Quote Of The Year

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

or

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

Saturday, October 24, 2015

Weekly Overseas Health IT Links -24th October, 2015.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
-----

IBM Says Watson Poised to Make Medical Breakthroughs

OCT 16, 2015 7:53am ET
The crush of Big Data in healthcare is creating information overload challenges that can only be solved by the cognitive computing capabilities of IBM’s Watson supercomputer, one of the company's executives contends.
By quickly identifying patterns and insights from the tsunami of data, Watson is designed to find the proverbial needle in a haystack that will lead to medical breakthroughs and better patient care.
So says Mike Svinte, vice president of global client engagement for IBM Watson Health, a business unit launched in April to help physicians, researchers, insurers and patients leverage big data, analytics and mobile technology to achieve better outcomes.
“Each one of us in this room will generate the equivalent of 300 million books of data—the challenge is how do we take advantage of that data,” said Svinte on Thursday during a keynote session at the MedTech 2015 conference in Buffalo, N.Y. “A vast amount of untapped data could have a great impact on our health yet it exists outside medical systems.”
-----

CIOs share meaningful use concerns at CHIME

Posted on Oct 16, 2015
By Bernie Monegain, Editor-at-Large
To say the final rule on Stage 2 of meaningful use and, the accompanying Stage 3 requirements work for CIOs who have to help implement them at their hospitals and health systems, would be a stretch.
Two separate sessions at the CHIME15 Annual Forum on Thursday indicated there remained ambiguity, anticipated difficulties and a short window for attesting to having met the measures.
Liz Johnson, RN, CIO of acute care hospitals and applied clinical informatics at Tenet Healthcare, and Pam McNutt, senior vice president and CIO at Methodist Health System teamed up Thursday morning to highlight some of the potential pitfalls to avoid.
"You guys really care about meaningful use to be here at 7 a.m.," Johnson remarked. "We feel your pain, and we'll try to share with you our insights."
-----

Global health IT market to reach $104B+ by 2020: 7 key trends

Written by Anuja Vaidya | October 15, 2015
The global healthcare IT market is set for rapid growth in the near future, according to a new report by Grand View Research.
Here are seven key trends:
1. The market is expected to reach value of $104.5 billion by 2020.
2. Increasing demand for enhanced healthcare facilities and introduction of technologically advanced systems are expected to boost market growth.
3. Electronic health records are expected to reach up to $26.72 billion in 2020.
-----

Seizures and Mosquitoes: The Rewards of Working Smarter With Data Science

by Ray Guzman Friday, October 16, 2015
Big Data has been defined as the oil of the 21st century. Just as crude oil must be refined into gasoline to power our cars, the large, complex data sets big data comprise aren't much use until they're honed into actionable insights. Data science deploys a range of tools --- from crowdsourcing to visualization -- to capitalize on the promise of big data.
Until recently, the U.S. health care system has been less than immersed in the big data revolution. What drives most providers are issues of compliance or the avoidance of financial penalties, such as those associated with readmission.
But the landscape is changing. Instead of looking at a population of diabetics and asking retrospective questions, such as "What percentage required hospitalization? For how long?," big data can help answer specific questions around a given population, diagnosis or risk factor. This intelligence is the fuel that providers need to produce the most effective, personalized intervention.
-----

HIT Vendors Seek Clarification of Info Blocking

OCT 15, 2015 7:55am ET
With much fanfare, the Office of the National Coordinator for Health Information Technology in April sent a report to Congress on the problem of electronic health information blocking.
Now, the HIMSS Electronic Health Record Association is taking ONC to task for its definition of information blocking.
“We believe that information blocking definitely needs to be addressed where it occurs if it’s intentional and unreasonable, based on the current ONC definition,” says Sarah Corley, M.D., EHRA vice chair and chief medical officer for NextGen Healthcare. “Where we need clarity is more examples of what is information blocking, because the devil is in the details.”
-----

Behavioral health data 'burdens EHRs'

Posted on Oct 15, 2015
By Mike Miliard, Editor
We've heard often lately that for population health to truly live up to its promise, behavioral health data will need to be much better integrated into the care process. But in their current state, at least, EHRs still might not be the best tools to help.
A recent study led by University of Colorado researchers and published in the Journal of the American Board of Family Medicine suggests that integration of behavioral health and primary care is still somewhat problematic thanks to EHR limitations.
"Almost half the U.S. population will meet the criteria for a mental health disorder during their lifetime," researchers write in the report, Electronic Health Record Challenges, Workarounds, and Solutions Observed in Practices Integrating Behavioral Health and Primary Care. "However, less than two thirds of these individuals will receive treatment. The prevalence and need for treatment of behavioral health disorders, which affect a broad percentage of the population, makes the case for integrated care."
-----

NHS e-Referral Service fails to report

Rebecca McBeth
12 October 2015
The NHS e-Referral Service is not producing any reports for users nearly four months after go-live.
Users of the electronic booking service were told that reports would not initially be available for the go-live of the new service in June of this year, but that they would be up and running in August.
However, the Health and Social Care Information Centre says it has been focusing on ensuring the service is running effectively and is, “now progressing towards making reports and extracts available”.
The information centre could not provide a date for the reporting function to start working again, but said it will, “provide an update on timings in the near future”.
-----

Patient data: not sharing a 'breach'

Thomas Meek
14 October 2015
GPs could be investigated for failing to share patient data when there is a duty to do so, according to the Information Commissioner’s Office.
Speaking at the recent Healthcare Efficiency Through Technology event in London, Dawn Monaghan, group manager for public services at the ICO, said that any GP who steadfastly refuses to share data with other health and care professionals at the point of care could be in breach of the Data Protection Act.
“What we would do actually is hold GPs to account if they were absolutely, categorically not sharing any data whatsoever when there should be times they are sharing,” she said.
“If that is the case, that might be considered unfair and a breach of principle one [of the Data Protection Act] depending on the circumstance. If that was brought to us as a complaint we would look at it.”
-----

NHS 24 IT system £41m over budget

Thomas Meek
14 October 2015
A project to implement a new IT system at Scotland’s NHS 24 is now £41.6 million over budget and more than two years behind schedule, according to a report by the Auditor General for Scotland.
The cost of upgrading NHS 24’s core telephone and online technology as part of a 'Future Programme' is now estimated at £117.4 million, more than 55% higher than the original estimate of £75.8 million.
The inflated cost is primarily due to delays in implementing the new system at NHS 24, which provides online and telephone-based health information and advice to the public in Scotland.
The new technologies were meant to be rolled out in June 2013, but a series of failures has meant implementation has been pushed back until the end of this month.
-----

Theranos disputes former employees' claims about test inaccuracy

October 15, 2015 | By Katie Dvorak
Health startup Theranos Inc. has made a name for itself in the industry by offering lab tests that require just a few drops of blood, but four former employees have claimed that this highly touted technology is used for just a small portion of the company's tests, the Wall Street Journal reported.
According to the former employees of the California-based company, who remain unnamed, the technology was used for only 15 out of more than 240 types of tests in 2014.
Further, the four were unsure of the accuracy of the Edison machine, which is used to test the blood samples, they told WSJ. In particular, one employee complaint to regulators alleged that Theranos failed to disclose the results of a report that cast doubt on the accuracy of its system.
-----

Healthcare providers falling short with identity access management

Posted on Oct 14, 2015
By Erin McCann, Managing Editor
When it comes to identity access management, most hospitals and healthcare providers are doing it all wrong.
At least that's according to a new report, conducted by security software provider IS Decisions, which found that despite HIPAA security rule which requires covered entities to implement technical policies around access management the lion's share of staff are struggling big time.
In fact, some 63 percent of them say they are able to log on to different devices and workstations at the same time. About half of them are required to log off manually, and about 30 percent do not have unique login credentials.
What's perhaps even more concerning is that a staggering 82 percent of healthcare staff say they have access to patient data, but just under a third of them actually don't have unique logins for the access.
-----

Doctors Lack Basic Knowledge about Their Patients, Survey Finds

OCT 14, 2015 7:49am ET
More than half of patients report that their medical history is missing or incomplete when they visit their doctor, and nearly half say their physician is not aware of what prescriptions they are taking.
Those are some of the results of a recent survey from health information network vendor Surescripts, which links providers to pharmacies. Other findings: 61 percent of those surveyed indicate their doctor does not know their allergies, 44 percent of physicians are unaware of hospitalizations or visits with other doctors, and 40 percent do not know about recent surgeries.
“This is a particular problem for patients with multiple illnesses and multiple physicians,” says Paul Uhrig, chief privacy officer for Surescripts. “What we’re talking about are fundamental gaps in doctors’ knowledge of people’s medical histories.”
-----

Jeb Bush health plan would 'reboot' Meaningful Use

October 14, 2015 | By Dan Bowman
Republican presidential candidate Jeb Bush, in unveiling his plan to reform the current healthcare system, said the electronic health record incentive program needs a "reboot," during a speech delivered Tuesday in New Hampshire.
President Barack Obama, through the Health Information Technology for Economic and Clinical Health (HITECH) Act and the Meaningful Use program, had a "golden opportunity" to make medical recordkeeping more efficient, shareable and secure, according to the former Florida governor. Instead, he said, more complexity has been created.
"The simple fact is that the information technology funding through the stimulus was not focused on creating a shared platform from all of us to benefit," Bush said.
-----

NIST: Patient safety risks stem from poorly designed EHRs

Jeff Rowe
Oct 13, 2015
Less than optimal design of EHRs doesn’t just make them harder to use.  It can make them dangerous.
So argues a recent paper from the National Institute of Standards and Technology (NIST), which was developed in order to provide an "empirical rationale" for standardized patient safety-focused usability guidelines. In order to capture a broad range of user expectations, knowledge and outcomes concerning EHRs, researchers used five different methods of empirical human performance data collection, including online surveys, on-site observations, follow-up interviews with users, usability testing of five different EHRs and expert reviews of those same EHRs.
According to the paper, “human factors guidelines for standardization . . . are provided to improve the safety-related usability of EHRs” in three different risk areas:
1) Consistently displaying information critical to patient identification in a reserved area to avoid “wrong patient” errors;
2) Providing cues to reduce the risk of entering information and writing orders in the wrong patient’s chart; and
3) Supporting efficient and easy identification of inaccurate, outdated or inappropriate items in lists of grouped information by having information presented clearly and in a well-organized manner.
-----

Deloitte: Consumers using more healthcare technology

Posted on Oct 13, 2015
By Bernie Monegain, Editor-at-Large
Americans are increasing their use of technology to improve their health, navigate the health system and flex their shopping muscles, according to a new report from The Deloitte Center for Health Solutions.
The report, "Health Care Consumer Engagement: No One-Size-Fits-All Approach," found that 22 percent of respondents used technology to access, store and transmit health records in the last year, up from 13 percent in 2013. Use was higher for those with major chronic conditions: 32 percent compared to 19 percent in 2013.
The study also shows that 16 percent of respondents who needed care went online for cost information, up from 11 percent in 2013. Millennials in this group increased the most, 27 versus 17 percent. Further, 71 percent of all those surveyed said they have not gone online for cost information but are "very" or "somewhat" likely to use a pricing tool in the future. 
-----

Why HIE design must focus on doctors' needs

October 13, 2015 | By Susan D. Hall
Health information exchanges hold the potential to improve clinical data sharing, yet many overlook an essential early step--understanding how clinicians use the information they're requesting.
A study published at BMC Medical Informatics & Decision Making highlights how a user needs assessment can help doctors make better use of information from outside sources.
The researchers found that 13.7 percent of hospitalizations generate at least one request for outside information, which takes, on average, 18 hours to receive. This information was coming by fax, which then was scanned into the electronic medical record, but also could be available on paper.
-----

5 ways hospitals can beat the 'weekend effect' in surgical outcomes

October 9, 2015 | By David Ferguson
Hospitals can take five actions to fight the higher rate of complications, mortalities and readmissions for surgical patients who undergo emergency procedures on the weekend, also known as the "weekend effect," according to a Loyola University Medical Center and Loyola University Chicago study.
That study found that "(t)he chance of death was 8 percent higher in 11 hospitals in England, 13 percent greater in five hospitals in the United States and 20 percent more likely in six Dutch hospitals."
-----

Health 2.0 Confronts Entrenched Health Challenges

by Rebecca Vesely, iHealthBeat Contributing Reporter Tuesday, October 13, 2015
What are the most difficult health problems facing communities today? Many speakers at the 9th annual Health 2.0 conference in Santa Clara last week pointed to the basics: safe streets, clean air and water, secure housing, nutritious food, companionship and access to primary care.
All affect health outcomes. And as providers increasingly are held accountable for the total health of their patients, new approaches,  including "population heath management" technology, are playing a bigger role.
While many said technology can be helpful to improve lives, some remain skeptical that digital innovators are aligned with patient and provider needs.
In a keynote address at the conference, U.S. Surgeon General Vivek Murthy said that in his travels around the country he hears "a sense of disempowerment that is deeply disturbing to me." Technology has the potential to help create a culture of prevention by giving people the tools to help them regain that lost power over their lives, he said.
-----

NIST issues EHR guide to improve usability, patient safety

Posted on Oct 12, 2015
By Mike Miliard, Editor
Bad EHR design can lead to data entry errors and risky workarounds that could jeopardize patient safety, according to a new document from NIST, which outlines ways to spot critical areas of risk and methods for improving user-centered design.
Aiming to provide an "empirical rationale" to drive standardized patient safety-focused usability guidelines, the NIST report takes aim at so-called "never events," working proactively to mitigate root causes of electronic health record use errors caused by suboptimal design and implementation.
"The ultimate goal is to drive and empower effective and safe human performance in the use of EHRs," officials write.
Researchers looked at five methods of human performance data collection, drawn from "different disciplines, backgrounds and perspectives." Multiple forms of data were gathered from these varying user types, enabing a more comprehensive look at the many ways EHRs are used.
-----

Researchers: IOM recommendations could have altered course of Texas Ebola case

October 12, 2015 | By Susan D. Hall
In a call to action on the Institute of Medicine report "Improving Diagnosis in Health Care," authors of a new Health Affairs Blog post outline how its recommendations could have changed things when a patient with Ebola came into a Texas emergency department.
The authors--Dean Sittig, a professor in the School of Biomedical Informatics at the University of Texas, Health Sciences Center at Houston, and Hardeep Singh, chief of the health policy, quality and informatics program at the VA Health Services Research Center for Innovations--say that EHR design and competing demands, such as meeting quality measures, can make nurses more focused on flu shot status than on travel history. And vital information captured in nurses' templates often never makes it onto doctors' radar.
When Thomas Eric Duncan initially came into the Dallas ED, a triage nurse recorded his vital signs and travel history to West Africa using standard EHR-based nursing documentation templates. However, the ED physician did not see these notes. Duncan was prescribed antibiotics, told to take Tylenol and sent home. He later returned to the hospital and died of Ebola last October.
-----

Enjoy!
David.

Friday, October 23, 2015

The RACGP Has More To Say On The Failure Of The Present Management Of E-Health. Not Happy Jan!

This appeared late last week:

RACGP disappointed with ACeH committee structure

16 October 2015
The newly established Australian Commission for e-Health (ACeH) Implementation Taskforce Steering Committee must include medical organisation representation, not just individual appointments, if it is to succeed.
The Royal Australian College of General Practitioners (RACGP) President Dr Frank R Jones said it was disappointing the committee, which will oversee the My Health Record system, did not include RACGP representation or any representative group.
“Appointments to the ACeH Implementation Taskforce Steering Committee should have been an inclusive process featuring stakeholder representative groups, not just individuals,” Dr Jones said.
“As the peak representative body for 31,500 GPs working in or towards a career in general practice with a history of being at the forefront of innovation, standards and education in the health sector, it is unacceptable that we and others have been excluded from the taskforce.
“This is regrettable. We have always stated we wish to work in collaboration with government.
“I do acknowledge there are clinician representatives on the committee, however they have been appointed in a personal professional capacity and not as a representative voice.”
The RACGP has been an advocate for a national shared electronic health record system, recently welcoming the commitment made by the Government in its 2015-16 budget to strengthen the national e-Health system.
Dr Jones said there were significant problems with the design and functionality of current My Health Record (previously known as the personally controlled electronic health record, or PCEHR), that required meaningful engagement between the Federal Government and general practice if it were to be a success and drive adoption amongst GPs, who will be the main users of the system.
The full release is here
Like the AMA, the RACGP has continued to be polite and tolerant of all the obvious missteps.
Surely the time to amp up the pressure has arrived - even if it is in private. However, results are needed soon or the mess will get worse I believe and we really could do without that!
David.

Thursday, October 22, 2015

The Macro View - General And Health News Relevant To E-Health And Health In General.

October 22 Edition
Well this is the week when we see the Government back in Parliament again and trying to keep up the positive momentum the new PM while the Opposition tries to re-set its approach to become seriously competitive again. The Opposition has gone mad on the ‘rich dude’ while the Government is watching what is going on at the Union Royal Commission.
Elsewhere we have all sorts of changes emerging with the funding of railways and so on - as opposed to the previous administration. Just how real any innovation agenda we will have to wait and see about.
As always politics and policy inevitably get mixed up in all this so a wide range of views get canvassed.
-----
Here is some other of the recent other news and analysis.

The Political Scene.

Half-truths obscure the debate over superannuation tax breaks

Date October 14, 2015 - 12:00AM

John Daley and Brendan Coates

Most of those who benefit from super tax breaks are high-income earners, not those in the so-called "middle".
The superannuation debate is plagued by myths. This month, the super industry lobby group the Australian Superannuation Fund Association issued a report to bust these myths and defend the existing tax breaks for superannuation. Unfortunately, the report replaces many of the myths with half-truths – which can be even more dangerous.
The most blatant half-truth is the ASFA's claim that three-quarters of the benefits of superannuation tax breaks go to middle-income earners. The ASFA defines middle-income earners as those earning between $37,000 and $180,000 a year. That enormous spread includes those just outside the top 3 per cent. Those people who earn more than 19 in 20 Australians may be surprised to find themselves described as "middle-income earners".
And then the ASFA glosses over the bottom 40 per cent of income earners, with incomes less than $37,000, who benefit very little from super tax breaks.
A more sensible definition of "middle-income" would start with those who are actually in the middle. In 2012-13, the median taxable income in Australia was $41,561. If we include, say, the 30 per cent of taxpayers on either side of this figure, the share of super tax breaks going to "middle-income" earners drops to less than half – nowhere near the three-quarters claimed by the ASFA.
-----

Turnbull, Shorten and aides to tackle policy challenges

David Uren

Malcolm Turnbull has promised new economic leadership but confronts the same old problems that bedevilled his predecessor: a budget in need of repair, an inefficient tax system, poor productivity and a fractious federation.
The Senate, which cruelled the aspirations of the Abbott government, remains as obstructive as ever. Labor, the Greens and assorted independents show no sign of shifting from their insistence that none but the wealthy may be left worse off by new legislation.
There has been an immediate shift in rhetoric with the new leadership. Turnbull summons excitement in the potential for inno­vation and the transformation of our cities, while declaring the cabinet will be open to all ideas free of ideological preconceptions.
New ministers are learning their briefs, making their first tentative forays into their policy areas and establishing taskforces to tackle a variety of issues.
With an election due within 12 months, the new cabinet is under pressure to clarify its mission and provide some detail of the policies that will differentiate it from Labor and from the Abbott government.
-----

Turnbull government revives Harper review, Professor Harper welcomes the news

Date October 17, 2015 - 12:15AM

Gareth Hutchens

Australia's retail trading hours could be radically overhauled, and ride-share services such as Uber more readily welcomed into the country, after the Turnbull government said it will launch an "enthusiastic response" to the Harper review of Australia's competition laws.
It means the long-standing monopoly-power held by existing taxi services could be broken up, and traditional retail hours loosened dramatically, while road transport regulations could be significantly modernised.
It also means laws governing where pharmacies can be located will be reconsidered, as will aggressively competitive behaviour from big businesses looking to expand.
Treasurer Scott Morrison says the Harper review has the potential to unlock "enormous opportunities" for the economy and Australians can expect an enthusiastic response to it from the Turnbull government.
-----

General Budget Issues.

Australia’s future must come before playing politics around the Budget

  • TERRY McCRANN
  • Herald Sun
  • October 10, 2015 9:00PM
JOE Hockey’s first Budget was all blood, sweat and tears and broken promises — although not nearly as many as the media (and the opposition) hysteria suggested.
His second Budget earlier this year was almost the exact opposite. Hockey stressed “jobs, growth and opportunity”. The highlights were not the cuts or the tax hikes of 2014 but a $5.5 billion package for business and a $4.4 billion one for families.
Obviously, there now won’t be a third Hockey Budget. So what will the First (Scott) Morrison Budget look like?
The answer to that depends on whether we get it before or after the election. That timing might also determine whether it’s both the first and last Morrison Budget.
And that after that it would be back to a Wayne Swan big deficit future with the treasurer, Chris Bowen, in a Shorten (or Albanese? Or Plibersek?) Labor government.
-----

Scott Morrison is staring down the barrel of a future of deficits

David Uren

The debate between Scott Mor­rison and his opposite number Chris Bowen about whether the budget faces a spending problem, as the Treasurer asserts, or a revenue problem, as Labor prefers, brings to mind Mr Micawber’s ­famous advice to Charles Dickens’s David Copperfield: “Annual ­income twenty pounds, annual expenditure nineteen pounds nineteen and six, result happiness. Annual income twenty pounds, annual expenditure twenty pounds nought and six, result ­misery.”
It is the gap between the government’s spending (too high) and its revenue (too low) that is the problem. It has been intractably stuck at about $40 billion for four of the past five years.
Research presented by the International Monetary Fund to finance ministers and central bank governors last weekend undermines the key assumption on which Treasury’s forecast of a return to budget surplus by 2019-20 is based.
The IMF has been troubled over the failure of world growth to meet its forecasts. Every time the fund has looked at world growth in the past five years, it has had to downgrade its forecasts. If the world economy had grown in line with the forecasts it made five years ago, the economies of the advanced world would be 14 per cent bigger than they are while those of the developing and emerging world would be 23 per cent bigger. But the forecasts of employment the fund makes for advanced countries have been much closer to the mark. Indeed, for a range of countries, including Germany, Japan, South Korea and Britain, employment growth has been better than the IMF predicted, although output growth has been worse. More workers are producing less output than was expected.
-----

Fact check: Do eight out of 10 taxpayers pay for Australia's social services bill?

October 14, 2015
Newly appointed Treasurer Scott Morrison has declared that Australia has a spending problem, not a revenue problem.
  • The claim: Treasurer Scott Morrison says that there are "eight in 10 income taxpayers required to go to work every day to pay for the $154 billion social services bill".
  • The verdict: In 2015, tax paid by fewer than the top five out of 10 income taxpayers is sufficient to fund Australia's social services bill. Furthermore, social services are paid from the consolidated revenue fund, which comprises all taxes raised by the Federal Government, with personal income tax providing just under half the total. Mr Morrison's claim is misleading.
Mr Morrison told ABC's 7.30 that while revenue as a proportion of GDP was within long-term averages, spending is at peak levels not seen since the Global Financial Crisis.
He illustrated the extent of Australia's spending problem by saying that most income taxpayers work every day to fund social services in Australia.
-----

The glaring hole in Scott Morrison’s plan

11:15pm, Oct 15, 2015
Rob Burgess  Economics commentator
ANALYSIS: Australian workers don’t just ‘work, save and invest’. They also ‘spend’ … or at least they used to.
All week, Treasurer Scott Morrison has been leaping to his feet in Question Time to tell Labor that “you can’t tax your way to surplus”, and that the choice at the next election is between steady or falling taxes with the Coalition or rising taxes with Labor.
On Wednesday, the “work, save and invest” Treasurer explained that his plan was to cut spending from 25.9 per cent of GDP this year, to 25.5 per cent next financial year and 25.3 per cent next year.
Low taxes and a slow reduction in spending will, so he says, eventually bring the federal budget back into balance and with luck allow the government to pay down the current debt – net federal debt is expected to peak next year at 18 per cent of GDP.
There is one big flaw this plan, however.
-----

Budget 2015-16: Revenue problem for Treasurer Scott Morrison as takings fall short

Date October 16, 2015 - 6:16PM

Peter Martin

Economics Editor, The Age

Weeks after Treasurer Scott Morrison declared his budget had "a spending problem, not a revenue problem", new finance department figures show revenue falling short.
The figures for the first two months of the financial year show revenue of only $61.113 billion in July and August, well short of the $63.336 billion expected when the budget was delivered in July.
Tax revenue is down $1.7 billion down on the budget forecast due to both slower than expected wage growth and weaker than expected dividend payments.
Superannuation tax receipts are about 20 per cent short of expectations and the resource tax has brought in less than half of what was expected due in part to the lower oil price.
-----

No longer a nation of home owners, now we're renting

Date October 17, 2015 - 5:20AM

Peter Martin

Economics Editor, The Age

Analysis
Once a nation of homeowners, we are becoming a nation of renters.
It's been two years since the latest update on housing occupancy and the one released on Friday show the proportion of households renting has edged up to 31.4 per cent. The proportion owning outright is only a point or two in front, at 32.5 per cent. Around 35 per cent of homes are mortgaged.
Back before the tax change that ignited negative gearing at the end of the 1990s around 40 per cent of households owned outright, and only 28 per cent rented.
It's the flipside of the boom in second properties that has made Australia a nation of landlords. The Bureau of Statistics says an extraordinary 1.5 million households now own properties they don't live in. Among high earners 39 per cent own a second, third or fourth property.
-----

Health Budget Issues.

NSW to push treasurers on GST increase to meet federal health cuts

Date October 15, 2015 - 6:31PM

Sean Nicholls

Sydney Morning Herald State Political Editor

NSW Treasurer Gladys Berejiklian will continue the push to increase the GST from 10 to 15 per cent to address a looming health funding gap at a meeting of her state and federal counterparts in Sydney on Friday.
The meeting with new federal Treasurer Scott Morrison is expected to cover implementing the abolition of the $1000 GST-free threshold for online purchases from overseas and establishment of a national register of foreign ownership of land titles.
Mr Morrison has also placed the recommendations of the Harper review of competition ­policy on the meeting agenda.
The review urged reforms across government sectors including health and education to which Mr Morrison has said he is keen to have the states and territories respond.
-----

Health funds lobby to lift fees

  • The Australian
  • October 17, 2015 12:00AM
Health fund members are set to be slugged with higher premiums, with insurers warning the federal government the private system is buckling under the pressure of rising costs and wasteful healthcare.
Despite regulators and Health Minister Sussan Ley ­acknowledging affordability is an issue, health funds are preparing to make ­applications in the coming weeks for premium ­increases that will flow through to members in April.
The managing director of Bupa’s health insurance business in Australia, Dwayne Crombie, yesterday said the erosion of the federal insurance rebate exacerbated any decision to pass on costs. Labor means-tested the ­rebate, reduced its scope and ­indexed it to inflation rather than the cost of premiums, prompting some members to ­reduce their level of cover or dump their policy completely ­because of the cost.
“The consumer is certainly looking a bit distressed,” Mr Crombie said. “We desperately need to figure out how we can slow down the rate of growth in the system, how we can make it more affordable and how the ­private system can complement the public system and still be sustainable.”
-----

Homeopathy Plus! director Fran Sheffield banned from promoting 'vaccines'

Date October 14, 2015

Amy Corderoy

Health Editor, Sydney Morning Herald

A homeopath who has repeatedly claimed to be able to prevent whooping cough with homeopathic "vaccines" has been banned from selling the products for five years and she and her business fined $138,000.
Central Coast homeopath Fran Sheffield is an advocate of alternative medicines who authorities have apparently been unable to prevent from making misleading claims about the benefits of homeopathy in contravention of federal medicines laws.
But the Australian Competition and Consumer Commission took Ms Sheffield to federal court, claiming she was misleading consumers with her business Homeopathy Plus! and its promotion of supposed whooping cough vaccines.
In December, the court found Homeopathy Plus! was making unreasonable and untrue claims that conventional whooping cough vaccines were ineffective, and homeopathic vaccines were a safe alternative.
-----
It has been an interesting time with the new Government settling in and all sorts of options now back on the table, including the Harper Competition Review - pharmacy might be worried. Health is also clearly under review as far as its budget is concerned. Lots to keep up with here! The next few weeks in Parliament will be telling as we run up to Christmas.
Enjoy.
David.

Wednesday, October 21, 2015

Notes From Community Affairs Committee - Senate Estimates of 21 October 2015 - Late Afternoon.

October 21, 6:12pm

Sen McDonald - Clearly a regulation clown.

Total idiot asking about e-cigarettes - total FW

A collection of e-health irrelevant people are wasting vast time on rubbish wrt. medical cannabis!!!!

How is that e-Health?

There are some grandstanders who just chatter away and waste time….

Move to e-Health @ 7:40pm after dinner

Madden , Fleming

Looks like some funding and scope changes in 17/18 after trials of various PCEHR Trials

Has been very long funding….2012-2017

Budget has been cut - matter for Department of Finance - not clear where the money went. Maybe the Medical Future Fund

Bowles does not know what is happening…no idea how much has been cut.

From July 2018 - No commitment - have funded the trials etc. up until June 2018.

Trials will decide what funding will happen. Funding depends on opt-out outcomes.

Advance Monies will be held by Dept. of Finance.

Matter for Government to make final decision.


Current Funding

For 2016 $26.5M

For 2017 $15.5M

Are now trialling both opt-in and opt-out!

PHNs are in as trial mediators etc. Who knows Metro or Remote.

Trials will be everywhere. Target to have evaluation by early 2017.

Human Rights Committee

Madden has noted what is going on and will provide submission.

Current records 2,442,824

1350 registrations per week in tax time - people using My Gov.

PCEHR signed up - 7090 organisations

PIP catches 75% of GP practices.

State data - on notice.

Hospitals - 452 Hosp. and Community centres - very little progress.

Crap chatting about ‘meaningful use’. Have no idea of concept.

Have 16 submissions on ePIP - will send paper to Govt next week.

Active use is looking at record and adding stuff.

Bureaucrat recognises GP is central and have not made much progress with them.

Bureaucrat is in denial that GPs might not press on with ePIP.

Madden understand GPs fundamental - ‘ really need to inspire GPs’

Thinks system is now usable for GPs - he is on another planet!!!

ACeH transition has been in operation for 6-8 weeks.

Looks like most of NEHTA will slip over to DOH and ACeH on basis on comments.

End about 8:10pm

Peter Fleming also answered a few questions

What was amazing was no talk of Strategy and how the 2 Labor Senators were desperate to convince all that the whole thing was wonderful. This thing now seems to have commitment from the utterly conned by DoH/NEHTA. Just awful!
-----

Again very disturbing nonsense. Sorry if anyone offended!

E & OE

David.

Now This Might Have The Effect Of Focussing The Mind Of Some GPs!

This appeared last week:

GPs face massive fines over PCEHR privacy breaches

| 16 October, 2015 |  
GPs and practice staff face jail and fines of up to $108,000 for misuse of the PCEHR system under controversial new laws being pushed through the Federal Parliament.
There have been long-running fears across the medical profession about the scale of civil sanctions for unauthorised use or disclosure of information on the controversial system which was launched three years ago.
But under the new regime the Federal Government is pushing to introduce, civil penalties will increase five-fold. 
Any health practitioner who “recklessly” flouts the system's privacy provisions will be fined up to $108,000 for each offence.
For so-called body corporates - such as a GP practices - a single breach will trigger civil fines of up to $540,000.
In a further tightening of the screw, the government plans for the first time to introduce criminal penalties of up two years in jail for privacy abuse of the PCEHR - although fines will be limited to $21,600 per offence.
The government argues the measures are necessary given the potential sensitivity of medical information held on the system.
But the Parliamentary Joint Committee on Human Rights says the fines are so high that the government is in danger of using civil law to impose “criminal” sanctions on those it prosecutes.
In a report released on Tuesday, the committee said proof of criminal offences had to be “beyond reasonable doubt”.
But under the government’s proposed regime, prosecutors would be imposing the sanctions based only on the “balance of probabilities” that wrong-doing had occurred.
This would breach article 14 of the International Covenant on Civil and Political Rights which mandates the right to a fair trial, the committee's report stated.
“The objective behind including civil penalties…substantially more than the penalty available under the criminal offence provision, without the usual protections available to those charged with a criminal offence...has not been explained [by the government],” the committee said.
The committee, chaired by former attorney general Philip Ruddock, also warns that using civil law provisions means the burden of proof can shift from prosecutors to defendants, undermining the presumption of innocence applied in criminal cases.
The AMA has said it is alarmed at the government’s move to protect privacy on the PCEHR system, claiming the sanctions are excessive.
More here:
I would suggest this is a very good reason to have nothing to do with the system unless it is much more useful and provides clear assurances that only deliberate actions can trigger penalties.
Yet again I would suggest this is another example of the out of touch bureaucrats in Canberra just going feral!
David.

Senate Estimates Covering E-Health Due After 4:30pm Today.

Here is the link to the Programme:

http://www.aph.gov.au/~/media/02%20Parliamentary%20Business/25%20Senate%20Estimates/supp1516/ca.pdf?la=en

Instructions on how to watch in the .pdf or use this link.

http://www.aph.gov.au/News_and_Events/Watch_Parliament

David.