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, November 28, 2015

Weekly Overseas Health IT Links -28th November, 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.
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Data Breaches: What and When to Disclose

NOV 20, 2015 2:37am ET
When a healthcare organization experiences a breach, there is so much to do, so many issues to consider. One is figuring out how much information to give the public and how quickly to give it.
Health insurer Anthem gave various estimates of the number of affected individuals following its massive hack as it tried to quickly get information out to the public and got some criticism for the changing numbers, but the company was still about 10-14 days away from being ready to start mailing notification letters when the hack was announced.
Other organizations have been criticized for not moving fast enough to go public. In many cases, local police or the FBI ask an organization to delay announcing a breach until their investigation is over, says Donna Wilson, chair of the privacy and data security practice at the law firm Manett, Phelps & Philips. “The intent is to capture bad guys and determine what they’ve done.” It can be a no-win scenario, she adds.
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Medtronic enables pacemaker monitoring by smartphone

Posted on Nov 20, 2015
By Mike Miliard, Editor
The new MyCareLink Smart Monitor from Medtronic, just approved by the FDA, enables patients with implantable pacemakers to use their smartphones to transmit secure data from their pacemakers to their physicians.
The MyCareLink app is available for free on Android and Apple platforms and works in tandem with a physician-prescribed portable device reader.
When the monitor is connected to cellular or Wi-Fi service, patients can initiate transmission of pacemaker data, uploading it to Medtronic's secure CareLink remote monitoring network.
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PwC: Technology a linchpin to primary care's future

November 20, 2015 | By Katie Dvorak
Technology will be one of the key drivers when it comes to "revving" up the role of primary care, according to a recent PwC report.
The report looks to the future of the healthcare economy, and the makeover primary care needs as the industry moves from a fee-for-service system to one based on value.
For the report, PwC interviewed 25 executives from healthcare, trade associations and academia; researchers also surveyed 1,500 clinicians and 1,000 consumers on the future of primary care.
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November 18, 2015

Telemedicine Market Nearly Doubled Since 2011, Group Says

By Alex Ruoff
Nov. 17 — The number of companies offering telemedicine services has nearly doubled in the past four years, the head of research for the country's largest health IT industry group said Nov. 17.
The number of technology vendors offering telemedicine services grew from 45 to 85 between 2011 and 2015, Brendan FitzGerald, the director of research for HIMSS Analytics, said during an online presentation.
Growth in the telemedicine industry over the past four years could be even greater than HIMSS is reporting, FitzGerald said. He said telemedicine is difficult to define because it incorporates video conference tools for health-care providers, telephones and possibly fitness devices.
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Apixio Launches Cognitive Computing Platform That Extracts and Analyzes Patient Data

November 19, 2015
by Heather Landi
Apixio Inc., a San Mateo, Calif.-based data science company, announced the launch of its Iris cognitive computing platform designed to bring advanced data insights into healthcare by extracting and analyzing patient data from electronic medical records (EMRs).
The Iris platform uses Apixio's proprietary data extraction tools and machine learning algorithms to create a self-learning system that’s designed, according to the company, to give healthcare providers better access to patient data to create a more accurate care profile, thus improving the quality and efficiency of healthcare. IBM’s Watson also applies a cognitive computing platform to healthcare.
The U.S. healthcare industry produces 1.2 billion clinical care documents and most of the information need for patient care is in unstructured documents, according to HIMSS Analytics.
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Feds Want mHealth Developers Better Educated on HIPAA

NOV 19, 2015 7:37am ET
The HHS Office for Civil Rights, which enforces the HIPAA privacy, security and breach notification rules, wants mobile health developers—as well as developers of other health IT products—to become more familiar with HIPAA.
OCR has rolled out a new portal, hosted by crowdsourcing platform vendor IdeaScale, to help developers learn about the rules and submit questions or offer comments, with a subtle warning that the portal should be used.
“Building privacy and security protections into technology products enhances their value by providing some assurance to users that the information is safe and secure and will be used and disclosed only as approved or expected,” the agency explains. “Such protections are sometimes required by federal and state laws, including the HIPAA privacy, security and breach notification rules. Yet, many mHealth developers are not familiar with the HIPAA rules and how the rules would apply to their products.”
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Cybersecurity: best practices for fighting insider threats

Posted on Nov 19, 2015
By Mike Miliard, Editor
Since the first Internet worm in 1988, Randy Trzeciak, technical director of the CERT Insider Threat Center at Carnegie Mellon University's Software Engineering Institute, has been on the front lines of cybersecurity.
With more than 25 years' experience in software engineering, information security and database design, he's hand an up-front seat for the evolution of security threats over the past few decades. Since 2001, Trzeciak and his colleagues at CERT have been researching the insider threats; to date it has collected and analyzed more than 1,100 incidents where insiders have intentionally or un-intentionally harmed an organization.
From that insight, he's identified patterns of technical and non-technical behaviors organizations could integrate into their insider threat anomaly detection capabilities. At the Healthcare IT News Privacy & Security Forum in Boston on Dec. 1, he'll discuss those – spotlighting the different types of threats posed by insiders and describing best practices for mitigating them.
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Axed patient feedback service cost £1.2m

Rebecca McBeth
16 November 2015
NHS England’s abandoned patient feedback service Care Connect cost on average £1,600 for every patient query resolved during the pilot phase.
A Freedom of Information request by Digital Health News reveals that the total cost of the scheme between 2013-15 was £1.25 million.
Pioneered by NHS England’s national director for patients and information Tim Kelsey, it allowed patients to go online, ring a telephone number, text or use social media to log concerns, ask a question or provide feedback on their experiences
Twenty-two trusts in London and the North of England piloted the service between July 2013 and February 2014. Care Connect case handlers completed 760 cases and dealt with another 220 “miscellaneous questions” via text, the FOI response reveals.
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Doubt cast on value of computerised CBT

Thomas Meek
17 November 2015
Computer courses to treat depression are likely to be ineffective, according to research by the University of York.
A study published in the British Medical Journal says that participants offered computerised cognitive behaviour therapy experienced “no additional improvement in depression” when compared with patients who received their usual care from a GP after four months of treatment.
The two-year REEACT trial included 691 patients with depression selected from 83 general practices across England.
Patients were randomised to receive 'usual GP care for depression' or 'usual GP care plus' one of two computerised CBT programme recommended by the National Institute for Health and Care Excellence.
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Irish hospital plans records access

Thomas Meek
18 November 2015
A hospital in Ireland plans to give patients access to their medical records by this time next year.
The private Galway Clinic is working with its electronic patient record provider, Meditech, to allow patients to see the data held on its Meditech 6.1 system, which is due to go live in November 2016.
Raphael Jaffrezic, chief information officer at Galway Clinic, said that giving patients access to this information, which is usually only accessible by clinicians, will help to “empower patients” to take control of their own care.
“We really want to give patients access to their record to engage them with their treatment,” Jaffrezic told Digital Health News.
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End of NPfIT in London and the South

Rebecca McBeth
19 November 2015
The National Programme for IT has come to an end in London and the South with the exit of the final trust to deploy Cerner Millennium from the BT data centre.
All of the trusts that received Cerner’s electronic patient record system have switched to individual supplier contracts with the company or with new providers.
Seventeen trusts that received Millennium from BT as part of NPfIT had to exit the BT data centre and move to individual contracts before 31 October.
A contract extension had to be enacted for North Bristol NHS Trust after it failed to exit on time, but it went live with its Lorenzo EPR from CSC on 15 November.
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Meaningful Use Stage 3 Not Set in Stone; Make Your Voice Heard

by Bethany Jones and Naomi Levinthal Thursday, November 19, 2015
Anantachai (Tony) Panjamapirom, senior consultant at The Advisory Board Company, and Ye Hoffman, senior analyst at The Advisory Board Company, contributed to this Perspective.
On Oct. 16, CMS published a long-awaited final rule that modifies the Electronic Health Record Incentive Program (aka meaningful use) requirements for 2015 through 2017 and establishes requirements for Stage 3, which starts in 2018. While CMS "finalizes" Stage 3 requirements within this final rule, the agency has signaled that these regulations are not set in stone. The public may submit feedback for the Stage 3 requirements until Dec. 15.
This public comment opportunity may be in response to the chorus of industry associations and lawmakers who recently have called for a delayed start to Stage 3. While CMS does not intend to propose stages beyond Stage 3, the program continues until at least 2024, as it is a component of the new Medicare payment methodology -- the Merit-based Incentive Payment System -- for eligible professionals. The meaningful use program appears to continue as-is for eligible hospitals. CMS encourages providers to comment on both Stage 3 requirements and the transition process to MIPS.
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Seeking Interoperability in a Sea of Data

Scott Mace, for HealthLeaders Media , November 19, 2015

While it has been an elusive goal for years, the costs associated with not having standardization are mounting and "interoperability is becoming the main act" for healthcare leaders, says an HIT expert.

This article appears in the November 2015 issue of HealthLeaders magazine.
Interoperability of electronic health records and other healthcare IT systems remains elusive. Healthcare organizations clamor for it and the federal government voices support, but until very recently providers and vendors have lacked incentive to do more than create isolated networks. Yet many providers around the country are creating their own workarounds to achieve at least partial interoperability. These efforts take a lot of work, but technology leaders undertake them in pursuit of cost savings and patient safety.
The Institute for Electrical and Electronics Engineering defines interoperability as "the ability of two or more systems or components to exchange information and to use the information that has been exchanged," and that is the commonly agreed-on aspiration of all stakeholders in healthcare.
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Telehealth Saves Money, Improves Patient Engagement and Outcomes

NOV 18, 2015 7:23am ET
First Health of the Carolinas, a four-hospital delivery system serving the mid-section of North Carolina, was an early adopter of home-based telehealth patient monitoring services in 2005.
The organization got multiple federal and private grants over the years, expanding to other care settings beyond the home. But other settings used different remote monitoring systems and the time came to standardize the technology so programs would not conflict with each other, says Patty Upham, director of the FirstHealth Care Transitions unit.
First Health in October 2014 adopted a remote monitoring platform from Health Recovery Solutions, starting with a 25-unit pilot program. Today, 160 units are being used as needed to monitor chronically ill patients, and then rotated to other homes, and more than 800 patients have been served. When setting up the system, the organization experienced minor video and firewall issues but they were quickly worked through, Upham says. “We’ve been doing this since 2005 so we’re pretty experienced.”
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'Post-EHR era'? Not so fast

Posted on Nov 18, 2015
By Mike Miliard, Editor
Many have commented these past couple years (including your humble correspondent) about the "post-EHR era." In the half-decade since Stage 1 meaningful use, the story goes, health providers all now have their electronic health records installed, humming and finely-tuned and are now turning their attention to newer and more advanced species of IT - to better prepare them for the realities of care coordination and analytics-driven population health management.
But a recent study in Health Affairs suggests the truth is a bit more complicated than that.
In "Electronic Health Record Adoption In US Hospitals: Progress Continues, But Challenges Persist," researchers show how EHRs may not be quite as widespread and commonplace as some might think.
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Special report: electronic document management

Docs for docs
As it moves towards paperless working by the end of the decade, the NHS will need both electronic patient record and electronic document management systems. But what, exactly, is the role of EDM? And why has uptake been relatively slow? Paul Curran reports.
Back in January 2013, health secretary Jeremy Hunt called for the NHS to become ‘paperless’ by 2018.
That aim has since been refined, so the health service is now charged with having paperless working in core services by this date and fully digital and interoperable records by 2020.
Some of this will be achieved by implementing electronic patient records; NHS England’s bid to the Treasury for a further round of technology funding indicates that some £2 billion will be needed to complete their roll-out over the next five years.
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Five Telemedicine Trends Transforming Health Care in 2016

Article By:
Nathaniel M. Lacktman
Telemedicine is a key component in the health care industry shift to value-based care as a way to generate additional revenue, cut costs and enhance patient satisfaction. One of the biggest changes to health care in the last decade, telemedicine is experiencing rapid growth and deployment across a variety of applications.
The quick market adoption of telemedicine is fueled by powerful economic, social, and political forces — most notably, the growing consumer demand for more affordable and accessible care. These forces are pushing health care providers to grow and adapt their business models to the new health care marketplace.
Simultaneously changing is the misconception that telemedicine creates a financial strain or relies on grant funding. Smart health system leadership are creating sustainable telemedicine arrangements that generate revenue, not just cost savings, while improving patient care and satisfaction. Research conducted by the American Telemedicine Association reveals that telemedicine saves money for patients, providers, and payers compared to traditional health care practices, particularly by helping reduce the frequency and duration of hospital visits.
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Federal privacy law lags far behind personal-health technologies

November 17
Jacqueline Stokes spotted the home paternity test at her local drugstore in Florida and knew she had to try it. She had no doubts for her own family, but as a cybersecurity consultant with an interest in genetics, she couldn’t resist the latest advance.
At home, she carefully followed the instructions, swabbing inside the mouths of her husband and her daughter, placing the samples in the pouch provided and mailing them to a lab.
Days later, Stokes went online to get the results. Part of the lab’s Web site address caught her attention, and her professional instincts kicked in. By tweaking the URL slightly, a sprawling directory appeared that gave her access to the test results of some 6,000 other people.
The site was taken down after Stokes complained on Twitter. But when she contacted the Department of Health and Human Services about the seemingly obvious violation of patient privacy, she got a surprising response: Officials couldn’t do anything about the breach.
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Batea: a Wikipedia hack for medical students

Posted on Nov 17, 2015
By Tom Sullivan, Editor-in-Chief, Healthcare IT News
Medical students use Wikipedia in great numbers, but what if it were a more trusted source of information? 
That's the idea behind Batea, a piece of software that essentially collects data from clinical reference URLs medical students visit, then aggregates that information to share with WikiProject Medicine, such that relevant medical editors can glean insights about how best to enhance Wikipedia's medical content.
Batea takes its name from the Spanish name for gold pan, according to Fred Trotter, a data journalist at DocGraph.
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Tie Financial Incentives to Data Exchange, Fed Advisers Say

NOV 16, 2015 7:47am ET
A Health IT Policy Committee task force has made four recommendations targeting financial and business barriers that are holding back the interoperability of healthcare information.
Paul Tang, M.D., chair of the interoperability task force, acknowledged that none of the recommendations are “likely to change the facts on the ground overnight.” But he argued that alignment of incentives for providers and vendors could foster business practices that result in routine interoperable data exchange.
According to Tang, a key inhibitor to health information exchange has been economic incentives—which he asserts at best have not encouraged, and at worst have even discouraged, sharing of clinical information among providers. Part of the problem is traditional fee-for-service payments models do not create incentives to make HIE processes and technologies a higher priority.
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EHR Adoption for Small Hospitals Continues to Lag

NOV 16, 2015 7:54am ET
Electronic health record adoption rates are on the rise among U.S. hospitals, with 75 percent of hospitals now having adopted at least a basic EHR system—up from 59 percent in 2013. However, small and rural hospitals continue to lag behind their larger, urban counterparts.
Those are among the findings of researchers who published the results of their analysis of 2014 American Hospital Association Annual Survey–IT Supplement data in the November issue of Health Affairs, concluding that nationwide hospital EHR adoption is “in reach” but requires attention to small and rural hospitals, which have “persistently lagged in their adoption rates.”
Researchers point out that since 2008 there has been more than a 10-percentage-point gap between small and large hospitals in adoption of at least a basic EHR system. As of last year, small hospitals had an EHR adoption rate of 68 percent, compared with 85 percent for large hospitals, while 66 percent of rural hospitals last year adopted at least a basic EHR system, versus 78 percent of urban hospitals.
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Study finds at-home telemedicine treatment for PTSD viable

November 16, 2015 | By Susan D. Hall
Telemedicine sessions at home can be a viable way to treat post-traumatic stress disorder in active-duty military personnel, according to a preliminary study published at Telemedicine and e-Health.
The study involved 10 previously deployed soldiers who agreed to complete eight sessions of behavioral activation therapy, a well-established treatment for depression, by telemedicine. All had experienced trauma during deployments to Iraq or Afghanistan.
During a pre-treatment session, a member of the research staff came to each soldier's home to familiarize him or her with the equipment and check the network connection--they used their own Internet service.
Two participants dropped out of the study, saying sessions took too much time away from their Army duties. One dropout, however, could be related to technical difficulties that soldier experienced, according to the paper.
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AEGIS introduces Touchstone Project to help providers adopt interoperability standards

Written by Max Green | November 13, 2015
Organizations adopting Health Level Seven's Fast Healthcare Interoperability Resources standards for exchanging EHRs have a new tool to help them with a smooth implementation — AEGIS' Touchstone Project.
Touchstone is a cloud-based testing platform designed to help guide providers through the implementation of FHIR to attain a high degree of interoperability and conformance. After one month of FHIR testing, Touchstone has performed more than 185 unique testing executions.
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California Researchers Eye Robots To Help People Age at Home

by Lisa Zamosky, iHealthBeat Contributing Reporter Monday, November 16, 2015
SAN DIEGO -- University of California-San Diego researchers are working to develop robots that can listen, speak and react to human needs.
Earlier this month, the university launched its Contextual Robotics Institute, a multi-disciplinary effort to develop robotic technology with artificial intelligence that can be used to help the country's growing elderly population "age in place."  
Rajesh Gupta -- professor and chair of the computer science and engineering department at UC-San Diego -- said the new institute's work is unique in that it draws heavily on cognitive sciences with the goal of developing robots that can read emotions and respond to people more like humans.
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Enjoy!
David.

Friday, November 27, 2015

It Seems It Is Government Policy Not To Actually Let We Mug Punters Know What Is Going On.

Two articles appeared this week to confirm the impression.
First we had:

Media consultants paid big money to train bureaucrats for Senate hearings

Date November 22, 2015 - 12:15AM

Adam Gartrell

National Political Correspondent

Exclusive
Federal government departments have paid external media consultants hundreds of thousands of dollars to train bureaucrats how to "perform" in Senate estimates hearings.
The consultants, who can be paid up to $30,000 a month, insist the training is not aimed at teaching public servants how to spin or avoid scrutiny – but some senators are not so sure.
While a search of government contracts suggests departments have spent about $160,000 on the training in recent years, the true cost is believed to be much higher but concealed through a sometimes opaque tender process.
For example, one major provider of Senate estimates training – Melbourne-based consultancy Media Manoeuvres – has been awarded at least $1.9 million in government contracts in recent years, according to the publicly accessible Austender website.
The contracts are typically for "media training" or "media awareness training". None mention Senate estimates training, even though that is a significant part of Media Manoeuvres' business.
On its website, Media Manoeuvres says it offers two levels of Senate estimates training: "awareness" and "performance skills". The latter involves simulations and role-playing scenarios.
Chief executive Sam Elam said the company regularly provided the training to various agencies. It was aimed at giving public servants the confidence to deal with what could be a very stressful experience when confronted by aggressive senators.
"It's high pressure and that can turn some people to water," she said. "It's about giving people the confidence to actually speak up."
Canberra-based consultant Laurie Wilson has delivered Senate estimates training to the Australian Public Service Commission and a wide variety of government departments over the past decade.
Last year, he was paid about $60,000 to deliver an extensive two-month training course to the Department of Finance.
More here:
We all remember NEHTA and DoH at Senate Estimates when asked re: e-Health. Stonewall training is what I would call it.
In the same week this popped up.

DTO snubs advice from peak industry bodies

The Government’s much vaunted Digital Transformation Office (DTO) closed door policy is rankling peak industry bodies that want access to the agency.
Laurie Patton, CEO Internet Australia (IA), the peak body representing Internet users claims a number of civil society and industry groups are apparently finding the door to the DTO firmly shut or are being left out of the loop when it comes to stakeholder engagement.
“We asked for a meeting and were told to come back next year”, Patton said. “They said they were too busy to see us”.
He believes the Australian Communications Consumer Action Network (ACCAN), the peak body representing all consumers on communications issues, also had appointments ‘bumped’ to next year because the DTO is “too busy”.
[At the time of writing this ACCAN was unable to be contacted for comment.]
“Expert organisations such as ourselves will be better able to assist if we’re involved from the outset, in the formative stages of the DTO's operations, rather than down the track when their plans and initiatives have been locked in,” Patton said.
“Our concerns were raised when a visiting expert from the UK highlighted the downside from the work of the UK DTO. “The message was that they’ve ended up with a two-class system. It’s fine for people who have access to the Internet and are digitally savvy, but disadvantaged groups and individuals who are not connected are now struggling to get access to essential government services”. “
IA approached the DTO offering to provide advice and assistance to ensure that everyone benefited and nobody was left behind as a result of its work.
More here:
So no talkies to anyone who might know something in technology while doing an innovation statement!
This all really just confirms what we are all becoming pretty used to. The bureaucrats etc. simply just roll on and ignore any external advice - while overestimating just how knowledgeable and informed they are.
It really gets very, very tiring  to see the same mistakes made over and over again!
David.

Thursday, November 26, 2015

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

November 26 Edition
The big macro issue at present is a discussion around just how complex, useless and expensive health insurance is and how the tax system is to be reformed in an era of ruling nothing in or out. It also now seems housing is now also being discussed, with older people being offered encouragement to downsize.
Pollies are back this week for a week or so - so we can expect more budget news and more moves on health policy. I wonder will we have some more e-Health thought bubbles
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Here is some other of the recent other news and analysis.

The Political Scene.

Tax incentives eyed for home downsizers

  • The Australian
  • November 20, 2015 12:00AM

Gretchen Friemann

David Uren

Scott Morrison is canvassing bold tax reforms designed to persuade retirees to downsize to smaller homes and plough more money into retirement-income products in a move that would boost the housing supply for younger families and create a boom in the use of annuities.
The plan would include a one-off exemption from stamp duty on the purchase of a smaller house.
As an extra incentive, profits from the sale of the family home would be excluded from the Age Pension assets test provided they were channelled into an ­approved retirement product such as life annuities and aged-care bonds.
Since being appointed Social Services Minister late last year, the Treasurer has argued that the burden of the Age Pension could be reduced by allowing retirees to tap the wealth captured in their homes.
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General Budget Issues.

  • Nov 17 2015 at 12:55 PM

Treasurer Scott Morrison hints at lower trend economic growth rate

Treasurer Scott Morrison has hinted the economy is unlikely anytime soon to return to the historic pace of growth that would deliver easy budget repair.
Mr Morrison suggested growth needs to rebound to "slightly above" 3 per cent, but effectively conceded it was likely to fall short of that pace.
"We are growing at 2.3 [per cent] and we will look to get ourselves back to about a 3 per cent [rate] which is just under trend.
"Now that's where we need to get to," Mr Morrison said.
Asked whether growth of 3 per cent would generate enough revenue to cover the government's needs, Mr Morrison conceded "you'd need to be slightly above that".
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Wage growth hits record low as Scott Morrison tries to lift incomes

Date November 19, 2015

Peter Martin

Economics Editor, The Age

Analysis
We were preparing for a wages explosion.
Two years ago, in his first major speech as workplace relations minister, Eric Abetz warned of "something akin to the wages explosions of the pre-Accord era" if employers and unions didn't rein in their deals.
Even as he spoke, wage growth was plummeting to new lows, heading down from its long-term average of between 3 and 4 per cent into the twos.
Since the minister spoke wage growth has plunged lower still, hitting 2.1 per cent for private sector wages in the year to September, the lowest result in records spanning back 18 years.
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No Morrison mini-budget mid-year

Published: 9:18 am, Friday, 20 November 2015
Don't expect some sort of fiscal extravaganza when Scott Morrison releases his first mid-year budget review.
The treasurer has made it clear that he won't be making the mid-year economic and fiscal outlook some sort of mini-budget for the government's new leadership.
'MYEFO is a budget update ... I have no ambitions for it to be more than that,' Morrison said in a recent interview.
However, he set down some markers in a speech this week, in tune with his predecessor Joe Hockey.
That is, the budget deficit will be reduced by around 0.5 per cent of GDP, expenditure will begin to decline next year from its present peak and net debt will start to decline the year after next.
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Health Budget Issues.

Quality of care in Australian hospitals lacks oversight

Date November 16, 2015 - 12:00AM

Jane Lee

Australia needs to collect more information to measure the quality of care that hospitals provide to patients nationally, an OECD report says.
The OECD's review of Australia's health system, to be released on Monday, said that it was performing "remarkably well" despite its "fragmented nature" and "sometimes strained" relationship between federal, state and territory governments over health funding. Australia was the OECD's fifth most obese country, it said, and its health system would in future have to deal with an increasing number of patients with diabetes and other chronic conditions. 
While Australia had improved its national standards for health care, it said: "A surprising lack of data on the quality and outcomes of care marks out Australia from its peers."
"This is particularly the case for primary health care, which has an under-developed pay-for-performance scheme, and for rural and remote health care. There are few indicators promoting quality of clinical care and patient outcomes, and there is little opportunity for GPs to be benchmarked against their peers."
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Australia must protect the foundations of its healthcare system

Date November 13, 2015

Brian Owler

What do we want our healthcare system to look in 10 years? The federal government's vision for Australia's healthcare system currently lacks clarity, let alone consensus. 
The Medicare Benefits Schedule (MBS) Review, the Primary Care Review, and now a review of the private health insurance sector are set against the background of reform of the federation and federal-state health-funding arrangements. In the midst of these reviews is a debate about tax reform, including the potential application of a 15 per cent GST on health. 
Is it no wonder that complaints to the health ombudsman are at an all time high, and that the largest source of complaints is patients who do not understand their policies and are unaware of their exclusions? 
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Removing natural therapies ‘too costly’, says health review

  • The Australian
  • November 16, 2015 12:00AM

Sean Parnell

Removing unproven natural therapies from the scope of the health insurance rebate is unlikely to deliver sufficient savings to warrant the cost of doing so, Health Minister Sussan Ley says.
The Australian has obtained the final review of natural therapies, commissioned by the former Labor government to ensure taxpayers were not subsidising bogus medicine, confirming there is insufficie­nt evidence to say the treatments benefit patients.
Chief Medical Officer Chris Baggoley chaired a specially convened committee of experts and tasked the Office of the National Health and Medical Research Council with examining the published evidence on 17 natural therapies.
“Overall, there was not reli­able, high-quality evidence available to allow assessment of the clinical effectiveness of any of the natural therapies for any health conditions,” the report concludes.
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Natural therapies: no clear evidence of health benefits, government review finds

Date November 16, 2015 - 5:56PM

Jane Lee

There is no clear evidence that natural therapies are effective, a government review says, prompting calls for taxpayers and private health insurers to stop paying for them.
A Department of Health review of 17 therapies covered by private insurance released on Monday stated it could not conclude that any worked.
While there was "low to moderate quality" evidence that some therapies – for example, massage therapy, yoga and tai chi - may have some health benefits, overall "there was not reliable, high-quality evidence available to allow assessment of the clinical effectiveness of any of the natural therapies for any health conditions", the report, by Chief Medical Officer Chris Baggoley, said.
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Fears Medicare safety net changes will hit most vulnerable

Date November 16, 2015 - 7:55PM

Jane Lee

A plan to cap rebates for out-of-hospital costs will lead to higher hospital admissions and suicide rates, rather than save the public money, doctors warn.
The Turnbull government had hoped its changes to the Medicare Safety Net would take effect from the start of next year. They are expected to save $266.7 million over five years, which would be put into the Medical Research Future Fund.
The changes will lower the spending thresholds required for patients to access benefits, but cap the benefits payable for individual medical services once this has been reached.
Psychiatrists and oncologists renewed their calls for changes to the legislation, which they say will make life-saving services more expensive for people who need them most.
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Medicare: Government 'may face political crisis' over rebate freeze

Date November 17, 2015 - 7:15PM

Gareth Hutchens

The federal government may face a "political crisis" in a few years if it does not reverse the freeze on the indexation of Medicare rebates, the deputy director of the Menzies Centre for Health Policy has warned.
Associate Professor James Gillespie says voters need to realise that Medicare is an industry, GPs are running businesses and that co-payments are here to stay.
But general practitioners may be forced to increase co-payments at some stage, to cover for lost income, if the Medicare rebate freeze continues "for the foreseeable future", he said.
Mr Gillespie told a forum at the Australian National University on Tuesday that Australia's health debate was finally recovering after the damaging row over GP co-payments.
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GP-ordered tests and scans a drain on Medicare budget

  • The Australian
  • November 21, 2015 12:00AM

Sean Parnell

GPs putting patients through ­extensive health assessments, or sending them off for sleep studies, iron tests, thyroid examinations or various leg scans, are responsible for some of the biggest increases in Medicare expenditure in recent years.
An expert taskforce reviewing the Medicare Benefits Schedule has been given access to data ­revealing increases by service, specialty­ and demographic, amid a clear trend for Australians to average more medical interventions each year.
The previously unreleased Medicare data gives some insight into the push for patients with chronic illness to be funded outside the traditional MBS system, and the need for clinicians to be compelled to follow evidence-based guidelines to avoid over-servicin­g or poor practice.
But it will only fuel the debate over the reason for the increase in Medicare-funded services per capita and whether doctors are respond­ing to patient concerns or profiteering.
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Better protection for consumers of complementary medicines

Date November 20, 2015

Amy Corderoy

Health Editor, Sydney Morning Herald

Australians who use complementary medicines could be protected from dodgy claims and products that don't contain what they say they do under proposals in a landmark review.
The independent review of medicines and medical devices should also please the fast-growing complementary medicines industry, as it also recommends more self-regulation and cutting red tape.
Complementary and alternative medicines are thought to be used by two in every three Australians, generating $3.5 billion in revenue each year in Australia alone, despite a poor evidence-base for many heavily advertised products and federal reviews that have found repeated breaches of advertising regulations. 
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Health Insurance Issues.

Let health insurers cover GP visits: Victoria University report

Date November 16, 2015 - 6:11PM

Julia Medew

Health Editor

Health insurers should be allowed to cover more health services, including GP visits, under a more privatised Australian health system, an independent report says.
Victoria University's Australian Health Policy Collaboration is calling for one of the greatest overhauls of Australia's health system since Medicare was introduced to offer universal access to healthcare in 1984.
In a report released on Monday, the group said a national system of mandatory insurance with regulated competition would motivate health services to limit costs.
At the moment, health insurers are not allowed to cover primary care services such as GP visits, radiology and pathology, or outpatient visits to specialist doctors such as endocrinologists or orthopaedic surgeons.
This means healthcare, particularly for people with chronic disease, is fragmented with many different providers and funders, including federal and state governments and health insurers that try to shift costs onto each other. The result is that no one carer or service provider takes responsibility for a patient with incentives to keep them well or to get them better efficiently when they are sick.
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Health insurance premiums to rise more slowly in 2016

Date November 17, 2015 - 3:46PM

Jessica Gardner

Companies & Markets Deputy Editor

Next year's health insurance price hike will be slightly lower than previous years, but nib boss Mark Fitzgibbon says customers need to "get used to the idea" of annual premium increases in the region of 5 to 6 per cent.
The push to rein in the rising cost of private health cover is an aim of Health Minister Sussan Ley's review into the $19 billion sector, which heats up this week, but Mr Fitzgibbon played down expectations it would deliver real change.
"I don't think there will be any initial big bang," he said.
Mr Fitzgibbon, speaking at a conference organised by investment bank UBS, said spending on health care across the country had run at about 6 per cent a year for the past 10 years. 
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Health insurers slam ‘rampant’ cost variations

Sarah-Jane Tasker

Australia’s top private health insurers are to reveal they are paying $800 million more each year on prosthetic devices compared to what public hospitals pay as they push for change under a federal government review.
NIB Holdings chief executive Mark Fitzgibbon said the insurer and the country’s other top funds had joined forces to engage a consultant to prepare a report on the international benchmarking price for prosthetic devices.
Health funds and hospitals met health department representatives yesterday as part of the government’s consultation on the private health insurance sector and the paper on prosthesis was expected to form part of the industry’s submission.
Mr Fitzgibbon said it was “outrageous” that insurers were forced to spend $800m a year more on prosthetic devices in the private system than they should.
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Want real health reform? Integrate public and private health into one mandatory insurance system

20 November 2015, 06:54 CET

Authors

  1. Francesco Paolucci
Associate Professor; Head of Health Policy Program, Sir Walter Murdoch School of Public Policy and International Affairs, Murdoch University
  1. Manuel García-Goñi
Associate Professor of Applied Economics, Universidad Complutense de Madrid
Health Minister Sussan Ley is considering applications from private health insurers to increase premiums by 6-7% in 2016, four times higher than the rate of inflation. Rising premiums and better value for consumers are on the agenda at Ley’s private health insurance reform consultations this month.
But while health-care costs are growing – due to an ageing population with higher rates of chronic diseases and greater use of health technologies – rising premiums are also the consequence of structural system design flaws.
To make the system sustainable in the long term, our report, released this week by Victoria University’s Australian Health Policy Collaboration, proposes a model that integrates public and private health expenditure into a universal, mandatory health insurance scheme.
Consumers would have the choice between private health insurers and at least one government-run provider (which could be a version of Medicare or an insurer as was Medibank). All insurers would have to provide a comprehensive set of health services to their customers, covering all essential aspects of their health care.
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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, as well as a review of Health Insurance.
Health is also clearly under review as far as its budget is concerned with six reviews underway. Lots to keep up with here! Enjoy.
David.