patients to secure appointments, and less than a third used an automated reminder system to notify patients of upcoming appointments – even though of those who did, 70 per cent found it reduced no shows and late patients.
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E-health system ‘halved appointments’ at Repat

Bension Siebert | 30 April 2015
ADELAIDE | The number of outpatient appointments available to older people and veterans at the Repatriation General Hospital has been halved because of the state’s troubled $422 million electronic patient records system, senior doctors have revealed.
The minutes of this year’s annual general meeting of the Medical Staff Society, given to InDaily by an SA Health employee, say that the Enterprise Patient Administration System (EPAS) has severely slowed patient care at the Repat.
“To accommodate the needs of EPAS, the Repatriation General Hospital has reduced outpatient appointments by 50 per cent,” the document says.
Outpatient services provided at the Repat include general medicine, surgery and rehabilitation, cardiology, mental health, neurology, psychiatry and urology services, among others.
SA Health was unable to confirm or deny the reduction in appointments before deadline this morning.
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Payments outsourcing stuck in Medicare waiting room

A final decision on whether more than $30 billion a year in Medicare benefit claims and payments processing will be outsourced to private industry looks no closer to resolution.
The Department of Health has confirmed it is still mulling over its options despite issuing a heavily publicised call out to commercial providers to submit Expressions of Interest (EOI) in August 2014.
“The EOI process is still with the Department of Health and possible next steps are under consideration,” a Health spokesperson told Government News late last week.
Despite a flurry of initial submissions last year, parts of industry now appear to have heavily tempered any expectation of movement on contracts or pilot projects until at least 2016 because of a new review of the Medical Benefits Scheme and the Pharmaceutical Benefits scheme instigated by recently appointed Health Minister Sussan Ley.
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NSW's top tech doctor reflects on nine months in the role


Intensive care 'much easier' than managing statewide e-health.

Nine months into the role, NSW Health’s inaugural chief clinical information officer Dr John Lambert is still coming to grips with the scale of the the job.
Lambert moved to Sydney from the western NSW town of Orange, where he headed the intensive care wing of a regional hospital, to take up the new role after the restructure of NSW Health's IT functions mid last year.
Intensive care has nothing on the health bureaucracy when it comes to daunting challenges, he told iTnews at HISA’s Sydney telehealth conference last week.
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Google might buy your patents to counter trolls

The idea is to attract sellers who might sell their intellectual property to patent trolls
Google might buy your patents to keep them out of the hands of litigious patent trolls that critics contend are hampering innovation.
For a two-week period next month, Google will accept submissions from patent owners and possibly bid on the patents as part of its Patent Purchase Promotion, wrote Allen Lo, the company's deputy general counsel for patents.
The idea is to keep some patents out of the hands of so-called patent trolls, or companies that use patent licensing and lawsuits as their primary source of revenue.
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Digital App Technology Benefits the Trauma Room

on April 22, 2015 at 9:36 am
Trauma specialists at Sydney’s Westmead Hospital have reported a positive response to the six-month trial of a new app designed specifically for the facility to assist with critical decision-making processes in time and resource restricted situations.
Available on iPhone and Android, the Westmead Trauma App was funded by a New South Wales Motor Accidents Authority grant and processes standard trauma algorithms (using a flow chart and easy-to-navigate options such as ‘pinch-to-zoom’, jump-words and pop-up boxes), presenting decision options based on the best available evidence.
Study author and trauma specialist Dr Jeremy Hsu noted the need for such a technology due to the nature of trauma response units, with urgent action needed and senior specialists not always on hand for consultation. The app has been designed for this very reason: quick, confident response in any situation.
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NSW Health CIO commends data centre flood recovery


Central facility back up and running within hours.

eHealth NSW boss Michael Walsh has publicly commended the efforts of Hunter Valley-based IT support staff who worked to turn around a power outage threatening one of the health system’s core data centres during last week’s storms.
The region bore the worst of a dramatic storm cell that hit NSW earlylast week, and wreaked havoc on the electricity supply at Newcastle’s John Hunter Hospital.
John Hunter currently houses one of three major data centre facilities used by NSW Health to runs its statewide IT core.
A spokeswoman for the department told iTnews the John Hunter back-up power systems kicked in as planned, but ICT services struggled under “frequent fluctuations in the main power supply”.
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  • May 1 2015 at 12:00 AM
  • Updated May 1 2015 at 4:46 AM

Lessons from David Thodey

Telstra's David Thodey spoke the AFR's David Ramli and Tony Boyd on his last day after six years as CEO of Australia's leading telco.
ON LEADERSHIP
I would say leadership has changed in the world. The days of the all-knowing CEO are just not real. You know the world is moving so quickly through the internet, social media and the way people are informed, so I think leadership has changed.
I really am a great advocate for values-based leadership. We have regulatory considerations but our values drive our behaviour more than rules and I think that any organisation has got to move that way because it drives people to take ownership and be accountable and it also drives a better outcome for the customer.
I don't think customer advocacy is optional anymore. Customers are better informed, more discerning, than ever before. People listen more to what they read on social media than any other advertising so you have got to be authentic in your leadership and focus on customers. The wonderful thing about it being driven by the customer and not just having it as another one of your goals is that it makes it fundamental to who you are, even if you fail. We fail every day, we are not perfect, but we have that orientation. It forces you to look outside. Always be measured by something that is not your own impression of yourself but by what the customer says. In the end that is the only thing that matters. It influences product design and technology decisions, culture, behaviour etc etc. One thing I want to be very clear about – we do not have all the answers.
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GP ordered to pay patient over privacy breach

30 April, 2015 Tessa Hoffman
A GP must pay $6500 to a patient after telling a police officer the man may have been psychotic.
The police sergeant had phoned the GP to ask if her patient could be “psychotic” after visiting him several days earlier to investigate a neighbourhood dispute and finding the patient spoke in a “highly excited and at times paranoid fashion”.
The GP — who had seen the patient at least 26 times over the previous two years for anxiety and stress at a Queensland medical centre — replied that “it was possible but further assessment was needed”.
The Australian Privacy Commissioner Timothy Pilgrim found that this constituted a breach of the Privacy Act 1998's National Privacy Principles, in a determination made in March.
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Babies using mobile media, new study reveals

  • AAP
  • April 27, 2015 11:11AM
More than a third of babies in the US are tapping on smartphones and tablets even before they’re walking or talking, according to a new study.
And by their first birthday, one in seven infants is using devices for at least an hour a day.
The results of the First Exposure and Use of Mobile Media in Young Children survey was presented to the Pediatric Academic Societies annual meeting in San Diego on the weekend.
The American Academy of Pediatrics discourages the use of entertainment media such as televisions, computers, smartphones and tablets by children under two-years-old.
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Sonoa Health wins University of Utah prize as it moves towards creating a Facebook-style website for your health

  • April 27, 2015 9:39AM
  • Mathew Murphy and Network Writers
  • News Corp Australia
AN Australian start-up has been recognised overseas for using gaming to help improve health as part of a personalised website that millions could soon be using.
Sonoa Health has taken out first prize at the University of Utah’s Games4Health competition for a series of personalised games targeting individual health issues.
Sonoa’s Health&games team, led by Dr Bow Tauro, is developing a series of games to raise awareness of certain health conditions.
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HEALTHKIT is a global platform for patients and practitioners around the world that is making healthcare efficient, effective and accessible for everyone and everywhere.  With practitioners in over 40 countries globally, Health Kit is one of the widest networks of practitioners and patients in the world.  Health informatics has more potential to save lives than drug innovations alone. 
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Here’s why Citadel Group Ltd surged 21% today

By Ryan Newman - May 1, 2015 | More on: VET
On a day where the S&P/ASX 200 (Index: ^AXJO) (ASX: XJO) has managed to piece together a slight gain, shares of Citadel Group Ltd (ASX: CGL) have skyrocketed just over 21% to be trading at a new high of $3.05.
Citadel, which boasts a market capitalisation of roughly $135 million, is a company that provides education and technology services to help its clients maximise value and business outcomes.
It listed on the ASX late last year and has generated a return of almost 36% since then, which compares very favourably to Vocation Ltd (ASX: VET) and Ashley Services Group Ltd (ASX: ASH), two other education providers which have plummeted in that time.
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Abbott Government calls for Medicare overhaul

The Abbott government has launched a review of the Medicare system, with a particular focus on dealing with funding models for high care patients, and those with chronic diseases, including diabetes.
One of the distinct possibilities is a move from fee-for-service towards an outcome-based funding model, such as occurs in several other countries, including the United States  with its Accountable Care Organisations.
According to a statement from Minister for Health, Sussan Ley, the feedback from consultations with stakeholders indicated Medicare’s structure no longer efficiently supported patients and practitioners to manage chronic conditions or the complex interactions between primary and acute care.
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Could robots like Alex Garland's sci-fi thriller Ex Machina's heroine Ava replace women?

Date April 26, 2015 - 9:46PM

Maureen Dowd

Are women necessary?
Not with Ava around.
Even without hair on her head or flesh on her legs, Ava has enough allure and cunning to become a classic film noir robot vixen.
Despite being a plastic and mesh gizmo locked in a glass cell, she can enmesh men with frightening ease.
Ava is the appealing heroine, or apocalyptic villainess, of Ex Machina, a stylish sci-fi thriller set in the near future, written and directed by Alex Garland, a 44-year-old Brit who wrote the 2002 zombie hit 28 Days Later.
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Enjoy!
David.

Sunday, May 03, 2015

This Is A Very Interesting Review Of Patient Access To Clinical Records. Worth A Read And Relevant To The PCEHR.

This appeared last week:

MDU advises GPs on patient access

23 April 2015   Rebecca McBeth
The Medical Defence Union has produced guidance for GPs to help them to ensure the confidentiality and accuracy of medical records being made available to patients online.
Practices have been contractually required to offer patients in England online access to their Summary Care Record information since the start of the month and some are giving patients access to their whole record.
The MDU said it has been contacted by a number of GPs with queries about giving patients access to their records online, including; whether they need to limit access to sensitive information; how to deal with parents' requests to access children's records; and what to do if a patient challenges the accuracy of a record.
Dr Beverley Ward, MDU medico-legal adviser, said: "Making confidential information about patients available online has logistical difficulties, and practices will need to consider how to allow patients to access information securely, while being sensitive to any information which may cause distress.
"Fortunately, there is plenty of guidance available for practices and for patients, but there are likely to be more queries about the accuracy and contents of records once patients begin to sign up for online access. For example, GPs may need to explain any abbreviations the records contain and will need to ensure test results are reviewed and discussed with the patient before they are uploaded to the online record.
"Another area of concern is requests by parents to access children's records. For children over 16, GPs should usually get their consent before granting access to someone with parental responsibility, but for under 16s the situation is more complicated." 
The RCGP suggests that full access for those with parental responsibility should be automatically switched off at age 11 and a discussion arranged with the child and parents to consider the extent of ongoing access. 
More here:
The last two paragraphs are of special importance - and should we find ourselves with a PCEHR that is opt-out we will need to carefully review access by parents to the compulsorily gathered records in a child / adolescent’s PCEHR.
Just deciding to have control passed when the patient is aged 18 clearly will not cut it and if not rethought there will be big trouble I predict!
David.

The Death Of the PCEHR Is Now Going To Be Drawn Out Forever. What Nonsense!

This appeared earlier today.

Ley to announce multimillion-dollar 'rescue package' for Labor health scheme

Date May 2, 2015 - 11:42PM

Adam Gartrell

The costly electronic health scheme is a white elephant and should be scrapped, expert says.
EXCLUSIVE
The Abbott government will spend hundreds of millions of dollars trying to salvage a Labor's electronic health scheme that has been branded an irredeemable failure.
Five hundred days after receiving a review into the e-health system – a scheme that has already cost taxpayers $1 billion over the last five years – the coalition still has not publicly announced whether it intends to save it or axe it.
But Fairfax Media has learnt the government has decided to try to save the system and will make the announcement in the May 12 budget. The rescue package is set to cost hundreds of millions of dollars over the next four years.
Labor announced the Personally Controlled Electronic Health Record system in 2010, pledging to get it up and running within two years at a cost of less than $500 million. The scheme allows patients to opt in to a personal electronic record of their medical history.
However, five years later, the cost has more than doubled and less than 10 per cent of Australians have signed up – a little over 2 million people. And only a few hundred of the country's 1300 hospitals are on board.
Former health minister Peter Dutton was a critic of the scheme and ordered a review shortly after the Abbott government won power. The review delivered its report in December 2013, recommending a raft of changes – including that it be made an opt-out scheme, rather than opt-in.
Mr Dutton has never responded to the report, effectively leaving the scheme in a costly limbo.
New Health Minister Sussan Ley still isn't publicly saying what the future holds.
More here:
The pathetic excuse offered is as follows:
“It decided to proceed with the program partly because even scrapping it would cost many millions of dollars. That's because the government is legally obligated to continue to provide e-health records and store them for up to 130 years.”
Given the usage is so low this is just a fig leaf to try and cover a totally naked policy! A move to 'opt-out' will be, of course,  an administrative and very expensive nightmare.

One has to wonder just where NEHTA will wind up fitting in all this.

I look forward to the enthusiastic reaction to this news from all around country. I am sure every doctor and patient in the country will be thrilled to see so much more investment is such a totally failed initiative.
What a farce!
David.

AusHealthIT Poll Number 268 – Results – 3rd May, 2015.

Here are the results of the poll.

What Do You Think Of The Recent Initiatives From Telstra In E-Health?

It’s Looking Like They Might Make A Positive Difference 3% (2)

They Seem To Be Making Some Progress 10% (7)

They Are Yet To Show Any Real Potential 73% (51)

There Is No Way The New Initiatives Will Work 6% (4)

I Have No Idea What To Think 9% (6)

Total votes: 70

The vast majority (73%) are pretty sceptical so far. Time will tell!

Good to see such a good number of responses!

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

David.