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, July 30, 2015

2016 Budget -Leaders have a Retreat and We Have A COAG Meeting! Not Much Substantive Happened.

July 30 Edition
Budget Night was May 12, 2015. We now await economic and  activity data reporting to see how successful it was. Interestingly there are some early indications the small-business stimuli might be working.
Parliament has risen so we are in for a few quiet weeks. Parliament comes back on 10th August - so we can expect things to warm up at that point!
There is a real sense that we are now seeing policy paralysis about balancing the Budget from all sides. It really is getting pretty sad. Happily, it seems Leader’s Retreat / COAG meeting has made just a small step towards change - a good thing indeed. A couple of the Premiers are now showing Mr Abbott just what leadership should look like!
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Here is some other of the recent other news and analysis.

General Budget Issues.

Treasurer Joe Hockey to take tax cuts to next election

Stefanie Balogh

Annabel Hepworth

Australia’s top tax rate is “way too high’’ and the taxation system is compounding the headache of bracket creep as a disincentive to earn, Joe Hockey has conceded as he gave his strongest indication yet he is “aiming’’ to take tax cuts to the election.
Ahead of a special federal and state leaders’ summit this week in Sydney on taxation and the federation, the Treasurer said tax reform was “absolutely essential’’.
He pointed to the economic paralysis in Greece as a warning to nations that they “cannot stop undertaking reform’’ and said one of the first steps in Australia “has been to try to reduce government expenditure’’.
Graham Bradley, former Business Council of Australia president, told The Australian “a holistic review of tax in Australia is the most important unfinished business of not only the current government but successive governments going back to the Howard era’’.
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  • Jul 20 2015 at 12:00 AM
  • Updated Jul 20 2015 at 5:11 AM

Abbott government to take tax cuts to 2016 election

The Abbott government plans to take a sweeping package of tax cuts to the next election, increasing pressure on this week's historic meetings with state and territory leaders to deliver a breakthrough on the goods and services tax.
After effectively committing to delivering future income tax relief, Treasurer Joe Hockey also challenged state premiers to front up to the political challenge of reform, suggesting they have become complacent about taxpayers' funds flowing from Canberra.
"The Commonwealth raises most of the tax revenue, hands it to the states – the states will be more precious about the taxpayer money they receive if they go through the hard politics of having to raise the money in the first place," Mr Hockey said.
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Economists warn Abbott government should not cut taxes until budget in surplus

Date July 20, 2015 - 8:44PM

Gareth Hutchens

Economists have warned that the Abbott government should not cut taxes again until its budget is in surplus or it raises more revenue, after Treasurer Joe Hockey said he would like to take tax cuts to the next election.
Mr Hockey said on Sunday he would like to be in the position to promise more tax cuts at the next election despite his government's $41.1 billion budget deficit.
But the Grattan Institute's John Daley has warned Mr Hockey's plan could put the budget in more trouble because his government has ruled out serious proposals to increase revenues at the same time.
He says the plan to cut taxes without raising new sources of revenue appears to assume that those tax cuts will be funded by future surpluses.
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Increase GST to 15 per cent and broaden to raise $256 billion: accountants

Date July 20, 2015

Jessica Irvine

Senior writer

The Abbott government should strike a quarter of a trillion dollar "grand deal" to increase the GST to 15 per cent and remove all exemptions, in return for personal income tax cuts and greater spending on pensions, health and education, the peak accountancy body says.
Ahead of a meeting between the Prime Minister and state premiers this week, new modelling by Chartered Accountants Australia New Zealand to be released on Monday  reveals increasing the GST this way would raise $256 billion over four years.
Households could then receive $171 billion in permanent tax cuts, pension and welfare boosts to fully compensate low income households for the impact of higher prices. 
This would leave $94 billion to abolish inefficient state taxes and fix state and federal budgets.
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  • Jul 20 2015 at 6:54 PM

Mike Baird has opened the door to a real tax debate

The Australian Financial Review
Suddenly, the Labor position that even root-and-branch tax reform should not even think about the GST has been left behind. Fresh from delivering the political formula to sell electricity privatisation, NSW Premier Mike Baird on Monday proposed lifting the 10 per cent GST to 15 per cent, in part to make up for shortfalls in state government health funding. Rather than outright opposition, South Australia's Labor premier Jay Weatherill, said he was "open to this discussion" if ways could be found to compensate low income earners. The ACT Labor chief minister Andrew Barr similarly welcomed Mr Baird's proposal. And former Victorian Labor Premier John Brumby said increasing the GST was the "least worst option" to deal with the states' unsustainable fiscal position. The outright opposition of Victorian Labor premier Daniel Andrews and his Queensland counterpart Annastacia Palaszczuk is now untenable.
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  • Jul 21 2015 at 6:33 PM

The state Premiers must face up to reform

by The Australian Financial Review
Today's special retreat of Australia's heads of governments was proposed by Tony Abbott as a way forward out of particularly acrimonious COAG meeting in April. The stumbling block then was Western Australia's unhappiness at its shrinking cut of GST revenue just as the collapsing iron ore price was crunching its royalty collections. But WA simply magnified the problem facing the rest of the nation - expectations of government services that were wildly inflated during the temporary bonanza of the our biggest ever export price boom. The entire national debate has struggled to accept this excess spending problem since Treasurer Joe Hockey's ill-fated first budget. But this is what the prime minister needs the premiers to square up to in the next two days. They all need to put politics-as-usual to one side and focus on making our federal system of raising taxes and spending fit the times.
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Sifting tax fact from fantasy

  • Terry McCrann
  • Herald Sun
  • July 21, 2015 12:00AM
ON Sunday treasurer Joe Hockey floated the “thought bubble” of Keating-style manana tax cuts.
Speaking on the Ten Network’s The Bolt Report, Hockey said the government was “aiming” to take personal tax cuts to the next election.
That is to say, they would only “promise” them — there was no mention of even trying to make them L-A-W, law, tax cuts before the election, albeit to kick in some time after 2016.
Then on Monday his prime minister Tony Abbott backed New South Wales Premier Mike Baird’s “thought bubble” of a “great big new tax on everything.”
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GST changes: plenty of problems as tax debate starts

Paul Kelly

The dam wall has begun to crack on the selfish denialism that pretends serious tax reform is not a necessity for Australia — but this is just the start in a process filled with dangers in confronting the malaise in our political culture.
NSW Premier Mike Baird is the most innovative political ­leader in the country, as his campaign on electricity privatisation proved. Baird’s GST initiative shows the impact that policy ­audacity can generate. His proposal is more than clever because it has flushed out other premiers who confront immense fiscal problems.
The key has been Baird’s linkage of a 15 per cent GST to finance the health/Medicare system out to 2030. He has tied the Liberal objective of GST reform to Labor’s most sacred objective of preserving the health model, one of the ALP’s proudest legacies.
This is the nexus that has broken the stalemate. Baird puts on the table the impossibility of funding future health needs. Guess what? He is talking not just his book but Labor’s book. It is a problem Labor deeply cares about. The responses from Melbourne and Adelaide proved this.
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Australian tax reform: options on the menu for Abbott and premiers at Coag

Increasing or broadening the base of GST? Hiking the Medicare levy? Scrapping negative gearing? Who supports which measures as political leaders gather for the Coag meeting in Sydney
Daniel Hurst Political correspondent
Tony Abbott will meet state premiers and territory chief ministers in Sydney on Wednesday to thrash out options for tax and federation reforms – but the prime minister has already praised a proposal to increase the goods and services tax from 10% to 15%.
Some of his state and territory counterparts have other ideas about how to meet budget shortfalls in health and education, which were exacerbated by Abbott’s cuts to long-term projected funding. Here is a summary of some big-ticket options and who favours them.
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Joe Hockey’s tax cuts unlikely without economic growth

David Uren

Joe Hockey talks about wanting to go to next year’s election holding out the promise of tax cuts at the same time as the commonwealth is encouraging the states to raise their taxes. This is not tax reform: it is simply shifting the commonwealth’s budget problem on to the states. And even that will not yield enough to give the commonwealth the latitude to be thinking about tax cuts.
The biggest cut in last year’s budget was the $80 billion in expected health and education funding that was taken from the states. The newly elected Abbott government had set itself the objective of returning the budget to a strong surplus of 1 per cent of gross domestic product within a decade. It took on some tough recommendations from its National Commission of Audit, slashing the indexation of age pensions and demanding co-payments for visits to the doctor. However, it squibbed on others, such as forcing middle and high-income earners out of Medicare altogether.
The audit commission recommendations included in last year’s budget went only two-thirds of the way to delivering the $65bn in savings the commission had calcul­ated would be required by 2023-24 to get the budget back on track.
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Australia's AAA credit rating rests on tough budget measures, S&P says

Date July 24, 2015 - 3:27PM

Benjamin Purvis

Australia's credit rating could be cut if political wrangling or an external shock such as a further decline in commodity prices mean the budget won't improve as expected, Standard & Poor's said Friday.
While the credit ratings agency affirmed the country's AAA rating with a stable outlook, it said that view was premised on the country maintaining "conservative budgetary policies" that would narrow the fiscal deficit.
"We could lower the ratings if Australia's budgetary performance does not improve broadly as we currently expect," S&P said. "Continued parliamentary gridlock on the budget could trigger this scenario, as could an external shock. The latter could come from further deterioration in Australia's terms of trade, for example, or from a sharp increase in the banking sector's cost of external funding."
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Told you so: the federal budget assumptions are rubbish

Date July 24, 2015 - 6:51PM

Michael Pascoe

BusinessDay contributing editor

One of our more common fibs is the phrase "I don't like to say I told you so".
Everybody loves to say it, which is why the phrase inevitably is followed by "but".
So let me say "I told you so" on one issue and lay the groundwork to say it again soon on another.
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Parliamentary gridlock could cost Australia its AAA credit rating: Standard and Poor's

Date July 24, 2015 - 5:10PM

Peter Martin

Economics Editor, The Age

Australia's AAA credit rating is at risk from parliamentary gridlock, one of the world's biggest credit ratings agencies has warned.
Standard and Poor's reaffirmed its AAA rating for Australia on Friday but said it could lower the rating if Australia's budgetary performance did not improve as it currently expects.
"Continued parliamentary gridlock on the budget could trigger this scenario, as could an external shock," it said.
The external shock could come from a further deterioration in Australia's export prices or from a sharp increase in the cost of overseas borrowing by banks.
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Health Budget Issues.

Brake on health spending a world trend

David Uren

The commonwealth government is following the precedent of governments around the advanced world in seeking to strengthen its budget by cutting growth in health spending.
New OECD research shows average growth in health spending across the advanced world has come down from 3.8 per cent per person to 1 per cent since the ­global financial crisis, whereas Australia’s rate of growth in the latest year was barely changed from the pre-crisis average at 2.9 per cent per capita.
The change in health spending has been most acute in troubled European economies, with Greece, for example, going from an average 5.4 per cent growth per capita in the four years before the crisis to an annual 7.2 per cent contraction in the four years ­directly to 2013.
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Medicare levy should go up, Andrews to tell COAG

Rick Wallace

The 2 per cent Medicare levy should be increased instead of lifting the GST to cover the nation’s burgeoning health spending needs, Victoria’s Labor Premier Daniel Andrews will tell this week’s COAG meeting.
Mr Andrews revealed he would push for a debate on increasing the levy — which went from 1.5 per cent to 2 per cent last year to pay for the National Disability Insurance Scheme — when state leaders meet Tony Abbott in Sydney on Thursday.
He said the levy rise could be sold to the public if the government guaranteed the proceeds would be spent on frontline health services and improving care for cancer and other conditions.
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CSIRO futurist: healthcare in freefall will eat entire budgets

Shane Rodgers

State budgets are on track to be completely consumed by healthcare costs if physical and mental health continues its current deterioration, an assessment of emerging “megatrends” reveals.
The recently released book Global Megatrends, by CSIRO futurist Stefan Hajkowicz, says changing lifestyles to improve health is a “big juicy low-hanging fruit” that could massively bolster productivity and economic growth. He cites CSIRO research showing that healthcare now accounts for 20 per cent of state and federal government budgets in Australia and, on current trajectories, this would be 40 per cent by 2043.
“If this trend continues, healthcare will consume the entire budgets of Australia’s state governments — an unsustainable situation,” Dr Hajkowicz said. “The … system will break. We’ll have health haves and have nots and many people will not be able to access basic health services.”
Australia’s gym and fitness industry was currently valued at $1 billion, based on 2834 businesses with annual growth of 4.8 per cent. Despite this, the number of overweight people continued to rise.
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Dual funding of health care needs examination

When Tony Abbott and the state and territory leaders sit down tomorrow to consider tax reform, the funding of health and school education will be at the forefront of the state leaders’ concerns.
Under the Constitution, health and school education are the responsibility of the states, yet these areas consume more than one-third of total taxation revenue.
The Prime Minister and Joe Hockey have signalled their desire for the states to take a greater share of the financial responsibility for these areas, but the Labor leaders have rejected any increase in the GST or broadening its base, leading to calls for new land taxes to meet the funding shortfall.
Total government expenditure was 27 per cent of gross domestic product in 1972, is presently 39 per cent and is projected to reach 50 per cent by 2050. This is unsustainable, particularly with the decline in our terms of trade.
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Health insurance premiums to rise by up to 10pc a year

Date July 21, 2015 - 12:29PM

Jessica Gardner

Companies & Markets Deputy Editor

Households struggling to afford the cost of private health insurance should brace themselves for more bad news.
The 'real' increase in the cost of premiums could hit as high as 10 per cent per annum over the next five years, new analysis by UBS insurance analyst James Coghill shows.
The data is troubling for customers, but also for insurers like Medibank Private, Bupa and nib, which are facing slowing revenue growth as customers shop around for cheaper deals.
Each year, private health insurers apply to the Health Minister to approve their premium hikes. Mr Coghill, in a recent note to clients, said these increases were expected to come in at the rate of about 6 per cent per annum in the coming years, which is already more than double the rate of inflation.
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Mike Baird's GST plan would still see health funding fall billions short

Date July 21, 2015 - 8:18PM

Sean Nicholls

Sydney Morning Herald State Political Editor

Premier Mike Baird's proposal to lift the GST to 15 per cent would still fall billions of dollars short of the revenue that modelling suggests is needed to cover escalating national healthcare costs.
Preliminary modelling Mr Baird is due to present to Prime Minister Tony Abbott's meeting of state and territory leaders on Wednesday shows lifting the GST to 15 per cent – without broadening its base – would raise an extra $36 billion by 2020.
However, after households earning below $100,000 are fully compensated for the rise and those earning between $100,000 and $155,000 receive back half the increase, the revenue boost is $18 billion.
This is $2 billion less than Mr Baird says needs to be raised in 2020 to cover an estimated $35 billion annual shortfall in national health costs by 2030.
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Increasing GST a fanciful fix for strained budgets

Date July 21, 2015 - 9:02PM

Ross Gittins

The Sydney Morning Herald's Economics Editor

Norman Lindsay called it the Magic Pudding. Economists call it opportunity cost. In the untiring campaign by some for an increase in the goods and services tax, a new magic pudding has been created. The trouble is, opportunity cost is real, but magic puddings aren't.
Why stop at eliminating state taxes? Why not use it to reduce a few federal taxes you don't like? 
Put at its simplest, the concept of opportunity cost says that if you've got a dollar, you can only spend it once. This truth might be glaringly apparent, but it's surprising how often grown men (and, less commonly, grown women) forget it.
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  • Jul 22 2015 at 2:14 PM

Medibank Private does not understand medicine: AMA president Brian Owler

The head of the doctors lobby Brian Owler says Medibank Private's hard ball negotiating demands are offensive and misunderstand the motivations of health professionals.
Referring to the market leading insurer's contract negotiation stoush with catholic provider Calvary Heatlh Care, the Australian Medical Association president said one of the 165 "highly preventable adverse events" that Medibank has said it will not pay for is maternal death associated with childbirth.
"Unfortunately, maternal death can and still does occur in a very small number of cases – as tragic as that is," he told the National Press Club in Canberra on Wednesday. 
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Medibank row: Stance will lead Australia to US-style system, says AMA president

Date July 22, 2015 - 6:58PM

Sarah Whyte

Health and Indigenous affairs correspondent

Australia is heading towards a "US style" healthcare system, the president of the Australian Medical Association has warned, saying the cost-cutting behaviour of private insurance giant Medibank is "offensive".
Under current negotiations with hospitals, Medibank has dramatically reduced its hospital costs by refusing to cover what it deems as mistakes made by a hospital. It will also not pay the hospital if a woman dies giving birth. 
"I find it offensive that a private insurer would refuse to cover the costs of that patient and hospital in such a tragic event," Dr Owler told the National Press Club on Wednesday.
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  • Jul 22 2015 at 6:39 PM

Coalition rejects Labor premiers' plan to hike Medicare levy

A push by state leaders to increase the Medicare levy has been shot down by the federal government while the NSW proposal to increase the GST without any associated tax reform was also given short shrift.
While Prime Minister Tony Abbott spent Wednesday with state and territory leaders seeking a long-term solution to fund public health, his ministers, led by Social Services Minister Scott Morrison, rejected outright a call by Queensland and Victoria to increase the 2 per cent Medicare levy to 4 per cent as an alternative to raising the GST. This would push the highest marginal tax rate to 51 per cent.
Separately, there was widespread concern within government at the prospect of increasing the GST solely to raise revenue rather than as a part of a broader changes to the taxation system.
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  • ul 24 2015 at 6:45 PM
  • Updated Jul 24 2015 at 6:45 PM

Pay over $3534 for a tonsillectomy and you are a fool

by Geoff Winestock
Health experts want Prime Minister Tony Abbott to rethink a decision to scrap a system of standard prices for medical procedures that is showing signs of slowing growth in hospital expenses.
The issue of how to curb hospital costs flared this week at the Council of Australian Governments where states demanded an extra revenue source to compensate for the Federal spending cuts. 
For the past three years, federal funding for state hospitals has been based on an assessment of the efficient price for each hospital procedure determined by the Independent Hospital Pricing Authority. The efficient price of a tonsillectomy is $3,534 and a hip replacement is $20,957. Some hospitals charge considerably more.
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  • Jul 23 2015 at 5:13 PM
  • Updated Jul 23 2015 at 7:40 PM

Plan to curb state hospital costs to ease funding gap

by Geoff Winestock
State hospitals would be paid based on a cost-control system that sets an efficient price for every medical procedure under an agreement between Prime Minister Tony Abbott and the premiers that revives one of the Rudd government's signature policies.
Prime Minister Tony Abbott and state and territory political leaders agreed on Thursday to work towards a system where the Medicare system is used to cover treatments in hospitals based on efficient pricing.
Experts said the plan sounds like "activity-based funding", a system Kevin Rudd wrote into the federal-state hospital funding agreement in 2010. Hospitals were funded according to the specific procedures they provided such as hip replacements or heart bypasses. The price per procedure was set by an independent regulator who analysed all similar hospitals. That plan was scrapped in last year's budget. The amount of federal hospital funding was reduced and linked to each state's population.
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Pharmacy Issues.

‘We support pharmacists to be pharmacists,’ says AMA

GPs remain concerned about the expanding role of pharmacists and what they might be paid to do in the future, AMA president Associate Professor Brian Owler in an address to the Press Club.

In his address A/Prof Owler discussed issues facing GPs such as the Medicare rebate freeze – doctors have just launched an “anti-freeze” campaign to battle it – and public hospital funding.
He told reporters, in response to a question by News Corp’s Sue Dunlevy, that the AMA supported pharmacists “to be pharmacists” but remained concerned by support in the 6CPA for their role to change.
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It is going to be very interesting to see what happens to the polls and consumer confidence over the next 2-3 months. With the pollies away in their electorates things should be stable for a while. Last week, probably because of issues and Greece, China etc. easing off.  we saw a good bounce - up a bit over 4%!
Enjoy.
David.

Wednesday, July 29, 2015

It Really Seems That SA E-Health Is Continuing Not To Be Managed As Well AS One Might Hope.

This appeared a few days ago.

More costs ahead for new RAH but not all beds will initially operate

THE new Royal Adelaide Hospital faces further cost blowouts, won’t have all the services of the existing RAH as promised and will open months late with about half its beds operating and a half-baked EPAS IT system.
State Parliament’s Budget Estimates health committee was told the $2.1 billion hospital faces extra costs including:
- $30 MILLION in claims lodged by the building consortium for removal of unforeseen contaminated soil, on top of a $1 million claim already settled;
- AN expected claim for time spent removing the excess soil;
- ‘MINOR’ modifications to the building plan.
There also will be costs for remediating the existing RAH site when it is taken over by Renewal SA including removal of nuclear and medical waste.
In the Estimates committee hearing Health Minister Jack Snelling confirmed he would dump a pledge that all services now at the RAH would be at the new RAH, saying instead they would go where there would be best outcomes for patients.
He was unable to say what services would not be at the new RAH, as senior clinicians are now working out where services would best be placed.
The hearing was told there had been no move by the builders to change the contract timetable which aims to have the hospital handover next April, so the Government should move on to site in January for three months of technical checks.
…..
Mr Snelling said the new hospital would run at about ‘half capacity’ when it opens, due to the existing RAH being largely emptied of patients in preparation for the transition.
Mr Marshall ridiculed the situation as delivering “half a hospital” saying Government promises of the new RAH operating at full capacity from April 18, 2016 had been exposed as a fantasy.
The hearing heard the troubled IT system for patient records, EPAS, will not be fully functional at the new RAH when it opens and paper records will continue to be used.
It also heard the antiquated CHIRON IT system in country hospitals is being used without a licence and the makers are taking the State Government to the Federal Court.
The full article is here:
The last two paragraphs say it all from an e-Health perspective and the rest of the article suggests there are many more problems that that!
Time for a bureaucratic and ministerial shake up I suspect!
David.

Tuesday, July 28, 2015

The SA Coroner Is Now Saying Snail Mail Is Really Not Good Enough. Secure Electronic Communication Is Becoming The Standard Of Care.

This appeared a little while ago.

Delayed hospital letter to GP led to patient death

20 July, 2015 Paul Smith
A leading cardiologist has been criticised for using 'snail mail' to inform a GP that he had prescribed warfarin to an elderly patient, with the letter arriving four days after the patient died.
Marjorie Aston suffered a fatal subdural haematoma when she fell and hit her head at her Adelaide home on 4 January 2013.
She had originally been prescribed warfarin for chronic atrial fibrillation two weeks earlier by Professor John Horowitz, (pictured) the director of cardiology at the Queen Elizabeth Hospital.
Professor Horowitz told the 86-year-old that she would need monitoring and should make an appointment to see her GP, Dr Fong Liew.
After the consultation, Professor Horowitz dictated a letter to the GP informing him that he had "arbitrarily” started Mrs Aston on a daily dose of 5mg of warfarin.
The letter also made it clear that she would need monitoring “until the dose is right”, the implication being that Dr Liew should take on the responsibility for the job.
However, although Dr Liew’s practice and the hospital was “separated by a carpark” — a distance of about 100m — the letter took two weeks to arrive, by which time Mrs Aston had already died.
In a inquest that concluded last week, the SA Coroners Court was told that although Professor Horowitz had referred Mrs Aston for an urgent INR test following his consultation —  a test that was carried out — he had made no provision for Dr Liew to be copied in on the results. 
Professor Horowitz told the court that it was common practice for a specialist such as himself to communicate with a GP by sending a letter by ordinary post.
However, deputy state coroner Anthony Schapel was dismissive. 
…..
 “Consideration should be given to the issue as to whether the general practitioner, on the advice of the specialist, should both initiate and manage the patient’s warfarin therapy,” he wrote in his findings.
The coroner added: “[Where] the specialist initiates warfarin therapy but does not intend to manage that therapy, the specialist should immediately advise the patient’s general practitioner, by the most efficient method of communication available, that warfarin therapy has been initiated and that the general practitioner is expected to manage that therapy.
“In this regard, the practice of communicating with general practitioners by way of ordinary post should be curtailed and be replaced by a means of communication that would include email and/or facsimile transmission.” 
More information: 
The full article is here:
The Coroner is right about a move to e-mail - but it would have been much better had he suggested a compulsory move to secure clinical messaging - rather than the now virtually obsolete facsimile or insecure e-mail. A little more specificity would have been very good indeed!
He also should have been suggesting that the time has well and truly come for specialists to adopt secure messaging!
David.

Monday, July 27, 2015

Weekly Australian Health IT Links – 27th July, 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 interesting week with a vast amount of peripheral noise and nothing heard from the Government / PCEHR team - hence it is business as usual from the Bureaucrats!
Enjoy the links!
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CeHA submission on PCEHR & HI discussion paper

Jul 242015
The 2013 Royle Review into the PCEHR resulted in 38 recommendations. Several years and one Health Minister later, some of those recommendations are finally being pursued by the Australian Department of Health. The Consumers e-Health Alliance submitted comments on the Department of Health’s Electronic Health Records and Healthcare Identifiers: Legislation Discussion Paper released in late May 2015.
CeHA’s submission can be found here.
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Link between electronic records and accreditation in focus

By Natasha Egan on July 20, 2015 in Technology Review
An electronic health records system is a strong indicator of whether an aged care facility will pass or fail accreditation, according to research to be presented at an upcoming national e-health conference.
University of Wollongong PhD student Tao Jiang said the study found that facilities not using electronic health records (EHRs) had a very high risk of failing aged care accreditation.
The study, which began in 2013, is looking at the relationship between using EHRs in residential aged care facilities and meeting the accreditation standards for client safety.
The first phase analysed the data from 2,754 residential aged care reports based on accreditation agency audits between 2 January and 3 December, 2013.
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iSperm turns your iPad into a home fertility test for men

Date July 20, 2015

Michael Gold

Call home, check your email, count your sperm: Taiwanese start-up Aidmics is hoping to cash in on the $US40 billion global human fertility market with an iPad-compatible gadget it calls iSperm.
Aidmics initially developed the product to help livestock farmers, but founder Agean Lin now plans to seek US Food and Drug Administration approval next year to expand its use to men.
"In the US, one out of every six couples has trouble conceiving," Lin, 35, told Reuters.
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Telstra invites AMA to tour telehealth site

20 July, 2015 Serkan Ozturk
Telstra has invited the AMA to tour its controversial GP hotline facility following claims the company is setting up in competition with GPs.
The 24/7 service, known as ReadyCare, allows patients to consult a GP on a video or telephone call for a fee of $69 plus GST.
There are concerns that doctors staffing the service will initiate scripts to patients following just one phone call.
But ReadyCare’s chief medical officer Dr Amandeep Hansra says Telstra is aware of the AMA’s opposition to the new service, which it believes is misplaced. 
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More costs ahead for new RAH but not all beds will initially operate

THE new Royal Adelaide Hospital faces further cost blowouts, won’t have all the services of the existing RAH as promised and will open months late with about half its beds operating and a half-baked EPAS IT system.
State Parliament’s Budget Estimates health committee was told the $2.1 billion hospital faces extra costs including:
- $30 MILLION in claims lodged by the building consortium for removal of unforeseen contaminated soil, on top of a $1 million claim already settled;
- AN expected claim for time spent removing the excess soil;
- ‘MINOR’ modifications to the building plan.
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On the road with an eHealth trainer

Created on Monday, 20 July 2015
According to Katrina Otto, one of Australia’s leading medical software trainers, doctors have been asking for more hands-on instruction with eHealth this year prompted by growing patient demand and a desire for better practice management.
“It may not be easy for a lot of practices, but we’re not going to go back to paper files; we need to accept eHealth is the future.” says Katrina. Ms Otto has been working directly with hundreds of general practices and specialist practices in the past 26 years.
“I personally would like to see us aim for continual improvement and the one thing I know for sure is what we do now in our paper-filled practices, chasing patient information all day every day, could be so much more efficient,” she said.
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eHealth support for aged care

By Natasha Egan on July 20, 2015 in Technology Review
An automated application tool is now available to assist aged care providers register for eHealth functions as part of a new managed service offered online by the National E-Health Transition Authority (NEHTA).
The eHealth Online Forms tool allows healthcare organisations to submit applications for the personally controlled e-health record (PCEHR) system, a unique healthcare provider number and a digital authentication certificate, all of which are required to access the national eHealth record system.
The joint initiative between NEHTA, the Department of Human Services and the Department of Health also provides customer support, tips and advice via telephone, email and the website.
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Ethics and law

Records access and management on closure of a medical practice

David J Carter
Med J Aust 2015; 203 (2): 109-110.
doi: 10.5694/mja15.00258
Summary
  • Despite uneven regulation, health practitioners registered with the Australian Health Practitioner Regulation Agency have immediate and continuing obligations to patients when contemplating practice closure.
  • Recent enforcement actions by regulators highlight the importance of knowledge and compliance with requirements relating to record management.
In July 2014, a Melbourne general practice made headlines when the Australian Privacy Commissioner found that it had breached the Privacy Act 1988 (Cwlth) by failing to properly secure patient medical records.1 The practice had relocated, leaving its records behind in a garden shed; when a thief broke in, the records became accessible to the public. The case raises the question of how patient medical records should be stored and transferred at the time of a practice closure or other change in operations, such as physical relocation or retirement of a practitioner. Significant changes to practice operations occur frequently in Australia due to corporatisation, relocation or retirement. This article outlines the legal and regulatory requirements that govern how patient records are to be managed in such circumstances.
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Practice closure caution

Charlotte Mitchell
Monday, 20 July, 2015
AWARENESS and careful planning are key to avoiding legal trouble over medical records when a practice closes, according to legal and management experts.
An “Ethics and law” article in the MJA outlines enforceable regulatory requirements governing the management of medical records for doctors when they close their practice. (1)
David Carter, lecturer in health services management at the University of Technology Sydney, wrote that in the ACT, NSW and Victoria there were specific laws regarding records management, while in other jurisdictions, privacy and information management laws affected records.
The Medical Board of Australia code of conduct also advised careful health information management at all times, particularly at practice closure.
Mr Carter said that despite the overlapping and complex nature of legal and professional requirements, health practitioners had immediate and continuing obligations to their patients’ care when closing a practice.
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On-demand doctor apps on trial

  • AAP
  • July 23, 2015 9:30AM
IT was 8 o'clock on a weeknight and Brooklyn resident Sarah Sheehan was reeling from a painful earache.
SHE wouldn't be able to see her doctor until the next morning, and that would require a 45-minute subway ride uptown.
That's when Sheehan, co-founder of an education technology business, remembered receiving a promotional code for a new company called Pager, an Uber-like service that sends doctors to patients' homes.
Pager and similar companies like Heal and Medicast aim to streamline medical care - cutting out waiting rooms, receptionists and trips to the doctor's office.
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myGov portal broadens its reach

Friday, July 24, 2015 - 10:01
The push is on to drive interactions between Australians and the Commonwealth Government online, and at the heart of this transformation is the two year old myGov portal managed by the Department of Human Services.
CIO Gary Sterrenberg is overseeing a rapid expansion of the services and functionality offered via MyGov, which now provides access to services such as welfare payments, medical rebates and e-health records, disability support, child support and veterans affairs. The Australian Tax Office also adopted the service, further boosting take-up and extending the range of online options on offer.
As at 31 March 2015, there were 6.5 million active myGov accounts and an average of 15,000 new accounts are created each day.  According to the department 30% of the population aged 16 and over have established MyGov accounts. Although it does not anticipate the entire population signing on and expects participation will top out at around 10 million users or less than 50% of the total population. Earlier this year, DHS added optional two-factor authentication to the service, allowing consumers to elect to provide their mobile phone number in order to have an SMS sent to them containing a one-off security code that must be entered into the site before access is granted.
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BlackBerry shows how a terrorist hacker could deliver lethal dose

Chris Griffith

A hacking demonstration has shown how a terrorist could access an infusion pump inside a hospital and deliver a patient a lethal morphine dose.
Conducted by BlackBerry in New York City, the would-be terrorist in the demonstration gained access to the wirelessly connected pump, a standard hospital item, hacked its password and issued remote commands on a computer to alter how it dispensed morphine.
The demonstration took place during a global security forum hosted by the Canadian firm which is rebranding itself as a major provider of security for all kinds of equipment that connects to the internet.
The business of making handsets is no-longer central to BlackBerry’s mantra, with chief executive John Chen demanding that smartphone production occur only where it is profitable.
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Delayed hospital letter to GP led to patient death

20 July, 2015 Paul Smith
A leading cardiologist has been criticised for using 'snail mail' to inform a GP that he had prescribed warfarin to an elderly patient, with the letter arriving four days after the patient died.
Marjorie Aston suffered a fatal subdural haematoma when she fell and hit her head at her Adelaide home on 4 January 2013.
She had originally been prescribed warfarin for chronic atrial fibrillation two weeks earlier by Professor John Horowitz, (pictured) the director of cardiology at the Queen Elizabeth Hospital.
Professor Horowitz told the 86-year-old that she would need monitoring and should make an appointment to see her GP, Dr Fong Liew.
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Health | Fri Jul 24, 2015 6:03pm EDT
Related: Health

Online symptom-checkers are often wrong

By Lisa Rapaport
(Reuters Health) - Online symptom checkers often misdiagnose patients’ problems, often encouraging people to seek care for minor issues that don’t need immediate attention and other times incorrectly telling people with true emergencies that treatment can wait, a U.K. study suggests.
Researchers tested 23 online and mobile apps used by millions of people who are trying to find out if their symptoms are serious and what might make them feel better. The apps were imperfect at best, offering the correct diagnosis on the first try only about a third of the time.
For triage - assessing the urgency of the problem - the apps were too cautious in situations requiring only self-care: only 33 percent of the time, on average, were patients appropriately advised not to go to the doctor.
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Dept of Health hands over IT services to Datacom

Datacom takes over IT services as part of 'outcomes-as-a-service' contract
The federal Department of Health has handed over all IT support services to Datacom as part of a $242 million 'outcomes-as-a-service contract'.
The five-year ICT infrastructure and support services deal with Datacom was awarded in March this year. The department approached the market in May last year with the view of signing a non-traditional IT outsourcing contract.
The department's ICT services contracts with IBM Australia and Accenture expired at the end of June 2014.
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Google to tackle patent trolls with free patents for start-ups

David Swan

Tech giant Google has long led a tirade against patent trolls, and now it’s escalating the war by giving eligible start-ups two free patents.
Google said today it will give start-ups two patents for free, which they can keep, as long as they join the LOT network, a cross-company effort including firms like Dropbox, SAP and Canon, to fight patent trolls.
As first reported by TechCrunch Google has opened the program only to the first 50 eligible start-ups, while eligibility requirements include that a company’s 2014 revenue has to be between $US500,000 and $US20 million.
Once the company has applied Google will then send it a list of three to five families of patents, of which they can select two.
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Microsoft's rolling Windows 10 launch: What's coming next

The slow and staggered launch of Windows 10 starts July 29, and will accelerate in the next few months with new devices and business features.
By Mary Jo Foley for All About Microsoft | July 24, 2015 -- 15:51 GMT (01:51 AEST) | Topic: Windows 10
Windows 10's July 29 "launch" next week is not a typical one for Microsoft. It's just the start of a slow and staggered rollout for the company's newest operating system.
Next week marks the start of availability of Windows 10 for PCs and tablets. Later in calendar 2015, as Microsoft officials said earlier this year, Microsoft will deliver Windows 10 Mobile for ARM- and Intel-based Windows Phones and new small ARM- and Intel-based tablets. Windows 10-based Surface Hub conferencing systems, HoloLens glasses and various IoT devices will happen starting later this year and beyond.
On Microsoft's earnings call earlier this week, Microsoft CEO Satya Nadella provided a rough timeline as to what Microsoft watchers should expect over the next few months, in response to a Wall Street analyst's question about the trajectory.
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Enjoy!
David.

Sunday, July 26, 2015

The Consumers eHealth Alliance (CeHA) Has Real Problems With The Order Things Are Being Done With The PCEHR.

The CeHA released their submission on the planned PCEHR and IHI legislation a day or so ago.
Here is the note on their web site.

CeHA submission on PCEHR & HI discussion paper

Jul 242015
The 2013 Royle Review into the PCEHR resulted in 38 recommendations. Several years and one Health Minister later, some of those recommendations are finally being pursued by the Australian Department of Health. The Consumers e-Health Alliance submitted comments on the Department of Health’s Electronic Health Records and Healthcare Identifiers: Legislation Discussion Paper released in late May 2015.
CeHA’s submission can be found here.
Here is the link:
They make some interesting points.
First they are not keen on having the Department and NEHTA planning the future rather than the new e-Health governance  entity - the ACeH taking the lead and responsibility - pointing out the old group have not got far in a decade or so.
As they say
“The Consumers eHealth Alliance considers it premature for the Australian Government to contemplate legislative changes and pilots to test an opt-out national electronic health record-sharing system.
Instead, the priority should be consultation on the formation, composition and operational aspects of the proposed Australian Commission on eHealth, as this new entity should rightfully be tasked with decision-making on future PCEHR/My Health Record (MyHR) developments.
We believe the Department should engage in very broad community consultation with stakeholders, with a view to identifying people with the necessary expertise and bringing them together as a foundation body. We do not believe the Department should try to pick participants, as this approach has failed to date as is evidenced in various related reports.”
Their concluding remarks are also quite clear and pointed.
CONCLUSION
The Real Issue:- Why is eHealth so Hard ?
This question has often been raised. The answer has long been known - but continues to be avoided !
WE suggest that the key factor has been lack of governance appropriate to the task.
The nature of the required governance was clearly spelt out in the principal recommendation in the Health Online final report to Parliament in 2001.
This report and most others since have recommended the involvement of all key stakeholders in a collaborative Governance/Management structure from day one. This would bring their operating needs to immediate attention and could be promptly reconciled within a teamwork environment.
The allied aim would be to avoid a repeat of a silo mentality that so often arises when the various interest groups are kept apart rather than developing a dedicated teamwork spirit actively engaging within an integrated framework.
The Department of Health and NEHTA have been struggling for almost 11 years now, yet have produced few practical results for the cost to date.
A string of consultants' reports have found issues and concerns, and scant evidence of worthwhile implementations and outcomes despite more than $1 billion in spending.
The Royle and Deloitte consultations have confirmed this, and in their reports they recommend significant changes in governance.
We should not carry on for an extended period without speedily acting on their advice, which involves creating a teamwork structure involving all key stakeholders.
----- End Conclusion.
All in all a useful contribution that makes some very powerful points. Well worth a download and read.
My only point of difference would be is that I think you need excellent leadership as well as dramatically improved governance.
David.

AusHealthIT Poll Number 280 – Results – 26th July, 2015.

Here are the results of the poll.

Do You Believe There Has Been A Proper Assessment Of The Risks To Patient Privacy Associated With The Change In The PCEHR To Opt-Out?

Yes 4% (7)

Maybe 2% (3)

Neutral 18% (32)

Probably Not 46% (83)

No 30% (54)

I Have No Idea 1% (1)

Total votes: 180

Looks like another fail to me. It seems most do not believe proper assessment has been done.

Good to see such a great number of responses!

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

David.