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."

Wednesday, February 24, 2016

The AMA Is Really Ramping Up Its Distress And Annoyance With DoHA and The Way They Are Running The mHR.

This appeared last week.

'Appalling cock-up': Morton lashes ePIP change

17 February 2016
THE new eHealth PIP change is premature and prone to failure because of the lack of consultation with doctors, according to the AMA General Practice Council chair Dr Brian Morton.
And the Department of Health has foreshadowed further changes after a spokeswoman says consultations will start on a tiered performance-based incentive this month.
The current incentive change, which came to light in mid-January and begins on 1 May, requires practices to show meaningful use of the My Health Record (MyHR).
In the first instance, this means practices must upload shared health summaries (SHS) for 0.5% of the standardised whole patient equivalent (SWPE) per quarter to stay ePIP eligible. In real terms, that is five SHS per full-time equivalent GP.
At the same time the department’s opt-out MyHR trials of about a million patients in Northern Queensland and the Nepean/Blue Mountains area in NSW do not go “live” until about 15 July, a 10-week timing discrepancy Dr Morton calls “ridiculous”.
“They should be holding off until the pilots have been run and the opt-out has actually happened,” he says. 
“It’s going to be an appalling cock-up because they haven’t listened to the profession, they’ve not listened to the stakeholders and they’re not giving us enough time.”
He says there are also numerous privacy issues that have not been taken into account and that, ultimately, the onus of registering patients is going to be on GPs.
More here:
Given that DoH needs the co-operation of the AMA and the RACGP to have any (remote) hope of the mHR becoming useful.
All discussions should be happening quietly and in private. Signalling via the press is just another sigh of what a mess the AMA thinks all this is and how bad a job DoH is doing in managing a critical set of relationships.
David.

Tuesday, February 23, 2016

Here Is A Larger Pile Of Spin Than I Have Seen For A Good While! Pretty Sad.

This appeared last week to let know Healthcare providers in the opt-out trial zones just where the mHR was up to.

My Health Record News - a digital bulletin for providers

Issue 1 - February 2016

Welcome

Welcome to the first digital bulletin for My Health Record, bringing you the latest news on the relaunch of My Health Record (originally called the Personally Controlled Electronic Health Record).

What is My Health Record?

My Health Record commenced on 1 July 2012. Like many similar initiatives around the world, it is a secure, online summary of an individual’s health information. It can be viewed by treating healthcare providers, including doctors, nurses and pharmacists across Australia.

My Health Record gives you access to information about a patient’s health which you may not otherwise have been able to see. To access this information you don’t need to copy it into your system or do any extra work. The information you can access through My Health Record is outlined below:
  • Shared Health Summary - A summary, authored by the treating doctor, of an individual’s health status including adverse reactions, medicines, medical history and immunisations
  • Hospital Discharge Summaries - A record of an individual’s hospital stay and any follow up treatment required
  • Diagnostic imaging reports - Such as ultrasounds or x-ray results (Currently Diagnostic Imaging reports are being updated by Northern Territory)
  • Prescriptions and dispense information - Such as dosages and frequency
  • Event Summaries - Clinical summaries of health events entered by the healthcare provider who was involved in the patient’s care to inform other treating healthcare providers
  • Specialist letters - Referral letters and reports from one treating healthcare provider to another

Through their clinical information systems, GPs can:

  • View hospital discharge summaries
  • View specialist letters
  • View and add medications
  • View an Event Summary contributed by another GP
  • Add a Shared Health Summary
  • Add an Event Summary

My Health Record:

  • The new name of the national digital health record system

Through their patient administration systems, hospitals can:

  • View medications
  • View Shared Health Summaries
  • View and create specialist letters
  • View Event Summaries
  • Add hospital discharge summaries

Individuals can:

  • View their Shared Health Summary and other health documents in their record
  • View Medicare or PBS claims
  • Add important information on allergies
  • Add emergency contact details
  • Add other medication they are taking
  • Add an Advance Care plan
  • Set access controls

My Health Record is growing!

  • Over 2.5 Million people have a record
  • 1 New record created every minute (on average 2015)
  • An extra 1 Million to get a My Health Record during participation trials
  • Over 2.9 Million Prescription and Dispense records
  • 8,010 Healthcare providers registered to use the system
  • Over 337,000 Clinical Document Uploads
  • Including 260,000 hospital discharge summaries

Why My Health Record is important.

Patient care

  • My Health Record facilitates the sharing of clinical and treatment information between healthcare providers as well as with individuals
  • It is ethical practice to ensure that the information you create about your patients is available and accessible by other healthcare providers involved in their care
  • As more information is contributed by different healthcare providers and as more patients sign up for a My Health Record, we will reach a tipping point where Australia’s health system becomes better connected
  • My Health Record helps deliver healthcare more efficiently and effectively by minimising unnecessary repeat tests, managing medication better and improving ontinuity of care

Access

  • My Health Record allows healthcare providers to access patient information quickly and easily
  • In a medical emergency, hospitals can get access to a patient’s record to provide the best possible care quickly, including information they may not have otherwise had access to

Security

  • The My Health Record system is a secure source of key clinical information

What’s new!

Overview: Improvements based on the review

In December 2013 an independent review of the system, titled ‘Review of the Personally Controlled Electronic Health Record’, was finalised. It found overwhelming support for a national digital health record system and made a number of recommendations to improve uptake and use. The 2015–16 Budget announcement is the Government’s response to the review. It includes:
  • Changing the name from PCEHR to My Health Record
  • Improving the usability of the system and increasing the clinical content in the records
  • Reviewing existing incentives to encourage use of the system by general practitioners
  • Refreshing training materials and training delivery for healthcare providers on how to use the system
  • Trialling new participation arrangements for individuals, including an opt-out system to inform future strategies for bringing forward the benefits of My Health Record nationally (see ‘Another million Australians to have a record!’ to the right)
  • Establishing a new agency (The Australian Digital Health Agency) as the single accountable organisation for digital health in Australia. This Agency is planned to be operational from 1 July 2016. Governance arrangements will reflect the key stakeholders and beneficiaries of the system

System: Making My Health Record easier to use

The My Health Record system is continuously improving to include more information and become easier to use.

Today’s My Health Record system includes:
  • Prescription and dispense documents
  • Consumer and Provider portal and system improvements
  • Specialist letters
  • Inclusion of Medicare data (MBS, PBS, RPBS, AODR)
  • Hospital Discharge Summary capability
  • Assisted registration for individuals
  • Healthcare provider access in an emergency situation
  • Pathology report capability
  • Diagnostic Imaging report capability
  • Security Improvements

The General Practice contribution

More patients will be able to share their health information through the My Health Record system in coming months, as general practices prepare to meet new ePIP eligibility requirements.

From May this year general practices will need to contribute about five Shared Health Summaries per GP per quarter, to maintain eligibility for the incentive payment.

The key contribution required from general practices is the shared health summary information for their patients. This will provide valuable clinical information for individuals and other healthcare providers involved in treating them.

New online and face-to-face training will help general practices and GPs become familiar with and confident to use today’s My Health Record system.

Formal, written notification to general practices of the new requirements will occur in March.

Trials: Another million Australians to have a record!

In mid 2016, around one million people living in North Queensland and the Nepean Blue Mountains of New South Wales region will have a My Health Record created (unless they choose not to).

Residents of these locations will be informed by letter that a My Health Record will be created for them, and that they have to notify the System Operator by 27th May 2016 if they don’t want one.

By creating digital health records for an entire geographical area, the trials will be an opportunity to understand the benefits and key considerations associated with a system of connected healthcare.

Training: How do I learn more?

New training will be available on the website from February 2016 for clinical and nonclinical staff including general practices, community pharmacies, residential aged care facilities, medical specialists, allied health, and hospitals.

Face-to-face training will be available in trial areas for General Practice, Pharmacies and Hospitals. It will also be available on demand for general practices outside trial areas.

Legislative changes: What they mean for you

Changes to the My Health Record legislative framework were made in November 2015 through the Health Legislation Amendment (eHealth) Act 2015.

These changes are designed to make it easier for you to connect to and use the system.
They are also there to protect individuals against misuse of their information.
What you need to know:
  1. Participation agreements for My Health Record will be abolished – these are the contracts you enter into with the System Operator when you register to use the system. From 1 March 2016 you will no longer need to complete these because they will be included in the My Health Record legislation. This will make the connection process quicker and easier.
  2. Penalties are changing – to protect the interests of individuals, there will be stronger sanctions against misuse of the system. These penalties won’t apply to you if you accidentally or inadvertently access an individual’s My Health Record. These won’t affect you if you are practicing in good faith.
  3. You won’t be required to store assisted registration application forms from early 2016 – you no longer need to store signed application forms or submit them to the System Operator. It is up to you to decide how to capture consent going forward.
We are currently creating materials that explain these changes in more detail and provide guidance on what they mean for the way you use the My Health Record system.

Suggestions please!

We want to know what you’d like to hear about in future editions of this digital bulletin.

To provide suggestions for topics or feedback, email the MyHealthRecord inbox.

For more information and assistance on My Health Record

Healthcare providers
Call 1800 723 471 (select option 2)

Individuals (healthcare recipients)
Call 1800 723 471 (select option 1)
Here is the link:
This is the contents of the brochure designed to encourage providers to adopt the mHR and what a joy it is.
We are told that the mHR has been improved to make it better and easier to use. That must still be in the works as when I logged in today it was just as empty and user-hostile as usual with no results and prescription information.
Really it still remains just a collection of departmental documents all piled up with no obvious searching or document selection capability other that just slug on through opening each tab to see what is hidden under it!
What a joke - I hope those lucky people who are being signed up - many I am sure will not be aware it has happened - find some more value that I can.
The money still seems to be being wasted with all this as far as I can tell!
David.

Monday, February 22, 2016

Weekly Australian Health IT Links – 22nd February, 2016.

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

E-Health has made it to the front page of the Saturday Financial Review - which I suppose can only be a good thing!
Elsewhere we have the Government propaganda winding up on the opt-out Trials and lots of new apps while we seem to have ongoing issues with SA and WA Health IT.
-----

My Health Record News - a digital bulletin for providers

  • Home
  • My Health Record News - a digital bulletin for providers
Below is the text only version of the My Health Record News digital bulletin.

Issue 1 - February 2016

Welcome

Welcome to the first digital bulletin for My Health Record, bringing you the latest news on the relaunch of My Health Record (originally called the Personally Controlled Electronic Health Record).

What is My Health Record?

My Health Record commenced on 1 July 2012. Like many similar initiatives around the world, it is a secure, online summary of an individual’s health information. It can be viewed by treating healthcare providers, including doctors, nurses and pharmacists across Australia.
-----
  • Feb 19 2016 at 6:00 PM
  • Updated Feb 19 2016 at 7:09 PM

Former Vic health minister calls for 'carrot and stick' incentives for e-health

There must be a "carrot and stick" approach to drive GPs and other healthcare providers to use electronic health records and online consultations to reach more patients at lower cost, says a former Victorian health minister.
New figures released by the Federal Department of Health show only 2.59 million Australians – just over 10 per cent of the population – and 7836 healthcare providers have signed up to the government's struggling My Health Record e-health system.
The number of patients is double the 1.3 million signed up in December 2013, just after the Coalition won government in Canberra, but the numbers are still well below the critical mass needed for healthcare providers to have a strong interest in signing up.
The call comes as tight budgets and a swarm of reviews into the rapidly growing $155 billion healthcare sector have put the big players on edge, with pathology companies and GPs threatening to launch an election year campaign against budget cuts from their waiting rooms. 
-----
  • Feb 20 2016 at 12:15 AM
  • Updated Feb 20 2016 at 12:15 AM

'Heart-sink' patients: tech pioneers battle healthcare inertia

In economic terms we have got a system that's entirely captured by producer interests.

Shelley Kleinhans, chief operations officer of Brisbane North PHN, wants the 1000 GPs in the area to bring their "heart-sink patients" to her organisation.
"We describe them to the GPs as: 'These are your heart-sink patients – when they come into your consult room, your heart sinks,'" she says.
"You think 'what is she going to present with today?' and 'how am I going to solve her problems in the 15 or 20 minutes that I have to treat her?'"
These patients have chronic diseases such as cancer, heart disease, diabetes and smoking-related shortness of breath – often compounded by social problems such as isolation, frailty and poor access to transport.
-----
  • Feb 20 2016 at 12:15 AM
  • Updated Feb 20 2016 at 12:15 AM

Telstra technology may save community nurses millions of kilometres on the road

by Ben Potter
Nurses employed by Victoria's Royal District Nursing Service drive 10 million kilometres a year, often just to watch an elderly patient take their medicine.
Now using MyCareManager a nurse can video call a patient on a wireless tablet at their home, watch the patient take their medicine or test their blood pressure or glucose. Results upload automatically.
If a patient's test results breach safe limits, an alarm goes off at the local Royal District Nursing Service (RDNS) station, and the nurse can call the patient, who just hits a green button to take the call.
The results are on the patient's tablet, so she can have a say in care planning. Family members can also be looped in.
-----

'Appalling cock-up': Morton lashes ePIP change

17 February 2016
THE new eHealth PIP change is premature and prone to failure because of the lack of consultation with doctors, according to the AMA General Practice Council chair Dr Brian Morton.
And the Department of Health has foreshadowed further changes after a spokeswoman says consultations will start on a tiered performance-based incentive this month.
The current incentive change, which came to light in mid-January and begins on 1 May, requires practices to show meaningful use of the My Health Record (MyHR).
In the first instance, this means practices must upload shared health summaries (SHS) for 0.5% of the standardised whole patient equivalent (SWPE) per quarter to stay ePIP eligible. In real terms, that is five SHS per full-time equivalent GP.
-----

My Health Record opens up to advance care directives

Consumers will soon be able to upload a PDF of advance care planning documents to their My Health Record (formerly PCEHR), the Department of Health has confirmed.
Consumers have always been able to add the name of the custodian of their advance care directive or other legal document but the ability to upload a PDF is a new, unexpected development.
The capability for individuals to upload a copy of their advance care planning documents, such as an advance care directive or a substitute decision maker, will be available in April. Healthcare providers will be able to do so through their clinical software later in the year, she said.
-----

New app helps people with neurological conditions practise speech

February 17, 2016 3.22pm AEDT
People with neurological disorders sometimes need to practise speech daily. from www.shutterstock.com.au

Authors

  1. David Ireland
Electronic Engineer and Research Fellow at the Australian E-Health Research Centre, CSIRO
  1. Christina Atay
Postdoctoral research fellow, The University of Queensland
  1. Jacki Liddle
Quality of life researcher and occupational therapist, The University of Queensland

Contributor

  1. Daniel Angus
Lecturer, The University of Queensland
Researchers at CSIRO and University of Queensland have developed an app called Harlie that is designed to chat with humans. Unlike Siri and Google Now – which are designed to answer specific questions – Harlie is designed for small talk. Its purpose is to help the user and health professionals understand the impact of neurological conditions on communication and well-being.
People with neurological conditions such as Parkinson’s disease and dementia can have trouble finding the right words and may lose track of their message mid-sentence.
Users of the app have a conversation with the chat-bot, which then analyses aspects of the health of the user’s voice and communication. This includes how well vowels are articulated, vocabulary and duration of mid-sentence pauses.
-----

GP software detects FH patients in 10 mins

Alice Klein | 17 February, 2016 |
A new Australian software tool allows GP practices to identify patients at high risk of familial hypercholesterolaemia (FH) in as little as 10 minutes.
The electronic screening tool, TARB-Ex, is being mooted as a way to bring the detection and management of FH into primary care, instead of leaving it to hospitals.
Only about 10% of patients with FH are currently identified, largely due to the lack of practical population-based screening tools.
According to the developers, the new tool works by scanning patients' electronic medical records for possible FH indicators such as high LDL-cholesterol (corrected for statin use), tendinous xanthomata, arcus cornealis and family history of cardiovascular disease.
-----

Why this app is a must have for GPs caring for the elderly

19 February 2016
ESSENTIALLY a text book in an app, Geriatrics at Your Fingertips has been produced by the American Geriatrics Society and is most suited to physician trainees and GPs caring for the elderly population. 
On opening the app, a table of contents directs the user to information on topics ranging from antithrombotic therapy to women’s health. 
There is basic information on the assessment and approach towards elderly patients, as well as on prescribing, specifically directed to the issues of polypharmacy and deprescribing. 
A tool section provides assessment instruments. For example, a mini-cognitive assessment tool and calculators that are general in nature, including for temperature conversion, BMI and creatinine clearance. 
-----

WA Health facing inquiry over bungled Fujitsu IT contract

Staff sacked, case referred to corruption watchdog.

By Allie Coyne
Feb 19 2016 11:45AM
The WA Department of Health is facing a potential corruption investigation after the state's auditor-general referred the department's mammoth centralised computing contract with Fujitsu to the WA anti-corruption body.
In a damning report released earlier this week, acting auditor-general Glen Clarke found the four-year contract - signed in 2010 for four years and for $45 million - had blown out by $81.4 million thanks to numerous weaknesses in oversight and controls.
The audit office had been alerted to the problem in late 2014 by the then-head of the Health department Bryant Stokes following his concerns about the contract.
The Fujitsu deal was signed to provide primary and secondary data centres as well as ongoing management and support of the infrastructure in the facilities.
-----

Broken bone? Soon you will be able to 3D print a new one

Date February 17, 2016

Rae Johnston

US scientists have created a prototype 3D bioprinter capable of creating human-scale, structurally stable tissues in any shape. Their study explores the capabilities of the new bioprinter for fabricating bone, cartilage and skeletal muscle using human as well as animal cells. And they've succeeded in making the printouts human-sized.
3D bioprinters are machines that print cells in layered patterns with the aim of creating a functional tissue or organ. However, the resulting constructs are often structurally unstable and too fragile for surgical implantation. And because they lack blood vessels, their size is constrained by the diffusion limit for nutrients and oxygen, which is around 200 micrometers — too small to make most human tissues and organs.
-----

NSW Health on track to deliver as-a-service hybrid infrastructure

NSW Health has entered the third stage of its transformation project, and said it will continue to work towards shutting down all its datacentres in favour of GovDC.
By Aimee Chanthadavong | February 18, 2016 -- 05:27 GMT (16:27 AEDT) | Topic: Cloud
NSW Health has just entered into the third phase of its transformation project that will involve migrating its existing services and systems into a hybrid as-as-service IT model.
Speaking at Criterion's Implementing an As-a-Service Model conference in Sydney on Wednesday, NSW Health director of infrastructure Andrew Pedrazzini explained the department is just at the start of migrating existing operations onto an as-a-service infrastructure by utilising the capabilities the department has since established.
The move comes after NSW Health started to overhaul its IT infrastructure back in 2009, when it recognised that all of its entities were operating separately.
-----

How Qld Uni removed the IT headache for genome scientists

Inside the Genomics Virtual Laboratory.

By Allie Coyne
Feb 17 2016 12:25PM
Modern genome research is incredibly data-intensive, using big pools of experimental data against catalogues of already available information in many different stages of work to perform genetic mapping.
It's a highly important area of research - scientists analyse genomes (the entire DNA content with a cell) to help them understand disease.
So it goes without saying that to undertake genomics research, these scientists need significant computational and storage resources.
-----

Telstra Corporation Ltd not just a retail telco anymore

By Mike King - February 18, 2016 | More on: TLS
Telstra Corporation Ltd (ASX: TLS) is known by many as Australia’s largest retail telecommunications provider, offering mobile services, home phone and broadband connections, but its other businesses are growing much faster.
Given the telco’s dominance of the retail mobile market with 16.9 million customer services and 3.3 million fixed data services, it’s surprising that the telco can continue to keep adding new users – but it did in the six months to end of December 2015.
Retail customers
Another 235,000 domestic retail mobile services were added, another 121,000 retail fixed broadband subscribers and 163,000 retail fixed bundle customers. 500,000 customers have also registered with Telstra Air – the telco’s nationwide Wi-Fi network, including 120,000 mobile customers. Telstra also has 329,000 NBN connections.
-----

Peter O'Halloran wins Healthcare CIO of the year

Peter O'Halloran

Second year in a row.

By Staff Writer
Feb 18 2016 6:00AM
The National Blood Authority’s CIO Peter O’Halloran has been named Healthcare CIO of the year in the Benchmark Awards for the second year in a row.
After impressing judges and peers alike with an app that allowed sufferers of bleeding disorders to better manage blood inventory in 2015, O’Halloran has taken home another gong in recognition of the innovative and ambitious work he is doing on BloodNet.
BloodNet is the NBA’s nationwide effort to link all of Australia’s pathology labs to its central database to create a single, real-time view of the whole country’s critical blood inventory.
The project is being driven by a need to better manage live-saving blood supplies through shortages and health crises, so Australia’s hospitals are never left in the lurch.
-----

Four futures for the health care system

Enrico Coiera
February 20, 2016
That healthcare systems the world over are under continual pressure to adapt is not in question. With continual concerns that current arrangements are not sustainable, researchers and policy makers must somehow make plans, allocate resources, and try to refashion delivery systems as best they can.
Such decision-making is almost invariably compromised. Politics makes it hard for any form of consensus to emerge, because political consensus leads to political disadvantage for at least one of the parties. Vested interests, whether commercial or professional, also reduce the likelihood that comprehensive change will occur.
Underlying these disagreements of purpose is a disagreement about the future. Different actors all wish to will different outcomes into existence, and their disagreement means that no particular one will ever arise. The additional confounder that predicting the future is notoriously hard seems to not enter the discussion at all.
-----

Translational medicine boost good for patients

Tim Lindsay and Harley Myers
Monday, 15 February, 2016
IN the lead-up to Christmas the Australian translational medicine community was given an early present as the federal government announced the formation of the $250 million Biomedical Translation Fund.
The fund, part of an overall package designed to promote innovation and entrepreneurialism, represents a welcome step towards making Australia a more hospitable place for bio-entrepreneurs. However, while the scheme is a good start, challenges remain.
For those unfamiliar with the term, biomedical translation refers to the process of converting ideas into tangible products. In essence this involves developing a base, scientific or clinical discovery, into a treatment, device, test or drug available in the clinic.
-----

Fintech, health tech driving interest in APIs

In Australia it is still early days for the discussion around APIs as a business tool but interest is growing, says the organiser of the local APIdays conference
The increased profile of the fintech and health technology sectors in Australia is helping drive the conversation around APIs as a business tool, according to Saul Caganoff, an organiser of the local APIdays conference.
“I think there’s a lot of interest in things that are happening in the financial sector, so fintech has gained a fair amount of visibility, particularly in the local Australian environment,” said Caganoff, who is also CTO of Sixtree.
“We’ve seen a lot of initiatives coming out of federal and state government focussed on the post-mining economy and innovation,” Caganoff said.
-----

The role of APIs in the evolving healthcare sector—Jonathan Stern, Regional VP ANZ, MuleSoft

February 14, 2016
The combination of an aging population and longer average life spans is putting increasing pressure on healthcare systems around the world. Existing facilities are struggling to cope with demand, while healthcare-related spending is consuming growing proportions of national budgets.
Advances in medical technology are contributing to the challenge with new procedures and medicines allowing treatment options that did not exist just a few years ago. While this trend is improving the quality of life for patients, it’s also adding to rising healthcare budgets and putting strains on hospital facilities.
The need for change
Confronted with these challenges, healthcare providers are looking for more efficient ways to deliver services that maximise patient outcomes while keeping spiralling costs under control.
-----
HealthcareLink.com.au, Australia’s online jobs platform for the healthcare and medical industry announced today that it has formed a partnership with HealthEngine, Australia’s largest online booking system and health marketplace, to provide medical practices access to competitive recruitment and employment services. The partnership will provide over 10,000 health practices currently registered with HealthEngine access to HealthcareLink’s platform, which has over 10,000 healthcare and medical professionals and a partnership with over 25 healthcare and medical recruitment companies nationally. The aim is to help medical practices leverage HealthcareLink’s network to find the best suited candidate for their practice as efficiently as possible. Dr Marcus Tan, CEO & Medical Director of HealthEngine, said “We are excited to bring this innovative recruitment solution to our clients, as it gives them a choice in how they source and recruit candidates for their growing practices.”
-----
Dear colleague,
Free FPM Opioid Calculator App is here
We are writing to share with you the launch of an exciting new tool that will revolutionise your opioid prescribing practices. The Faculty of Pain Medicine, ANZCA has developed a smart phone application designed to calculate dose equivalence of opioid analgesic medications.  
The FPM Opioid Calculator app is a functional adaptation of the Opioid Dose Equivalence Table recently researched, developed and endorsed by the FPM Education Committee. Therefore you can be assured that the calculations are accurate and safe. The app provides easy accessibility and consistency to facilitate research, improve education and fill a void in availability of reference conversion data in clinical practice.  
-----

Get a sickie note online

A new online service will issue medical certificates and repeat referrals all for the low fee of A$19.99.
The most common reasons for sick notes are heavy migraines, diarrhoea, periods, back pain, and the flu. Dr Sicknote was created to help those most in need by offering a quick, easy and simple solution to get a medical certificate for work.
Melbourne based Dr Sicknote is staffed by general practitioners (GPs) and registered with the Australian Health Practitioners Regulatory Agency (AHPRA).
It’s web site stresses that it is not about people ‘chucking sickies’ in fact it actively discourages it.
-----

My Health Record fast tracks pathology

STATE & territory health departments want to fast-track a project which would allow reports from hospital pathology labs to be uploaded to the My Health Record.
Northern Territory Health ceo Stephen Moo said this was a new initiative agreed to recently in association with the National E-Health Transition Authority (NEHTA).
NEHTA may use the Healthcare Identifiers and the Personally Controlled Electronic Health Record Services technology that has been used to get specialist letters and diagnostic imaging reports into the system from Northern Territory hospitals.
-----

EPAS Project Manager

Contract/Casual
SA, Adelaide
Posted on 17.02.2016
WHO WE ARE
Peoplebank is a preferred supplier to SA Government for professional ICT contract staffing. With ongoing opportunities available in leading SA Government organisations, you will have the unique opportunity to be part of some significant projects at a state wide level.
WHAT WE NEED
We are currently seeking highly experienced Project Manager for a prestigious State Govt. ICT project. To be considered for this cutting edge opportunity, it is imperative that you display the following expertise…
-----

Helping clinicians connect with patients

The MedicalDirector Clinical and PracSoft 3.16 Connect release will enable clinicians to better engage with their patients more cohesively with features that will enhance patient care and ease administrative pressures on practices.
This release is the latest addition to MedicalDirector’s annual release schedule and ensures that clinicians are provided with the most up to date features to support their practices. 
 “We are excited to be able to provide our customers with innovative features that will support the increasing demands on clinicians within the Australian health sector”, said MedicalDirector CEO, Mr Phil Offer. “Through continuous stakeholder engagement, we have built this release to further help our customers”.
The key features across both products that will help customers include:
Revamped Recalls:  A streamlined recalls and reminders workflow has reduced the number of steps required to complete this task by over 50%. This improved process also automatically records the action taken in the patient record. “Customers have reported the revamped recall process is saving their practice over 2 hours a week”, said Mr Offer.
-----

NBN talks up ‘game-changing moment’ for HFC

NBN CTO holding discussion with CableLabs about Full Duplex DOCSIS 3.1
NBN chief technology officer Dennis Steiger has hailed as a “game-changing moment” an announcement from CableLabs that it has proved the viability of full duplex communication over hybrid fibre-coaxial (HFC) connections using the DOCSIS 3.1 standard.
CableLabs is a US-based R&D consortium responsible for developing cable broadband standards.
“Existing technologies mostly use either Frequency Division Duplexing (FDD) or Time Division Duplexing (TDD),” CableLabs said in its announcement.
With FDD upstream and downstream data is transmitted over different frequencies, while TDD involves upstream and downstream traffic taking turns over the same spectrum.
-----
Enjoy!
David.

Sunday, February 21, 2016

The Financial Review Has A Collection Of Articles On E-Health On Their Saturday Front Page. Not Good Advice Offered I Believe!

The two main articles were these. First we had:

Former Vic health minister calls for 'carrot and stick' incentives for e-health

Feb 19 2016 at 7:09 PM
There must be a "carrot and stick" approach to drive GPs and other healthcare providers to use electronic health records and online consultations to reach more patients at lower cost, says a former Victorian health minister.
New figures released by the Federal Department of Health show only 2.59 million Australians – just over 10 per cent of the population – and 7836 healthcare providers have signed up to the government's struggling My Health Record e-health system.
The number of patients is double the 1.3 million signed up in December 2013, just after the Coalition won government in Canberra, but the numbers are still well below the critical mass needed for healthcare providers to have a strong interest in signing up.
The call comes as tight budgets and a swarm of reviews into the rapidly growing $155 billion healthcare sector have put the big players on edge, with pathology companies and GPs threatening to launch an election year campaign against budget cuts from their waiting rooms. 
The use of electronic patient management systems is mainly at trial stage and lags behind similar moves in other consumer industries, such as banking and aviation, by a decade.  
"I think the government should be exploring all options – carrot and stick," said Bronwyn Pike, chairman of Western Health – a large public hospital network based in Melbourne's west – and until recently head of Telstra Health, which offers health IT services including a tablet-based portal for online consultations and conferences. 
Experts such as Ms Pike, and health insurance bosses such as Australian Unity's Rohan Mead, say e-health records are urgently needed to reduce waste and duplication of the kind experienced by John Dalziel, a retired Melbourne advertising executive and Australian Unity health fund member.

Four specialists, four sets of tests

Mr Dalziel, 76, went into the Epworth Hospital at the end of 2014 for surgery to remove a cancerous bowel section, but contracted septicaemia and had to stay for a month. 
He was seriously ill, and said he received excellent care from four different specialists. But when he came out of intensive care, he wondered why they each still called on him so regularly and ordered their own tests, even though they shared the results, instead of co-ordinating their visits. 
"It just seemed amazing to me that I had those four eminent specialists waiting on me. I don't mean to sound ungrateful. [But] each one of them was a very good specialist and could easily have recognised the symptoms the others were looking for and called them in if it was necessary," Mr Dalziel said. 
"When I read about the bad budget situation I think they could have saved a fair bit of money without reducing the care I received." 
Lots more here:
Here is the second article

'Heart-sink' patients: tech pioneers battle healthcare inertia

In economic terms we have got a system that's entirely captured by producer interests.

Feb 20 2016 at 12:15 AM
  • "In an attempt to arrive at the truth, I have applied everywhere for information but in scarcely an instance have I been able to obtain hospital records fit for any purpose of comparison. If they could be obtained, they would enable us to answer many questions. They would show subscribers how their money was being spent, what amount of good was really being done with it or whether the money was not doing mischief rather than good." - Florence Nightingale, 1863, quoted by Rohan Mead, Australian Unity's chief executive, September 2015
Shelley Kleinhans, chief operations officer of Brisbane North PHN, wants the 1000 GPs in the area to bring their "heart-sink patients" to her organisation.
"We describe them to the GPs as: 'These are your heart-sink patients – when they come into your consult room, your heart sinks,'" she says.
"You think 'what is she going to present with today?' and 'how am I going to solve her problems in the 15 or 20 minutes that I have to treat her?'"
These patients have chronic diseases such as cancer, heart disease, diabetes and smoking-related shortness of breath – often compounded by social problems such as isolation, frailty and poor access to transport.
Brisbane North PHN was a pioneer of Team Care Co-ordination, a multidisciplinary team approach to treating such patients. Many are hospital "frequent flyers", consuming an outsized share of the $105 billion spent annually on health by state and federal governments.
Government health budgets, and the additional $50 billion spent directly by patients and their private insurers, are a fiercely contested battleground in an era of flagging tax revenues and soaring healthcare costs.
Health Minister Sussan Ley has launched an armada of reviews aimed at trimming spending. Initial budget cuts to pathology rebates have already drawn threats by pathology companies and doctors to carpet-bomb waiting rooms with election year anti-government leaflets.
Brisbane North PNH, one of 31 federally funded primary health networks, had its own electronic health records system built a decade ago. It aimed to support co-ordinated care and keep more patients out of hospital by enabling GPs, hospital doctors and other clinicians to instantly share case notes.
The 2000 participating patients in a trial from 2005 to 2007 were 26 per cent less likely to be admitted to hospital than a control group of 1000, a study found.
Co-ordinated care is one way health experts reckon the health budget could be trimmed or better spent. Brisbane North PHN also uses a localised version of Map of Medicine, a British software system that maps optimal "clinical pathways" for the treatment of different ailments.
When a GP in Brisbane North PHN's area encounters a chronically ill patient, she contacts a care co-ordinator at the organisation – a registered nurse – who checks in on the patient at home.
The care co-ordinator then arranges support. This could be as simple as helping the patient to take the right medicines at the right time, engaging local services to take her shopping once a week or take out the wheelie bins to prevent falls. The co-ordinator can also help to buy walking aids or pay for exercise classes or physiotherapy.
"Their role is to understand what a person needs and work with them to keep them out of hospital – and delay admission to a nursing home," Kleinhan says.
Hospital and nursing homes are the costliest ways to provide services, so reducing admissions can save a lot of money.
Lots more here:
Leaving aside the obvious comment regarding the frequent mention of Telstra’s offerings the issue that concerns me here is the failure to acknowledge that just waving the term ‘e-health’ will not suddenly see a cure to all that ails the health system.
Interestingly, with a comment like this “The use of electronic patient management systems is mainly at trial stage and lags behind similar moves in other consumer industries, such as banking and aviation, by a decade.” there is denial of all the technology presently used by GPs, hospitals, labs abd so on. What is missing is not ‘e-health’ (whatever that is) but the leadership and governance mechanisms to have all this technology actually sharing information to improve co-ordination and information flows.
If the PCEHR was a workable solution, and properly designed, it would have been adopted with alacrity. Sadly this was not the case and so we are now where we are.
Unless the new planned Australian Digital Health Agency and its Board and CEO can turn things around and leverage what exists with some sensible well planned initiatives we are all in strife.
I am not sure the advice from a former State Health Minister to stick with an implementation that has failed rather than move to a new direction deserves to be taken at all seriously - despite the fact that the problems she identifies are important. It is here plan for the future which is deeply flawed and probably should be ignored.
David.