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, March 12, 2016

Weekly Overseas Health IT Links - 12th March, 2016.

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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Google's AI outfit focuses on health tech

Rebecca McBeth
1 March 2016
Google-owned artificial intelligence company DeepMind has launched a new division to work with NHS clinicians on developing technology to improve patient care.
DeepMind Health’s first project is an iPhone app designed to help identify patients at risk of dangerous complications.
Developed with the Royal Free London NHS Foundation Trust, Streams will help clinical staff detect cases of Acute Kidney Injury, which is a contributing factor in up to 20% of emergency hospital admissions.
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NQF issues guidance on measurement of HIT patient-safety efforts

March 4, 2016 | By Susan D. Hall
The National Quality Forum (NQF) has issued a new report on health IT safety and how it should be measured.
The 99-page guidance offers a framework for determining the effect of health IT on patient safety and prioritizes key measurement areas, according to an announcement.
The guidance is the product of a committee of 22 health IT and safety experts that the NQF convened on the topic. It is based on three high-level concepts:
  • Safe health IT: To ensure that health IT is accessible and usable as needed and that health IT data are complete, accurate, secure and protected.
  • Using health IT safely: To ensure that features and functionality are used as intended and that there are procedures in place to monitor and detect problems.
  • Improving patient safety: To ensure that health IT is used to reduce patient harm and improve safe patient care.
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Telehealth Could Deliver Over $6B in Healthcare Savings Yearly

The global adoption of telehealth technologies will potentially allow governments to make substantial savings on healthcare, while delivering important medical services to both rural and under-served communities, according to business intelligence provider GBI Research.
The company’s latest report* states that the telehealth market is being driven by the accelerated development of mobile technology and applications, a greater need for cost-effective healthcare, rising populations, and increased government funding.
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Could Twitter Be a Recruitment Tool for Cancer Trials?

Study suggests it has untapped potential for linking patients to clinical trial enrollment websites
THURSDAY, March 3, 2016 (HealthDay News) -- Twitter might help boost the number of cancer patients who enroll in clinical trials of potential treatments, a new study suggests.
A number of cancer centers and cancer care groups use Twitter, the online social networking service, to provide health information and education. But it wasn't known how much information about cancer clinical trials was available on Twitter.
To find out, researchers analyzed more than 1,500 tweets that contained the term "lung cancer" during two weeks in January 2015.
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National efforts take aim at reaching semantic interoperability

Published March 03 2016, 7:41am EST
As the healthcare industry grapples with the daunting challenges of achieving interoperability, stakeholders are focused on solving the fundamental problem of ensuring that all parties “speak the same language,” through the use of common data models and vocabularies.
Semantic interoperability, the ability of two or more healthcare systems to share clinical information and use it meaningfully, is a critical requirement for enabling population health management and the rapidly approaching transition from fee-for-service to value-based care models.
However, the lack of a universal terminology standard is a major barrier to communication between different electronic health record systems and the ability to derive clinical meaning from EHR data imported or queried from elsewhere.
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HIT Think What are healthcare CIOs losing sleep over now?

Published March 02 2016, 12:10pm EST
Liz Johnson has led a variety of informatics efforts at Tenet Healthcare, where she’s now chief information officer for acute care hospitals and applied clinical informatics. In her role, she provides information services and applied clinical informatics leadership for Tenet’s hospitals.
Johnson also has risen in her roles at the College of Healthcare Information Management Executives (CHIME), where she particularly has keen interest in policy initiatives and frames CHIME’s responses to federal policy, which carry significant weight in influencing HIT regulation. In 2017, she’ll be CHIME’s board chairman, leading the organization as it continues efforts to expand its influence.
Johnson recently answered questions from HDM Editor Fred Bazzoli on her expectations for the coming year.
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Hurley Medical’s EHR analysis is playing a key role in Flint’s water crisis

By John Morrissey
Published March 03 2016, 7:24am EST
Without the power of electronic health records, the discovery of high levels of lead in the water supply of Flint, Mich.—and subsequent proof that its children were accumulating high levels of lead in their blood—is a tragic story that might not even be known to this day
Acting on a hunch, a pediatrician at Hurley Medical Center ordered an analysis of blood test records that compared blood lead levels in small children before and after the city switched its water supply from Lake Huron to the Flint River in a cost-saving move.
The results, calculated from hundreds of specific records that were identified and then geographically mapped, took just two weeks. The stark evidence showed a doubling, and in some places a tripling, of lead levels in 1- and 2-year-olds—ages in which the neurotoxin can cause significant developmental damage. Those results led to a shutdown of the Flint water supply and reestablished the lake water source.
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GAO: Obtaining EHR data a challenge to identifying adverse patient safety events

February 29, 2016 | By Marla Durben Hirsch
Pulling data from electronic health records to efficiently identify adverse events is one of the "key challenges" hospitals face in reducing such events, according to a new report from the Government Accountability Office (GAO).
The report, part of a study of six selected hospitals from April 2015 through February 2016 regarding implementing evidence-based practices, found that all of the hospitals faced the same challenges in using EHRs to reduce adverse patient events.
Obtaining data on adverse events requires substantial time, resources and investment in EHR systems. In addition, hospitals needed to use multiple vendors to obtain the data, had trouble reconciling the electronic records with paper ones, and had to deal with EHR data that was inaccurate.
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Fast-growing medical scribe industry poses risks to patients, and to product design

Soon there will be one scribe for every seven doctors. What will that mean for EHRs?
March 02, 2016 09:35 PM 
LAS VEGAS – As electronic health records have proliferated in recent years, so has the use of medical scribes. That's an unwelcome development for two big reasons, said two chief medical information officers at HIMSS16 on Wednesday: patient safety and EHR usability.
Scribes are unlicensed individuals hired and trained to enter clinical information into EHRs at the direction of physician. The scribe industry has grown quickly since HITECH Act spurred massive EHR adoption.
More than 20 companies provide scribe services in 44 states, according to data provided by S. Luke Webster, MD, system CMIO at CHRISTUS Health, and his colleague, George Gellert, MD, associate system CMIO. A tally in 2014 estimated that 10,000 scribes were working in the U.S. That number is doubling annually, with more than 20,000 expected this year.
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Safety collaborative releases copy and paste safety guide

March 1, 2016 | By Marla Durben Hirsch
The Partnership for Health IT Patient Safety, a collaborative convened by the ECRI Institute, has released its safe practice recommendations for using the copy and paste function in electronic health record systems.
The copy and paste function can increase efficiency, create continuity of care and save time, but it also holds risks if not used correctly, including compromising the integrity of the record and creating bloated notes, according to an announcement.
The toolkit, the Partnership's first release in a series of evidence-based recommendations to improve health IT safety, provides four recommendations regarding copy and paste.
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ONC finds significant disparities in use, access to online medical records

March 1, 2016 | By Marla Durben Hirsch
The number of people using IT for their health needs increased "significantly" between 2013 and 2014, but socio-demographic disparities remain, according to the latest data brief from the Office of the National Coordinator for Health IT.
The data brief shows that the percentage of individuals offered online access to their medical records grew by over one-third to nearly 4 in 10 (38 percent) in 2014. Not surprisingly, individuals whose provider had an EHR were offered online access to their medical record three times more than the rate of those whose provider did not have an EHR, 22 percent compared to just 9 percent.
However, the differences varied widely based on income, education, race and proficiency in English. More than half (53 percent) of people with incomes above $100,000 were offered access to their information, compared to 27 percent of those that had incomes of less than $25,000. Sixty-six percent of those with incomes over $100,000 actually viewed their record, compared to 36 percent of those whose incomes were less than $25,000. Fifty-two percent of those with more than a four-year college degree were offered online access compared to 19 percent of those who were not high school graduates.    
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Better research required for effective use of teleheath

March 3, 2016 | By Susan D. Hall
Telehealth research tends to be overly positive, as it is often based on short-term projects, according to a paper published at Journal of Medical Internet Research, which suggests that future research should study the impact and effective use of telehealth.
"Future research is needed to identify additional factors that promote telehealth acceptance, such as human-technology interaction, organization of the healthcare system and social factors," write members of the Transatlantic Telehealth Research Network.
The authors point to barriers to telehealth for chronic care including reimbursement, the need for extensive care teams to work with patients, effective data management from various devices, the ability to apply predictive analytics and application of data into clinical practice. Efficient business models must emerge if technology-driven healthcare services are to grow.
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St. Luke's Marc Chasin: CIO now an active member at the leadership table

December 11, 2015 | By Katie Dvorak
The hospital chief information officer is at the intersection of technology and clinical care more than ever before, says Marc Chasin, M.D., CIO of St. Luke's Health System.
As a physician, that's where his passion is, he tells FierceHealthIT in an exclusive interview.
"I actually feel now that my role is an active participant in the transformation of care and the way that healthcare is going from volume to value," adds Chasin, who also serves as the Boise, Idaho-based health system's chief medical informatics officer.
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E-observations reduce cardiac arrests in Scottish hospital

Rebecca McBeth
2 March 2016
NHS Fife has seen a significant reduction in cardiac arrests in one of its hospital’s busiest areas after deploying an electronic observations and early warning system.
The health board became the first in Scotland to deploy a full scale electronic track and trigger system when it went live with Patientrack at its Victoria Hospital six months ago.
The Medical Admissions Acute Unit has seen the number of cardiac arrests fall by as much as two thirds since deploying the technology.
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Concerns Emerge Over Electronic Records Errors In ERs

Shefali Luthra of Kaiser Health News Mar 2, 2016
The mouse slips, and the emergency room doctor clicks on the wrong number, ordering a medication dosage that’s far too large. Elsewhere, in another ER’s electronic health record, a patient’s name isn’t clearly displayed, so the nurse misses it and enters symptoms in the wrong person’s file.
These are easy mistakes to make. As ER doctors and nurses grapple with the transition to digitalized record systems, they seem to happen more frequently.
“There are new categories of patient safety errors” in emergency rooms that didn’t exist before the push to use electronic record systems, said Raj Ratwani, who researches health care safety and is the scientific director for MedStar Health’s National Center for Human Factors in Healthcare in Washington, D.C.
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Judy Faulkner: 'Good software is art'

In a frank conversation with Healthcare IT News, the Epic CEO says her company gets a bad rap. But the numbers show it more than stacks up.
March 01, 2016 07:48 PM 
LAS VEGAS – For Judy Faulkner, the quest for interoperability started in 2004.
“We were the first,” she pointed out in an interview with Healthcare IT News, on Tuesday in a meeting room at the Epic booth. As she walks into the small space, she is in search of chocolate, and she finds it.
She settles into one of the sofas, prepared to make her way through a series of questions.
The interview begins with the topic of interoperability because Epic has a reputation – among some circles – of being a “closed system.” 
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ONC proposes direct review of health IT certification to improve interoperability

Medical records should be able to “to speak and listen in the same language,” officials say in HIMSS16 session.
March 01, 2016 01:53 PM 
LAS VEGAS - Health IT products will be certified directly by the Office of the National Coordinator under a proposed rule change, officials announced in the National Coordinator Spotlight session Tuesday at HIMSS16. Senior members of the ONC described the change as necessary to make sure that medical record sharing becomes a reality.
Elise Adams, acting director of policy at ONC said, “it’s crucial that we certify technology,” in emphasizing the importance of improved interoperability. Medical records should be able to “to speak and listen in the same language,” she said.
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Ponemon: Healthcare Cyber Attack Averages One Per Month

By Elizabeth Snell on March 01, 2016
Healthcare cybersecurity can improve as healthcare organizations are averaging about one cyber attack per month.
LAS VEGAS - Healthcare cybersecurity must improve, as organizations average about one healthcare cyber attack per month, according to a recent Ponemon survey.
In The State of Cybersecurity in Healthcare Organizations in 2016, Ponemon also found that 48 percent of those surveyed said their organizations have experienced an incident involving the loss or exposure of patient information during the last year. However, only half of respondents also said that their organization currently has an incident response plan in place.
For the survey, 535 IT and IT security practitioners in small- to medium-sized healthcare organizations in the U.S. were interviewed. Furthermore, 64 percent are employed by HIPAA covered entities, while 36 percent work for business associates of covered entities.
"Based on our field research, healthcare organizations are struggling to deal with a variety of threats, but they are pessimistic about their ability to mitigate risks, vulnerabilities and attacks," Larry Ponemon, chairman and founder of The Ponemon Institute, said in a statement. "As evidenced by the headline-grabbing data breaches over the past few years at large insurers and healthcare systems, hackers are finding the most lucrative information in patient medical records.”
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Karen DeSalvo: ONC launching 3 app developer challenges to advance FHIR

The funding will go toward patient- and provider-facing apps, as well as a ‘store’ where consumers can download them.
March 01, 2016 05:00 PM
LAS VEGAS – National coordinator Karen DeSalvo, MD, announced three new developer challenges that aim to advance interoperability through the emerging Fast Healthcare Interoperability Resources standard Tuesday morning at HIMSS16.
The “challenge grants” have three streams: a consumer-facing, vendor neutral app based on FHIR, a provider-facing app, and a discovery place where people can go to download those apps. 
DeSalvo said the intent is “to create a world that is more Internet-like,” more akin to the technological advancements that Americans are accustomed to in banking, retail and so many other industries. 
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Meet the R2D2 of hospital technology

BY Jenny Gold, Kaiser Health News  March 1, 2016 at 4:16 PM EST
Meet the Tugs — a team of 27 robots now zooming around the hallways of the new University of California-San Francisco hospital at Mission Bay. They look a bit like R2D2, dragging a platform around behind them. Instead of drones, think of them more as little flatbed trucks, ferrying carts of stuff around the vast hospital complex — food, linens, medications, medical waste and garbage. And they do it more efficiently than humans.
“This one is going up to one of the floors. It’s carrying meals that were ordered in probably the last 20 minutes,” said Dan Henroid, who is in charge of this elite fleet, as he pointed to a robot motoring by him.
Henroid, who is also director of nutrition and food services for the USCF Medical Center, says each Tug travels about 35 miles each day. Over the past year, they have made more than 157,000 trips through the hospital.
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Halamka: Meaningful Use has run its course

Published March 01 2016, 7:03am EST
Never one to mince words, John Halamka, MD, CIO of Boston’s Beth Israel Deaconess Medical Center issued a wide-ranging call to action for healthcare information technology, including electronic health records, big data and analytics, cloud and mobility solutions.
Delivering the opening address at a pre-conference symposium entitled “Are We There Yet? Health Information Technology’s Report Card,” Halamka declared that the Meaningful Use program has “run its course” and that the healthcare industry must move away from the EHR Incentive Programs to outcomes based payment models for clinicians and hospitals while embracing new reimbursement approaches.
While EHRs had been “perfectly engineered” to meet regulatory requirements, he evaluated the performance of these systems to date giving them a C+ grade overall. The problem, according to Halamka, is that in order for a clinician to get through a patient encounter and be Meaningful Use Stage 2 compliant they must enter 141 structured data elements to calculate electronic quality measures that “probably aren’t going to be used.”
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ONC's Steve Posnack: New Interoperability Proving Ground 'like Match.com for FHIR'

Project aims to highlight interoperability successes and bring the community together to address challenges.  
February 29, 2016 06:16 PM 
LAS VEGAS – Steve Posnack of the Office of the National Coordinator for Health IT likened ONC’s new Interoperability Proving Ground to online dating sites.
“There’s a lot going on around interoperability, we just have to prove it,” Posnack, director of ONC’s office of standards and technology, said on Monday morning.
That is the intention of the Interoperability Proving Ground Posnack unveiled last week and outlined at HIMSS16 – to highlight interoperability successes and bring the community together to address challenges.
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ONC releases report to Congress on HIT progress, barriers

March 1, 2016 | By Katie Dvorak
In its annual report on the state of HIT to Congress, the Office of the National Coordinator looks back at the progress it made in 2015 and at the barriers that still need to be overcome.
The ONC says throughout 2016, it will continue to "build the economic case for interoperability," coordinate with industry stakeholders to increase enhance consumer access to data, and to care and discourage health information blocking, among other goals.
Efforts that the agency highlights in the report made last year include broad, sweeping initiatives like the Health IT Strategic Plan 2015-2020 and its Interoperability Roadmap, as well as its growing role in areas like patient engagement, delivery system reform and precision medicine.  
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LIVE FROM THE CHIME-HIMSS FORUM: Are CIOs Prepared to Facilitate OpenNotes?

February 29, 2016
by Mark Hagland
At the CHIME-HIMSS Forum on Monday, much discussion revolved around the OpenNotes initiative
In his speech to attendees at the CHIME-HIMSS Forum on Monday, Marc Probst, the CIO at the Salt Lake City-based Intermountain Healthcare, and incoming chairman of the board of the College of Healthcare Information Management Executives (CHIME) strongly emphasized some of the policy-oriented initiatives the association is pursuing, among them its National Patient ID Challenge, its exploration of partnerships for personalized medicine, and its new partnership with the OpenNotes initiative.
Just last week, CHIME had announced its partnership to accelerate information-sharing between patients and providers. In its Feb. 25 announcement, the association had quoted CHIME president and CEO Russell Branzell as stating that “We are seeing a tremendous swing toward value-based care and consumerism in healthcare. Patient engagement is a big part of that movement, but to be true partners in their care, patients must have access not only to their basic health records, but the notes that clinicians make during appointments. This partnership with OpenNotes is a terrific opportunity to promote innovative change in medical practice designed to increase patient engagement,” he was quoted as saying in the announcement.
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Burwell: EHR giants Epic, Cerner, Meditech among those taking pledge to standardize health IT

The vendors, as well as organizations like HIMSS and AHIMA, will support standardized APIs and will make patient access easier, the HHS secretary says.
February 29, 2016 09:53 PM
Nearly every big name in healthcare technology has pledged to use standardized APIs, to make patient access easier and to not block information, Department of Health and Human Services Secretary Sylvia Burwell announced during her HIMSS16 keynote Monday night.
“Companies that provide 90 percent of electronic health records used by hospitals nationwide as well as the top five largest private healthcare systems in the country have agreed to implement three core commitments,” she said.
Companies that offer the most EHRs – Cerner, Epic and Meditech  -- were among those that took the pledge.
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HHS, Epic, Cerner, More EHR Vendors Make Interoperability Pledge

By Jennifer Bresnick on February 29, 2016

The healthcare industry is coming together to combine their efforts to make health data interoperability a core competency for providers and vendors, HHS says.

LAS VEGAS – At a keynote address during the 2016 HIMSS Conference and Exhibition, HHS Secretary Sylvia Burwell announced a broad industry initiative to further health data interoperability, information sharing, and patient engagement.
More than a dozen professional organizations, the five largest healthcare systems in the country, and electronic health vendors representing 90 percent of the EHR market in the United States have all agreed to implement three core principles to reduce information blocking, increase patient access to their own health data, and embrace national interoperability standards, including those related to privacy and security.
 “These commitments are a major step forward in our efforts to support a healthcare system that is better, smarter, and results in healthier people,” Burwell said.  “Technology isn’t just one leg of our strategy to build a better healthcare system for our nation – it supports the entire effort.”
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Medical Device Vulnerabilities High on CIO's List of Worries

Scott Mace, March 1, 2016

The CIO of a California hospital shares security horror stories from his experience in the telecom industry and calls unsecured devices "a big, big, big problem."

As HIMSS gets underway, the healthcare IT world is still shaking from last month's audacious privacy breach at a California hospital. Hollywood Presbyterian Hospital paid a $17,000 ransom to a criminal enterprise that broke into the hospital's system, encrypted data, and demanded an even larger payment.
While the concept of "ransomware" is not new, the very public ransom payment by Hollywood Presbyterian once again ratchets up the pressure in healthcare executive suites and boardrooms to do something different, and soon, to protect healthcare's digital assets.
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Room for error: EHRs in the ER pose safety risks

March 1, 2016 | By Zack Budryk
As electronic health records (EHRs) become a part of healthcare's "new normal," particularly in the emergency department, experts are concerned the new status quo is introducing more opportunity for medical errors, according to Kaiser Health News.
Medical errors are already the nation's third-leading cause of death, and widespread adoption of EHRs has created new ways for mistakes to be made, such as a nurse entering the wrong symptoms or a doctor clicking on the wrong number and overprescribing a medication.
In ED settings, KHN notes, the pace is so fast that many healthcare workers must power through processes they may not have had sufficient time to learn; in other cases, ED-based EHR programs previously were developed independently of the hospital's main system, but are being replaced by newer, unfamiliar hospital-wide systems.
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Credit card tech may solve health identity and payments issues

Published February 26 2016, 12:29pm EST
Can the same technology that is used to reduce fraud with counterfeit credit cards be used to deal with security issues involving healthcare identity, authentication and payments?
That’s the question before the Smart Card Alliance, which believes that smart card technology can address both concerns.
A just-released white paper from the alliance offers the premise that EMV chip technology can be used to address identity authentication issues within healthcare, just as it is being used to deal with credit card fraud.
The paper was developed by the Health and Human Services Council of the Smart Card Alliance.
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Texting can help smokers quit the unhealthy habit, reveals new research

February 29, 2016 | By Judy Mottl
Text messaging can help college-age smokers quit the unhealthy habit, and is an economical and easy-to-deploy technology, according to a study published at the Journal of American Medical Association's (JAMA) Internal Medicine.
While the study's authors, from Linköping University in Sweden and the Cambridge Institute of Public Health in England, write that since they were able only to assess the short-term effects, the results were comparable with traditional interventions, the text-based program "has the potential to improve the uptake of effective smoking cessation interventions" in the long-term.
The research involved a 12-week clinical trial that collected data from 1,590 college-age smokers in Sweden, split into two groups, who all had a goal of quitting smoking within one month of enrollment. The group receiving messaging were sent 157 support texts; the control group was sent one text every two weeks thanking them for participating in the study.
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Enjoy!
David.

Friday, March 11, 2016

It Rather Looks Like The DoH Have Messed Up Another E-Health Program. Hardly A Surprise!

This appeared last week:

GPs fear aged care referrals lost in IT blackhole

| 2 March, 2016 |  
GPs fear vulnerable patients needing aged care services are falling through the cracks due to ongoing problems with a new national referral system.
The Federal Government changed the aged-care service referral pathway from a local to a central system in July last year with the launch of the My Aged Care website - through which all GP referrals for care now have to be made.
By September the government had admitted the system was cluncky to use and advised GPs to fax referrals for home care, such as wound dressing or blood pressure checks, until it could create a better web form.
Six months later no new form has been devised. It has also became necessary last month to use the website to make Aged Care Assessment Team (ACAT) referrals, which assess eligibility for high-level care, such as entering an aged care facility.
The unresolved IT issues have led GPs to warn that they fear referrals for vulnerable patients are taking too long or even going missing.
They say they don't know if patients are facing lengthy delays or whether their referral has been actioned. 
Dr Trina Gregory, of Port Macquarie GP Super Clinic, says she sends referrals by fax, but does not hear back. 
It then becomes necessary to ask the practice nurse to chase up each referral.
“I feel sorry for the nurses who get left with this whole mess,” she told Australian Doctor.
The centralised system also meant GPs could no longer provide patients with the name of the service provider they had referred them to, added Dr Nathan Pinskier, chair of the RACGP’s expert committee on e-health and practice systems. 
As a result, some elderly patients became confused when contacted by a provider and would hang up when they phoned, he explained.
Illana Halliday, CEO of the Aged and Community Services Association (NSW & ACT), said the national system had been beleaguered with constant “glitches” since its rollout.
In response, the association had sent a “long list of issues” to the Department of Health.
These included the added administrative burden on providers making referrals and failure to promote the system, causing patients to make direct requests to services.
There were also issues with the pipeline which was leaving GPs out of the loop, she said.
“Those who do the referrals can’t get feedback, because My Aged Care only contacts the customer directly.
More bad news here:
Looks like another real mess to me on the basis of the stories told here!
Well worth a read of the full article!
David.

Thursday, March 10, 2016

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

March 10 Edition
The macroeconomic stresses seem to have eased a little more with markets rising around the world.
With that said there a still some who have a few clues who are pretty worried.
Here is a link to one such from the legendary Bill Gross.
March 2, 2016

Sunshine, Lollipops and…

Our Sun – a rather tiny star in the galaxial scheme of things – seems inexhaustible. But 5 billion years from now, it will swallow, instead of nurture the Earth as it burns itself out – first contracting, then expanding like a flaming candle turned firecracker. Not to worry though. We won’t be around. It’s not that we are beyond worrying; it’s that our lives are much shorter and we needn’t think much about it. In the nearer term, there is global warming/climate change, and other such down to Earth problems as paying the bills and getting kids into the right colleges. Still – there are presumably inexhaustible things that deserve our attention in the here and now. One of them is finance-based capitalism and our assumption that the risk/ reward historically inherent in it will be sufficient to drive economic growth forward. Unlike the Sun, whose fate and lifespan can be scientifically determined, there is little evidence that anything could ever change what has been until now a flawed, yet the best economic system conceivable. Capitalistic initiative married to an ever expanding supply of available credit has facilitated economic prosperity much like the Sun has been the supply center for energy/ food and life’s sustenance. But now with quantitative easing and negative interest rates, the concept of nurturing credit seems to have morphed into something destructive as opposed to growth enhancing. Our global, credit based economic system appears to be in the process of devolving from a production oriented model to one which recycles finance for the benefit of financiers. Making money on money seems to be the system’s flickering objective. Our global financed-based economy is becoming increasingly dormant, not because people don’t want to work or technology isn’t producing better things, but because finance itself is burning out like our future Sun.
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Also, in Australia, we are now see a set of continuing bun-fights on pathology funding, health insurance costs as well as negative gearing and superannuation. Will be fun to watch. Mr Trunbull and Mr Morrison seem to have disappointed with the lack of a clear plan.
Two weeks ago we heard there would be a before the Budget announcement of  tax proposals so that will happen soon. Stay tuned!
Here is a summary of interesting things up until the end of last week:
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General Budget Issues.

  • Feb 28 2016 at 5:18 PM

PM needs to define his purpose

by The Australian Financial Review
What is the point of Prime Minister Malcolm Turnbull, we asked three weeks ago in the wake of his dumping of a substantial tax reform package that would deliver an economic growth dividend. That question has become the central theme of national politics. The government has lost purpose because it has shied away from the critique Mr Turnbull made of Tony Abbott in September 2015: that the then prime minister had not provided the economic leadership needed to revive growth and secure national prosperity. As we foreshadowed, the government instead has been dragged into debate about piecemeal tax changes and forced to fight – including with itself – on Labor's preferred territory.
It started late in 2015, when Treasurer Scott Morrison flew up the white flag on fiscal repair by allowing any projected budget surplus to drift into the 2020s. Instead of fiscal fortitude, Mr Morrison sought an economic growth dividend from incentive-sharpening income tax cuts, financed by an increase in the goods and services tax. But Mr Turnbull over-ruled this option before Australians returned to work from their summer break. Among the casualties are hopes of a new federalist bargain on federal-state responsibilities that would tackle cost-shifting and fiscal featherbedding in areas such as health. And, then, last week's defence white paper committed the government to a lot more extra spending – as much as it is justified by security considerations – that would push the early 2020s budget back into the red.
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Spending cuts must fund tax relief, Scott Morrison tells MPs

10:38am DAVID CROWE
Amid heightened talk of an early election, the Treasurer has warned Coalition MPs that old approaches to spending restraint had not gone far enough, forcing the need for greater cuts in upcoming budgets to help fund the tax relief for ordinary workers.
Malcolm Turnbull yesterday insisted he expected the election to be held “in the normal way” in August, September or October, but Industry Minister Christopher Pyne said it would be “very difficult” to avoid calling a double dissolution election
The last date for a double dissolution election this year is July 16, setting a deadline for Mr Turnbull if he wants to clear out the upper house after more than two years of obstruction of the ­Coalition’s agenda.
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Abbott’s warning is timely but Turnbull must deliver

  • The Australian
  • March 1, 2016 12:00AM
Tony Abbott’s detailed defence of his time in office undoubtedly was inconvenient for Malcolm Turnbull. It included elements of score-settling and legacy protection, but the former prime minister also accurately set out the task required of the incumbent. Mr Turnbull is committed to some form of taxation, federation and industrial relations reform to take to an election this year and his Treasurer, Scott Morrison, must deliver a budget in May. Mr Abbott is clearly still smarting from the criticism used by his usurper in September, that his government lacked an economic narrative. So, retrospectively, he has mapped out a first principles guide to reform. “The first law of governing is that you can’t spend what you can’t raise through taxes and borrowings,” he wrote in the Quadrant article published in The Weekend Australian, “and the second law is that today’s borrowings have to be paid for — with interest — by tomorrow’s taxes.”
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  • Updated Mar 2 2016 at 7:31 AM

Government cools on negative gearing as 'hypocritical' Abbott turns up heat

Plans by the Turnbull government to limit negative gearing by high-end investors are hanging by a thread after Tony Abbott joined a backbench revolt and dared Prime Minister Malcolm Turnbull and Treasurer Scott Morrison to fund tax cuts through spending restraint, not tax increases.
But Mr Abbott's call, made to the weekly meeting of Coalition MPs, was slammed as "downright hypocritical" by senior members of the government who pointed out that Mr Abbott, as prime minister, introduced more than $20 billion in tax increases to help fund his tax cuts, including the abolition of the carbon tax.
Mr Abbott's tax increases included the reindexation of petrol excise, the so-called income tax deficit levy on high-income earners, and the backpackers tax. 
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  • Mar 2 2016 at 11:43 AM
  • Updated Mar 2 2016 at 8:52 PM

GDP rises 0.6pc in September quarter, up 3pc for the year

 A sustained burst of spending, led by households in the powerhouse states of NSW and Victoria, helped the economy shrug off another quarter of falling national income and commodity price falls, triggering rallies in the Australian dollar and the stock market.
December quarter National Accounts showed the economy grew 0.6 per cent from the September quarter and 3 per cent from a year earlier, a pace that is only just above the level Treasury regards as the economy's "trend" or potential growth rate, which is consistent with strong jobs growth.
The figures buttress a recent flurry of buoyant retailing company results and help explain the underlying strength of the labour market in late 2015, which has seen the jobless rate hover well below the 6.5 per cent forecast in last year's budget.
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Health Budget Issues.

Pathology sector launches campaign against bulk-billing cuts

Date February 28, 2016 - 6:00PM

Jane Lee

Exclusive
Pathologists will ask millions of patients to sign a petition against bulk-billing incentive cuts in a national campaign against the Turnbull government in the lead-up to the next election.
Doctors at 5500 private collection centres will on Monday begin approaching their patients to sign a petition asking the Senate to block the cuts, due to come into effect from July 1 if passed.
The cuts could "reduce access to quality health care", which may mean patients go without vital tests if they could not afford them, travel further to hand in samples and wait longer for results, the petition says.
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True blood: cutting through confusion about pathology cuts

March 1, 2016 11.26am AEDT
Bruce Baer Arnold
Assistant Professor, School of Law, University of Canberra
The pathology sector in Australia is no longer a cottage industry. It is dominated by a handful of billion-dollar enterprises that analyse blood, tissue and other samples. These tests enable timely diagnosis of a range of illnesses and allow clinicians to optimise treatment by ensuring patients get the right mix of medications for specific conditions.
The sector uses advanced technology, involving high-cost specialist equipment rather than individual pathologists equipped with a microscope. It’s big business. The overall Sonic group, which includes one of the two leading services, last year reported annual revenue of more than A$4 billion.
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Primary Health Care in billing shake-up

  • The Australian
  • March 1, 2016 2:44PM

Sarah-Jane Tasker

Primary Health Care has created a private billing division to develop a new model for its medical centres, in a bid to curb the impact of cuts to federal government subsidies.
The company (PRY) announced today that Henry Bateman, the son of the late founder of Primary Ed Bateman, would step down from the role of general manager Medical Centres to pursue other opportunities.
Primary said that following Mr Bateman’s departure it had decided to separate bulk billing and private billing in its Medical Centres structure.
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Doctors share the blame for a sick budget

Date March 1, 2016 - 9:00PM

Ross Gittins

The Sydney Morning Herald's Economics Editor

Some of my best friends are doctors. These days, I even have in-laws who are doctors. I've just become a grandad and my tiny grandson stands a fair chance of ending up as a doctor, too.
But I'm still a journo, and have to do my job. So let me let me adapt something Kerry Packer said about a youthful Malcolm Turnbull: never get between a doctor and bag of money.
If you wonder why it will be so long before we get the federal budget back into surplus, doctors are part of the reason.
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Malcolm Turnbull to states: fix health budget yourselves

  • The Australian
  • March 4, 2016 12:00AM

David Crowe

Rebecca Puddy

Malcolm Turnbull is holding out against state pleas for an emergency $7 billion fix for public hospitals ahead of a showdown on health policy within weeks, telling the premiers to develop their own ­solution before expecting federal aid.
The Prime Minister is facing collective pressure from the states and territories to top up their funds for health and education through to 2020, reversing decisions in the May 2014 federal budget that scaled back the growth in federal funding by $80bn across a decade.
His message is that the states and territories must start to fix their funding gaps before expecting the commonwealth to solve the problem, raising the idea of state spending cuts or tax rises.
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Health Insurance Issues.

Pain hits the family pocket

March 1, 2016 9:00pm
Herald Sun
FAMILIES will be sickened by the latest health fund premium increases that will see more than $200 a year added to the cost of their cover from next month.
As reported in today’s Herald Sun, this increase represents a 5.5 per cent rise on average and is the ninth successive rise of more than 5 per cent.
Families hoping for tax relief in the tax reforms promised by the Turnbull government will question why the government is not able to impose greater control over the cost of health insurance.
The total increase since 2002 is a massive 142 per cent, compared with inflation of less than 50 per cent across the economy in that time.
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Health fund premiums will rise by another 5.59 per cent on average from next month

March 2, 2016 12:00am
John Rolfe, Cost of Living Editor News Corp Australia Network
EXCLUSIVE
HEALTH fund premiums will rise by another 5.59 per cent on average from next month, adding more than $200 a year to the already-steep cost of family cover and delivering insurers an extra $1 billion of revenue.
The increase, which will be confirmed today by Health Minister Sussan Ley, is the ninth in a row of five per cent-plus increases.
Steep successive rises dating back as far as 2002 mean a policy that cost $2000 then will now set a household back $4840 — an increase of 142 per cent, compared to economy-wide inflation of less than 50 per cent.
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Private health insurance premiums to rise by 5.6 per cent in April

Date March 2, 2016 - 9:45AM

Michael Koziol

Journalist

Private health insurance premiums will rise by an average of 5.59 per cent this year, an outcome Health Minister Sussan Ley is chalking up as a win for consumers.
In January, Ms Ley required insurers to resubmit their applications for premium increases, citing her concern that the process did not allow the government to fully scrutinise an insurer's financial position.
Twenty Australian funds subsequently lowered their demands, Ms Ley said. The result is the smallest price hike in four years, and compares to a long-term average of 6.1 per cent a year.
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Private health insurers push up premium prices from April 1

  • The Australian
  • March 2, 2016 12:00AM
Private health insurance premiums will rise more than 5 per cent on April 1 despite members already dealing with higher ­out-of-pocket fees and other medical expenses.
Insurers have convinced Health Minister Sussan Ley that the industry needs to ­raise premiums again to respond to significant cost pressures. Although the rates vary, the average increase is 5.59 per cent, with funds agreeing to the lowest price rise in four years after Ms Ley gave a commitment to reform.
Premium rises have averaged 6.1 per cent since 2002, but health funds made it clear to the minister that major reforms, such as overhauling the prostheses list, would help them address affordability issues that have forced members to cut back their level of cover.
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Health insurance premium lift wins analyst tick

  • The Australian
  • March 2, 2016 10:47AM

Sarah-Jane Tasker

The federal government is not hitting insurer’s profitability too hard to improve affordability for private health insurance given the more than five per cent premium increase agreed, according to analysts.
Health Minister Sussan Ley has agreed to an average premium increase, to take effect from April 1, of 5.59 per cent, which is the lowest increase in four years.
Premium rises have averaged 6.1 per cent since 2002 but this year Ms Ley forced health funds to resubmit increase applications, warning they had to be lower. She also highlighted that the level of capital companies held should be taken into consideration.
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Consumer groups urge action after private health insurance premiums rise by 5.6 per cent

March 2 2016 - 7:47PM
·         Alexandra Back, Michael Koziol
Consumer advocacy groups have urged action by both government and policy-holders as private health insurance premiums are set to rise by an average 5.6 per cent.
Health Minister Sussan Ley announced the rise on Wednesday, saying it was the smallest price hike in four years, and called it a win for consumers.
Under federal legislation, private health insurers must apply to the minister for approval of premium changes. The increases usually apply from April 1. The smallest increase in recent years was 5.06 per cent in 2012.
In January, Ms Ley requested insurers resubmit their applications for premium increases, citing her concern that the process did not allow the government to fully scrutinise an insurer's financial position.
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Government’s tough talk fails to hit private health hikes

  • The Australian
  • March 2, 2016 9:17PM

Sarah-Jane Tasker

The federal government’s tough rhetoric towards private health insurers has not translated to significant cuts to annual premium increases, with analysts surprised the industry was not hit harder.
Health Minister Sussan Ley has agreed to an average premium increase of 5.59 per cent to take effect from next month. Premium rises have averaged 6.1 per cent since 2002 but this year Ms Ley forced health funds to resubmit their increase applications, warning they had to be lower. She also highlighted that the level of capital companies held should be taken into consideration.
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We’ll use our $6bn stake as leverage, Ley warns insurers

  • The Australian
  • March 3, 2016 12:00AM

Sean Parnell

The $6 billion spent subsidising private health insurance is not ­delivering value for money and will be used by the federal government to leverage reforms, Health Minister Sussan Ley said yesterday.
As reported in The Australian, the government has approved April 1 premium increases averaging 5.59 per cent, under a process the minister said required her to consider whether insurers needed it, rather than whether members could afford it. Ms Ley had been expected to announce industry ­reforms at the same time as she announced premium­ increases.
But instead she reiterated her belief that the pricing of prostheses and other devices need­ed to be more competitive, and members deserved more certainty and transparency with policies.
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Private health cover: governments only care about rising costs when they're paying, not you

With another hike in premiums, consumers have to weigh up whether they are better off paying money to an insurer, or saving for a rainy day
We have a health spending crisis, or so we’re told. So much so that the federal government has dedicated itself to reigning in the “rapid and unsustainable” rate of spending growth.
Of course, it’s only a crisis when it comes to government funding. But what about the spiralling costs for consumers?
When it comes to what pollies expect Australians to shell out in out-of-pocket expenses or private health insurance premium rises, suddenly it appears there is no such crisis at all.
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Editorial: Private health insurance premiums bleeding Aussies dry

March 6, 2016 1:00am
The Sunday Mail (Qld)
SOARING private health premiums are becoming a joke in Australia.
Unfortunately, we’re quickly heading down the path of the US medical system, universally panned as the costliest and most cumbersome in the world. And Australians are voting with their wallets. The exodus of average Australians fleeing private health insurance is extraordinary.
Middle-class Aussies have had enough.
The result of this exodus is bad news for the Federal Government because it will place an even greater strain on the public system. The problem is healthcare costs are climbing at unsustainable rates. As the population lives longer, it is a massive challenge for politicians.
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Health is also clearly still under review as far as its budget is concerned with still a few reviews underway and some changes in key strategic directions. Lots to keep up with here with all the various pre-budget kites still being flown! Enjoy.
David.

Wednesday, March 09, 2016

Now This Is Really Well Overdue! Would Be Good If It Extended To The mHR!

These appeared last week. First this.

Australian national auditor to comb over myGov

Calls for public submissions.

By Paris Cowan
Mar 3 2016 11:32AM
The Australian National Audit Office has revealed it will undertake an in-depth audit into the implementation and benefits realised by the myGov service gateway.
MyGov has been progressively rolled out since early 2014, managed by the IT team at the Department of Human Services. It acts as an authentication layer providing single log-on access to a range of government transactions from tax returns to electronic health records.
It has been touted as a success by the Commonwealth, with 8.6 million registered users at last count and almost 200,000 logins every day, but its implementation has not been without controversy.
Soon after launch, an Australian security researcher uncovered cross-site scripting flaws in the portal that could enable a hacker to hijack myGov user accounts.
The portal has also encountered a series of usability obstacles.
Last month DHS spokesman Hank Jongen announced the agency had kicked off a concerted program to prioritise and address the most common customer complaints about myGov.
More here:
and this:

MyGov to feel the audit blowtorch

Date March 3, 2016 - 5:21PM

Noel Towell

Reporter for The Canberra Times

Frustrated users of the troubled myGov web portal now have the chance to contribute to an official review of the government web portal's performance by the Commonwealth's Audit Office.
The Australian National Audit Office wants stakeholders and members of the public to make submissions to its report which is due to be tabled in parliament in spring this year.
The giant Department of Human Services, which runs myGov, has had an unhappy recent history with ANAO audits after it was savaged in mid-2015 for its performance in answering its phones.
The Audit Office says it is conducting a "performance audit" of Human Services' performance in implementing myGov, and whether the intended benefits of the portal have been realised.
myGov was launched in 2013 and is used by several million Australians as a portal to access their Centrelink, Medicare, Child Support, Department of Veterans' Affairs, e-health, and DisabilityCare accounts.
The portal is a cornerstone of the Commonwealth's strategy of moving more and more transactions online, where they are cheap, and away from the traditional face-to-face or over-the-phone methods of service delivery.
But serious problems have emerged with the security and operability of the myGov, with users complaining of being locked out of their accounts, outages and other glitches.
There have also been serious concerns raised that the portal leaves users' information vulnerable to cyber-criminals.
Despite former Human Services Minister Stuart Robert lashing out at critics of the portal last month as "wrong" and "badly misinformed", the department has acknowledged some of the problems and initiated a program in January to identify and try to tackle the most serious issues.
More here:
As readers will know all Consumers need to go through the myGov portal to get at their mHR so having it work seamlessly - which it really doesn’t right now - is important. For example I don’t have a working mobile and the portal keeps demanding its number - sign of the times I guess!
I hope the audit will be followed up by looking at the mHR and fixing it up. No one else seems to know what to do….
David.