Quote Of The Year

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

or

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

Thursday, April 07, 2016

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

April 7  Edition
The macroeconomic stresses seem to have eased a little more with markets rising around the world. Indeed the major stock market indices in the US are flat to up for the calendar year. However we are not really out of the wood just yet.
posted on 02 April 2016

Uncertainty Still Hangs Over The Global Economy

From the Dallas Fed
This post authored by Arthur Hinojosa
The global outlook has rebounded from a low point in January but remains weak due to volatile financial markets and low commodity prices. In a speech to the National Association for Business Economics, International Monetary Fund (IMF) First Deputy Director David Lipsky said, "The IMF's latest reading of the global economy shows once again a weakening baseline ... . Moreover, risks have increased further, with volatile financial markets and low commodity prices creating fresh concerns about the health of the global economy."
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In Australia, things are also looking up for the present, although the recent long weekend has slowed improvement down.
With Budget Night now May 3 we won’t have long to wait to see what is happening. COAG seems to have been a fiasco. Tax cuts of some sort and superannuation changes seem to be the favoured outcomes.
Here is a summary of interesting things up until the end of last week:
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General Budget Issues.

Big earners pump up tax take

A surge in the number of Australians earning at least a million dollars a year and paying record tax is underpinning the revenue system as more people on low wages find themselves paying almost nothing.
A breakdown of Australian Tax Office figures highlights the growing gap between those with ultra-high incomes and those on the tax-free threshold.
After falling in response to the global financial crisis, the number of people who earned more than $1 million while paying tax climbed to a record 11,082 in the 2013-14 financial year. It was an increase of more than 31 per cent over the past two years.
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Budget 2016: Cutting business taxes does not lead to growth, says study

Date March 28, 2016 - 11:45PM

Mark Kenny

Chief political correspondent

Cutting the company tax rate will neither create the jobs nor produce the economic growth that the government and the business lobby claim it would, according to a historical examination of Australia's business tax reductions and that of comparable OECD economies.
An analysis by the progressively inclined think-tank, The Australia Institute, has looked at the data and found the drop from a company tax rate that was nearly 50¢ in the dollar when it began falling in 1988 toward its current 30¢ rate in the early 2000s failed to produce the much vaunted "growth dividend" that proponents assert is the automatic result of such a move.
And the experience of other countries tends to support the finding, showing that GDP growth rates in low company tax jurisdictions are no different from higher ones.
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Health insurance: Why we have to suffer soaring premiums

Date March 29, 2016 - 11:07AM

Marc Moncrief

Despite the private health insurance premiums hike, Health Minister Sussan Ley says the average family with hospital and general health cover will save $166 a year, thanks to her intervention.
April 1 is the day those of us who buy private health insurance are hit with our annual premium increase, but what may seem like a cruel Fools' Day joke is one of the main things that make our healthcare system work.
This year's premium increase will vary from between nearly 9 per cent and just under 4 per cent, depending on the carrier, but it will average out at 5.59 per cent. That's a four-year low, but it is receiving extra attention because: 
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Federal election 2016: Turnbull discusses ditching Abbott health cuts

  • The Australian
  • March 29, 2016 11:01AM

Rachel Baxendale

 “We will be presenting to the Premiers and the Chief Ministers a proposal that’s obviously under discussion at the moment,” Malcolm Turnbull told reporters at Sydney’s Holsworthy army barracks.
Malcolm Turnbull has indicated his government will ditch Tony Abbott’s cuts to state hospital funding, but declined to comment on reports the move will put a $5 billion hole in the budget.
Asked about The Australian’s report today that state governments are confident they will be offered a four-year hospital funding agreement to 2020 based on the formula agreed upon under the Gillard Labor government, the Prime Minister highlighted the importance of federal, state and territory governments working together on health funding.
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High-powered CEDA Commission backs Labor tax policy to balance the budget

Date March 30, 2016 - 12:51AM

Peter Martin, Jessica Irvine

A high-powered independent commission has backed Labor's approach to capital gains tax and negative gearing, undercutting Prime Minister Malcolm Turnbull and Treasurer Scott Morrison who say it will "smash" housing prices.
The Balanced Budget Commission, established by the Committee for the Economic Development of Australia, includes two former heads of the Department of Prime Minister and Cabinet and one former Cabinet Secretary. Between them, Paul McClintock, Terry Moran and Ian Watt have served prime ministers Howard, Gillard, Abbott and Turnbull.
"No economic problem which is in our power to resolve is graver or more urgent in Australia than the persistence of large budget deficits," the Commission chair Mr McClintock said, launching the report at the National Press Club on Tuesday.
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States could collect income tax under radical plan to be discussed at COAG

Date March 30, 2016 - 10:41AM

Michael Koziol

States and territories would collect their own income tax for the first time since World War II under a radical proposal to be considered at a meeting of state and federal leaders this week.
Declaring himself a "pragmatist" on the issue of fixing the vertical fiscal imbalance between the Commonwealth and the states, Scott Morrison left the door open to becoming the first Australian treasurer in 75 years to allow states to control a portion of income tax.
If agreed, the proposal would adopt an idea put forward in the 2014 National Commission of Audit that was dismissed by former prime minister Tony Abbott.
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Morrison rejects budget surplus plan

Updated: 12:41 pm, Wednesday, 30 March 2016
Treasurer Scott Morrison has dismissed research from a think tank that would bring the budget back to surplus within two years.
The Committee for Economic Development of Australia report released on Tuesday recommends several options to raise revenue by $15 billion and cut expenditure by $2 billion that would return the budget to balance in 2018/19.
That would be two years earlier than what Mr Morrison predicted in his mid-year budget released in December.
But the treasurer said you don't tax your way back to a surplus.
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Australia’s 'alarming' budget deficit could be eliminated by 2018 through raised taxes, budget cuts: CEDA

By Zac Crellin @zacrellin on March 30 2016 9:28 AM
The federal budget could be returned to a surplus as soon as 2018, according to five plans released by the Committee for Economic Development of Australia (CEDA).
The plans, which anticipate that Australia’s eight-year-long deficit will continue for another four years if things don’t change, call for varying combinations of tax reform and reduced spending.
CEDA chairman Paul McClintock said that “Australia’s deficit problem is particularly alarming” due to the country’s current period of sustained economic expansion lasting a quarter of a century.
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Why the states should charge income tax

Date March 30, 2016 - 8:40PM

Peter Martin

Economics Editor, The Age

State governments will need to fill a hospital funding gap if the Prime Minister's tax plan is implemented. Fairfax's Peter Martin gives his analysis.
Suddenly the election is about something else: how our states have had it too good for too long. And about how we've had it even better.
In every previous election we've been able to vote for better hospitals, schools and roads at the state level (which of course we want) and for lower taxes or lower budget deficits at the Commonwealth level (which of course we also want).
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Why we should worry about fixing the budget

Date April 2, 2016 - 12:15AM

Jessica Irvine

Senior Writer

Individual tax cuts scrapped

Treasurer Scott Morrison indicates that individual tax cuts - which he has previously flagged - will not be possible until the budget is in better shape.
There has been no official recession in Australia for a quarter of a century, but the federal budget has been in deficit for eight years in a row.
Does that bother you? It should.
Simply passing on the tab to future generations because the current generation of taxpayers is unwilling to pay enough taxes to fund the public services they currently enjoy is deeply unfair.
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COAG: Malcolm Turnbull's radical plan on state taxing powers knocked back

Date April 1, 2016 - 8:03PM

Mark Kenny

The Prime Minister's 'full-blooded' income-tax sharing proposal to fund hospitals has been rejected by state and territory leaders, but short-term funding has been secured.
State and territory leaders have flatly rejected Malcolm Turnbull's radical plan to have them assume a portion of income taxing powers, unceremoniously consigning the idea to the political dustbin.
And they notched up another win also on short-term health and hospital funding signing a heads of agreement document with the Commonwealth for an extra $2.9 billion from July 2017, to 30 June 2020, along with a lift in the 6 per cent cap in the growth of Commonwealth funding to 6.5 per cent.
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Malcolm Turnbull's 'moment of clarity' following tax plan failure

Date April 2, 2016 - 5:55PM

Leesha McKenny

Urban Affairs Reporter

The Prime Minister says the states cannot any longer credibly ask the federal government to raise taxes for them if they are not prepared to raise taxes themselves.
The Prime Minister has hit back at the rejection of his income tax plan, painting its defeat as a "moment of clarity" that revealed the states lacked the stomach for reform and must live within their means.
Malcolm Turnbull on Saturday brushed off suggestions that the failure of what he hailed as only days ago as "the most fundamental reform to the federation in generations" marked a major humiliation for his government.
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Health Budget Issues.

Australian Medical Association welcomes prospect of COAG funding deal

Date March 27, 2016 - 4:47PM

Matthew Knott

Communications and Education Correspondent

The doctors' peak body has hailed the prospect of a $7 billion emergency hospitals funding deal between Canberra and the states as a welcome break from the policies of the previous Abbott government.
Prime Minister Malcolm Turnbull will meet premiers and chief ministers on Friday for a much-anticipated Council of Australian Governments (COAG) meeting, with health and education funding at the top of the agenda.
As well as extra money for hospitals, the leaders will also discuss NSW Premier Mike Baird's plan to spread out the final two years of Gonski school funding across four years
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Diagnostic fees may cost families 'thousands'

Labor MPs have warned that Sunbury and Macedon Ranges residents being treated for serious illnesses, including cancer, could face large bills for MRIs, X-rays and mammograms under changes to the Medicare benefits schedule (MBS).
McEwen MP Rob Mitchell and Opposition health spokeswoman Catherine King discussed federal cuts during a visit to Sunbury’s new Lake Imaging clinic last week.
The two Labor MPs said many clinics would be forced to charge patients for scans and tests that were previously bulk-billed.
Figures released by the Australian Diagnostic Imaging Association show upfront fees could range from $93 for an X-ray to $396 for a CAT scan, and up to $1000 for a positron emission tomograph (PET) scan.
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  • Mar 28 2016 at 11:45 PM
  • Updated Mar 28 2016 at 11:45 PM

Health system will be pushed past breaking point, states warn

Private health insurance will cost even more and the public health system will be pushed past breaking point unless some of the $57 billion in cuts to public hospitals inflicted on the states in the 2014 federal budget are reversed, South Australia has warned.
With federal and state leaders and Treasurers to meet on Thursday night and Friday this week in what could be the last such gathering before a federal election, the SA government will release on Tuesday a study by EY modelling the impact of the cuts if they go ahead over the next decade without redress.
Prime Minister Malcolm Turnbull, who spent Monday at home in Sydney discussing the health funding issue and other budget matters with Treasurer Scott Morrisons, has been willing to negotiate extra money for hospitals if only to neutralise it as an election issue.
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Child dental scheme a 'success' despite government's failure to promote it

Date March 29, 2016 - 4:45PM

Julie Power

Bad brushing habits, more access to sugary snacks and bottled water has caused a gradual rise in the number of children's teeth affected by decay.
A federal government program that has provided free dental care to one million children and which Health Minister Ley indicated could be dramatically overhauled, has been judged a success in a review by Ms Ley's own department.
Headed by the country's top medical officer, the review team's report said it was "pleased" that the two-year old scheme, the Child Dental Benefits Schedule, had provided free dental care to children "at an age when preventive measures can be most effective." 
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COAG: Radical tax plan to fix hospitals

  • Business Spectator
  • March 30, 2016 12:00AM

David Uren

Sarah Martin

Malcolm Turnbull is proposing only a short-term fix to the states’ hospital funding crisis with a four-year deal to 2020.
States are divided on a radical tax plan to levy their own income taxes to secure hospital funding as premiers warn they want the federal government to foot the bill for their long-term health needs.
Malcolm Turnbull is proposing only a short-term fix to the states’ hospital funding crisis with a four-year deal to 2020, but has suggested states would be allowed to levy their own income tax surcharge beyond that to cover health and education costs.
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A $5 billion patch won’t fix hospitals

Date March 30, 2016 - 12:15AM
EDITORIAL
The archive of statements issued after meetings of the Council of Australian Governments (COAG) reads like an endless trail of disappointments. Many worthy and urgent issues are discussed at these regular meetings of state and federal leaders, topics are duly noted and scheduled to be raised again, but too often the most earnest of plans are deferred to the never-never.
Another COAG meeting looms for later this week. The context and timing of this one is important. Budget preparations are under way and, depending on how the Senate votes on bills designed to reinstate a watchdog for the construction sector, a double-dissolution election might be held in little more than three months.
This COAG meeting is especially important, though, for the health sector. Two years ago, in its poorly conceived, slash-and-burn budget, the Abbott government removed funding guarantees for hospitals and changed the indexation on funding increases for hospitals.
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Health: It’s time to change when care and cash collide

  • The Australian
  • March 30, 2016 12:00AM

Michael Owen

Senior health adviser John Maddison says health costs are growing faster than income in South Australia and the state’s 30-year-old health infrastructure needs to be more efficient.
The divisional medical director, a member of a ministerial ­advisory group for the state Labor government’s controversial health reform plan, Transforming Health, knows first-hand the scope of the problem facing state-based health networks across the country.
“What we’re trying to do is to ensure that people get the same good health outcomes no matter where they end up in the health system and there’s clear evidence that that’s not the case now in hospitals around Adelaide,” Dr Maddison said yesterday.
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Government to trial 'Health Care Homes' for chronic illness sufferers

Tom Iggulden reported this story on Thursday, March 31, 2016 06:05:00
KIM LANDERS: A Federal Government plan to provide better care for people with chronic illnesses is being cautiously welcomed by consumer health groups.
The $20 million trial of what will be called "Health Care Homes" will help GPs tailor care for their patients.
Political reporter Tom Iggulden has more from Canberra.
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Plan revealed to revolutionise healthcare

March 31, 20167:10am
authorBlockSingleThe Federal Government today is promising to revolutionise care offered to the more than four million Australians with multiple chronic diseases.
It is billing the package as one of the biggest reforms in Medicare’s 30-year history with the aim of keeping sufferers out of hospital and leading happier, healthier lives.
It could also ease the pressure on the public hospital system. Half of all potentially avoidable hospital admissions in 2013-14 were to treat chronic conditions. That is one every two to three minutes.
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Coalition's healthcare plan has pros and cons, say medical experts

Federal government’s ‘healthcare homes’ scheme gets a tick for better coordinated handling of the chronically ill but a fail on funding details
The federal health minister, Sussan Ley, announced the government’s plans for ‘healthcare homes’ on Thursday. Photograph: Mick Tsikas/AAP
Medical experts have welcomed federal government plans to trial better coordinated healthcare for people suffering multiple chronic illnesses, but have questioned funding levels and when the program will be rolled out nationally.
On Thursday the health minister, Sussan Ley, announced a plan for “healthcare homes” – primary healthcare centres or GPs – to coordinate tailored care packages for patients with multiple chronic conditions. The cost of health services would be bundled into regular quarterly payments rather than patients paying on each visit.
The plan also proposes more data collection and use of digital health records to measure patients’ progress and share information between doctors.
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COAG and hospitals: Look beyond the funding to fix our health system

Opinion
Before Malcolm Turnbull and the states start haggling over hospital funding, it's worth looking at why the system costs so much to run. Maybe it's not just cash, but waste and inefficiencies that need addressing, writes Mike Steketee.
Why do our hospitals cost so much to run? Like $55 billion a year and rising rapidly?
It is the question worth asking before Malcolm Turnbull and the premiers start haggling at today's COAG meeting over how best to pour more money into hospitals. Yes we are an ageing population and the health system is devising ever more clever ways to treat us.
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Health Insurance Issues.

April 1 premium rises prompt half a million angry Aussies to quit health insurance

March 28, 20168:00am
Sue Dunlevy News Corp Australia Network
EXCLUSIVE
A PREMIUM rise three times the inflation rate has unleashed consumer rage on health funds with more than half a million people planning to quit their cover.
Premiums will rise by around $200 a year for a family and around $100 a year for singles on April 1.
And almost half of all health fund members plan to shop around to find a better deal a Galaxy poll commissioned by health fund iSelect has found.
More than 530,000 Australians told the survey they planned to ditch their insurance altogether, a move that could increase pressure on public hospitals.
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Half a million angry Australians are going to quit their private health insurance funds

A premium rise, signed off by Health Minister Sussan Ley, of three times the inflation rate will likely result in around 500,000 Australians giving up their private health insurance.
A Galaxy poll commissioned by iSelect has found that more than 530,000 Australians are planning to ditch their health cover, which could put a huge increase of pressure onto public hospitals.
On April 1, premiums will rise by around $100 for singles and $200 a year for families, pushing members to either shop around or drop their cover entirely.
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530,000 Australians to dump private health insurance when premiums jump $200 on April 1 

  • Up to 530,000 Australians expected to ditch private health insurance
  • Premiums are increasing an average $200 for families from next month
  • 71 per cent of those covered will 'take action' when prices go up on 1 April 
  • Almost 500,000 people dropped or changed cover last year
  • Analysts say many people are 'confused' by law around waiting periods 
  • The Private Health Insurance industry is worth more than $20 billion 
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  • Mar 29 2016 at 11:22 AM

From banking to insurance - Craig Drummond's challenges at Medibank

You could be forgiven for thinking Craig Drummond likes regulated industries considering he has jumped from the highly regulated National Australia Bank to the even more highly regulated Medibank Private.
Drummond was well versed in dealing with regulators while head of finance and strategy at NAB. His day-to-day job involved regular contact with the Australian Prudential Regulation Authority, the prudential supervisor for Australian banks.
Also, he was very familiar with the Financial Conduct Authority in the UK thanks to his handling of the sale of NAB's UK operation, Clydesdale. That sale was only allowed to go ahead after NAB agreed to put aside £986 million ($1.86 billion) in provisions to cover the potential cost of Clydesdale's mis-selling of payment protection insurance, fixed rate tailored business loans and interest rate hedging facilities.
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Why the actual hit on health insurance premiums is so much higher

  • The Australian
  • March 30, 2016 12:00AM

Andrew White

The headline figures say health insurance premiums will rise 5.59 per cent from Friday. But thousands of Australians have already been told their premiums are rising by twice that and more.
The average figure is only that: a guide to across-the-board increases, leaving funds on the defensive as they are questioned by customers whose policies now cost more than $5000 a year.
Average premium rises are nearly three times higher than wages growth of just 2 per cent in 2015, leaving some, including incoming Medibank Private chief executive Craig Drummond, to describe runaway healthcare costs as not “fully sustainable’’.
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Not-for-profit health funds ride popularity

  • The Australian
  • March 30, 2016 12:00AM

Sarah-Jane Tasker

Not-for-profit health insurers are increasing market share with customers turning away from big companies as annual premiums rise.
Members Own Health Funds, which represents 15 not-for-profit and mutual private health insurance funds, attracted 34.7 per cent of net industry growth in 2015, against a market share of 20.7 per cent.
The industry body said independent research conducted last month also showed that while overall industry growth in the private health insurance market slowed by 12.9 per cent from 2014 to 2015, MOHF’s growth increased by 24.9 per cent.
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Private health insurance ‘propping up public system’

  • The Australian
  • March 31, 2016 12:00AM

Sarah-Jane Tasker

Private health insurers have warned that the federal government’s funding battle with the states must address the increasing cost shift from public hospitals to the private sector, arguing it could reduce premiums.
The health insurance industry highlighted that there had been a substantial rise in benefits paid to public hospitals to cover private patients, with the figure hitting more than $1 billion in the past year.
In the 2014-2015 financial year, on top of that figure, private patients also brought into the public system an estimated $173.7 million in prostheses payments and $467m in medical fees.
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2 Apr 2016 - 4:40pm

Australians dropping private health cover as value for money questioned

There's growing anger and confusion over whether Australia's private health insurance industry is providing their customers value for money.
2 Apr 2016 - 4:40 PM 
Around the country, Australians are getting unwelcome news in the mail. From April 1, health insurance premiums have gone up by about $200 a year for a family and around $100 a year for singles.
The average annual cost to a family is about $4,000. The average premium is going up 5.6 per cent, or $200.
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Pharmacy Issues.

A matter of trial and error

Profession waits for more information on professional service future

Community pharmacists are waiting for further news on the timeline for the first tranche of 6CPA professional service trial programs.
Federal Minister for Health Sussan Ley announced at APP 2016 earlier this month the first three trials to be funded out of the $50 6CPA Pharmacy Trial Program.
However there is not, as yet, a timeline for the trials launch, duration, assessment or implementation.
The first three trials are:
  • Improved medication management for Aboriginal and Torres Strait Islanders through pharmacist advice and culturally appropriate services;
  • Pharmacy based screening and referral for diabetes; and
  • Improved continuity in the management of patients’ medications when they are discharged from hospital.
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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 - although narrowing it seems to be largely focussed on Super! Enjoy. Only a month to the Budget.
David.

This Is All Part Of The Effort The Government Is Undertaking To Really Take Away Any Concept Of Health Information Privacy.

I spotted this last week:

Why you might want to become a Jedi Knight for this year’s Census

MARCH 17, 2016, ANNA JOHNSTON
In the week before Christmas last year, the Australian Bureau of Statistics quietly trashed your privacy. We have only a few months to claim it back.
In December 2015, the ABS announced its plans to collect and keep the name and address of every person in Australia, starting with the August 2016 census. And to then use your name and address, to link your census answers to other sets of data, like health and educational records, so that the ABS can develop “a richer and dynamic statistical picture of Australia through the combination of Census data with other survey and administrative data”.
That’s right – census data could be linked to health records too. So that the ABS can do things like “(understand) and support … people who require mental health services”.
This proposal represents the most significant and intrusive collection of identifiable data about you, me, and every other Australian, that has ever been attempted. It will allow the ABS to build up, over time, a rich and deep picture of every Australian’s life, in an identifiable form.
Up until now, the name and address portion of census forms was not retained by the ABS; just as soon as the rest of your census answers were transcribed, the paper forms were destroyed.
But the new proposal is to keep name and address, as well as your answers to all the Census questions included this year, such as sex, age, marital status, indigenous status, religious affiliation, income, education level, ancestry, language spoken at home, occupation, work address, previous home address, vehicles garaged at your address, and the relationships between people living in the same home.
Statements from the ABS which trivialise the risks posed by stripping away census anonymity have missed the point. Seeking to justify the proposal by saying that the ABS will never release identifiable information ignores the point that they shouldn’t have it in the first place. And, as my mother taught me – you shouldn’t make promises you cannot keep.
The risks include leaks from corrupted ABS staff, or organised criminals who wish to perpetrate identity theft and fraud by hacking into the database. The ABS is not magically immune to the risk of data breaches. It was only last year that one of their staff was convicted of leaking data to a friend at the NAB as part of a multi-million dollar insider trading scam.
Here is the link:
Here are the document links:
I you think the Government is not going to use all this information to poke around and look at you healthcare records I reckon you are dreaming…
David.

Wednesday, April 06, 2016

We Will Now Have To Keep A Close Eye On Qld Health As They Splash The Money About!

This appeared last week

Qld Health offers suppliers spot on exclusive e-health panel

Asks for help in big transformation drive.

By Allie Coyne
Mar 30 2016 6:15AM
Queensland Health is asking its IT suppliers to bid for a spot on a limited new panel that will help it move ahead with a mammoth e-health drive.
In the past two years the state government has committed to transforming its procurement in order to make it easier for industry to do business with agencies.
At the same time it has embarked on a significant e-health push, last year bundling the strategic and operational IT functions of its Health department into a new division dubbed eHealth Queensland.
The move was intended to bolster the state's efforts to create a "fully integrated health system", underpinned by an electronic medical record and accessed by a mobile workforce.
Since then, Queensland Health has debuted a 20-year plan for IT investment, kicked off efforts towards the $226.6 million replacement of its patient administration system, and started procurement for a $91 million overhaul of its laboratory information system,
eHealth Queensland has also embarked on the first step in a massive program of systems transformation by signing Fujitsu and Orion Health to provide the underlying plumbing tying all its systems together, before it starts to tackle them one by one.
More here:
This is definitely a very big plan and project - with all the attendant risks. I look forward to hearing from friends up north just how it is all proceeding. There is certainly experience from SA and WA that could provide useful lessons!
David.

Tuesday, April 05, 2016

It Seems Clinicians Are Still Not All That Impressed With The myHR!

This appeared last week.

GP continue to shun MyHealth Record scheme

Paul Smith | 30 March, 2016 | 
Only 380 GPs appear to be actively using the billion-dollar MyHealth Record despite its recent Federal Government “reboot”.
According to Department of Health figures, 378 “providers” updated or uploaded a shared health summary (SHS) to the system in February.
Only 60 providers in Queensland posted the summaries — meant to be MyHealth Record’s information backbone — during the month.
In WA there were only 19 providers; in SA just 18 and in Victoria just 51.
From next month, the government will attempt to put more pressure on doctors to become involved by making it mandatory for GP clinics to upload a fixed number of summaries to receive ehealth Practice Incentive Program payments.
The summaries include a list of current medications, diagnoses, allergies and immunisation histories.
February 2016: documents uploaded/updated to MyHealth Record

Shared health summaries
Discharge summaries
Event summaries
Specialist letters
Diagnostic reports
ACT
2
52
1
0
0
NSW
1661
15,895
178
505
0
NT
3960
2,104
7,887
1115
1946
Queensland
727
4,939
51
0
0
SA
85
874
56
0
0
Tasmania
160
660
6
0
0
Victoria
324
678
417
0
0
WA
164
535
27
0
0
While GP engagement with the MyHealth Record remains extremely patchy, hospitals in northern Sydney and north Brisbane have begun uploading patient discharge summaries en masse.
A total of 15,700 and 4600 were uploaded, respectively, during February.
More here:
What is interesting here is, with the absence of the NT (which uses a different system) is how few clinicians are actually uploading shared health summaries.
Approximately 6000 Shared Health Summaries a month - when you think of the number of GP consultations per month - just highlights how little the system is being used.
Pity the money being spent on this is not being spent to add some real value.
There is also a long and very well researched article in the Financial Review from last weekend which makes some interesting points:
  • Apr 2 2016 at 12:15 AM

'One size fits all' a recipe for ill health in endless medical records quest

How's this for a truly awful example of everything that's wrong with the health system:
Patient A is a 57-year-old customer of health insurer nib. She had 19 hospital admissions over a two-year period, costing nib in excess of $85,000, "due to her multiple chronic ailments, lack of care co-ordination of her healthcare needs and siloed communication across primary care, hospitals and specialists involved in her care," according to the insurer.
Mrs A, who had a history of pulmonary hypertension, diabetes, chronic back pain and numerous other chronic diseases, is the archetype of the high-care patient at the centre of the Turnbull government's big new plans for primary health care in this country.
Only on Thursday Prime Minister Malcolm Turnbull and Health Minister Sussan Ley said care for the chronically ill will be overhauled under a new system of Health Care Homes, in which electronic records will be a key component.
Australians with high-care needs see up to five different GPs a year. About 20 per cent of the population live with two or more chronic diseases, and half of all avoidable hospital admissions in 2013-14 were due to chronic conditions.
"There is still far too much evidence of overservicing, overcharging and avoidable treatment," nib managing director Mark Fitzgibbon says.
At the centre of this debate is a concern that the Federal governments much vaunted national My Health Record has failed to reach most Australians. Since it was launched in 2012, 2½ million people have signed up, vastly less than is needed to make the system a truly national record.
In frustration private health providers are creating their own systems. While this is helping lift the number of people with easily accessed data, there are risks that the process will ultimately lead to a fractured national record.

Good progress but much to be done

"I think [the private health insurance] industry is making good progress on this front, but there is much to be done. At nib we're especially interested in helping people make better decisions around their treatment options and choice of health-care provider through initiatives such as Trip Advisor style [website] Whitecoat," Fitzgibbon says.
New Medibank chief executive Craig Drummond said this week that the nation's soaring medical costs, which have pushed health insurance premiums up by 5 to 6 percentage points a year for the last decade, are unsustainable.
Leading up to Friday's Council of Australian Governments meeting, South Australian Premier Jay Weatherill dismissed $5 billion of extra federal funding for state hospitals as "a Band-Aid on a much bigger wound."
One of the most egregious shortcomings is the failure to share and collect patient information. This syndrome, with its endless anecdotes of repeat orders for unnecessary tests and scans, and wasted medicines, has become a symbol of the waste and inefficiency endemic in the health system.
"We can't co-ordinate before we're connected," Calvary Health Care chief executive Mark Doran says.
"Ambulances don't talk to New South Wales Health. In the ER [emergency room] they ring on the phone to tell you something is coming and they write it down on a piece of paper. It is crazy. Why wouldn't the ambulance be transmitting data to the hospital?"
Despite past failures, billions of taxpayer dollars are once more being thrown at e-health initiatives including a fresh $485 million injection into the federal My Health Record program.
Lots more here:
These few lines really say what most who read here know:
“The Grattan Institute's Dr Stephen Duckett says Australia's pursuit of e-health "has been a tragedy".
"We are way behind other countries, such as Denmark, and we have started off in so many of the wrong places to the extent that the then-Labor government conceptualised success not in terms of meaningful use, but in terms of how many people signed up," he says.
While governments tinker and try to push systems on to doctors and patients, healthcare providers are finding solutions based on the needs of patients and clinicians.”
David.

Monday, April 04, 2016

Weekly Australian Health IT Links – 4th April, 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

It has been a pretty amazing week with all sorts of things happening behind the scenes. Expect some interesting stuff to come out in the next few weeks.
Note today is April 4 - the day those sucked into the myHR opt-out experiments can indeed choose to opt out. This is something I strongly advise at this point!
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  • Apr 2 2016 at 12:15 AM

'One size fits all' a recipe for ill health in endless medical records quest

How's this for a truly awful example of everything that's wrong with the health system:
Patient A is a 57-year-old customer of health insurer nib. She had 19 hospital admissions over a two-year period, costing nib in excess of $85,000, "due to her multiple chronic ailments, lack of care co-ordination of her healthcare needs and siloed communication across primary care, hospitals and specialists involved in her care," according to the insurer.
Mrs A, who had a history of pulmonary hypertension, diabetes, chronic back pain and numerous other chronic diseases, is the archetype of the high-care patient at the centre of the Turnbull government's big new plans for primary health care in this country.
Only on Thursday Prime Minister Malcolm Turnbull and Health Minister Sussan Ley said care for the chronically ill will be overhauled under a new system of Health Care Homes, in which electronic records will be a key component.
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GP continue to shun MyHealth Record scheme

Paul Smith | 30 March, 2016 | 
Only 380 GPs appear to be actively using the billion-dollar MyHealth Record despite its recent Federal Government “reboot”.
According to Department of Health figures, 378 “providers” updated or uploaded a shared health summary (SHS) to the system in February.
Only 60 providers in Queensland posted the summaries — meant to be MyHealth Record’s information backbone — during the month.
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My Health Records (Information Commissioner Enforcement Powers) Guidelines 2016

The My Health Records Act 2012 (My Health Records Act) establishes the My Health Record system. The My Health Record system contains online summaries of individual’s health information which can be viewed by their registered treating healthcare providers, including doctors, nurses and pharmacists across Australia.
The Australian Information Commissioner (the Information Commissioner) has various enforcement and investigative powers in respect of the My Health Record system, under both the My Health Records Act and the Privacy Act 1988 (Privacy Act).
Section 111 of the My Health Records Act provides for the Information Commissioner to make enforcement guidelines outlining how he or she will approach enforcement issues under the My Health Records Act and the Privacy Act. The Information Commissioner must then have regard to these guidelines in exercising his or her investigative and enforcement powers in relation to the My Health Record system. The purpose of these guidelines is to promote transparency in the Information Commissioner’s processes, given the Information Commissioner’s important role in relation to the My Health Record system.
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Primary Health Care sells Medical Director to Affinity Equity Partners

Date March 29, 2016 - 10:49AM
Primary Health Care is selling its Medical Director business to Affinity Equity Partners for $155 million as part of the group's strategic review.
"The successful sale of Medical Director, at an attractive multiple, delivers on one of the key capital recycling initiatives from the strategic review," managing director Peter Gregg said in a statement on Tuesday.
"Through the progressive execution of these initiatives, we are creating the flexibility to strengthen our balance sheet and to fund future growth from the existing capital base," he said.
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Primary sells Medical Director for $155m

  • Business Spectator
  • March 29, 2016 9:36AM

Elizabeth Redman

Primary Health Care has agreed to sell its Medical Director software business for $155 million to funds advised by private equity giant Affinity Equity Partners.
Primary (PRY) says proceeds from this sale and from the sale of its Barangaroo property will reduce its net debt to about $900m.
The sale, first revealed by DataRoom last week, follows a major strategic review by Primary.
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Medical Director software is changing hands

29 March 2016
PRIMARY Health Care is selling its Medical Director software to a private equity firm for $155 million.
The sale to Affinity Equity Partners was announced in a statement to the stock exchange on Tuesday and is expected to be finalised by the end of the financial year.
Primary's managing director, Peter Gregg, says the company will continue to use Medical Director in its chain of clinics.
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My Health Record outage

The My Health Record system is scheduled to be upgraded from 7:00am to 5:30pm on Saturday 2nd April 2016 (AEDT).   The My Health Record system will available as read-only during this time.
Your record can still be accessed and viewed, however you and your healthcare providers will not be able to add new information on your record, update an existing record or remove information from your record during this time.
Linking a myGov account and creating a new record in the My Health Record system is not possible during read-only.
Any change to these times will be published on the My Health Record Service availability page.
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Allscripts has its eye on all states' EMRs

Healthcare software vendor Allscripts sees its involvement in a $420 million project in South Australia as a beachhead to the rest of the country.
Allscripts' 2011 contract to provide an electronic medical record (EMR) across all South Australian hospitals - a total of 74 sites - is "one of the biggest projects" in the southern hemisphere, Allscripts APAC managing director David Chambers told iTWire.
The ongoing rollout will see the software in use at the new Royal Adelaide Hospital when it opens later this year.
The state-wide project in South Australia is "an opportunity to press forward on the other states," he said.
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The value of a wearable is in the data it collects

Consumers bought fitness bands and smartwatches in droves, but many of those devices have ended up in sock drawers due to a broken user experience.
Wearables are starting to evolve past smartwatches into shirts, pants, tattoos, hats, glasses, shoes, sporting goods, and more, as sensor technology improves to eliminate the need for wrist worn devices. The value of wearable technology is not in the hardware – which should be unobtrusive and almost automatic - but in the data that is collected from the devices. Consumers are experiencing trouble trying to make sense of it all.
According to Argus Insights a new report on Wearables shows the disconnect between the user experience, expectation of usefulness, and the app. For example, Jawbone Up is leading ‘delight’ as a great ‘all in one app,’ but at the same time users express discontent with the Jawbone bands.
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Why you might want to become a Jedi Knight for this year’s Census

In the week before Christmas last year, the Australian Bureau of Statistics quietly trashed your privacy. We have only a few months to claim it back.
In December 2015, the ABS announced its plans to collect and keep the name and address of every person in Australia, starting with the August 2016 census. And to then use your name and address, to link your census answers to other sets of data, like health and educational records, so that the ABS can develop “a richer and dynamic statistical picture of Australia through the combination of Census data with other survey and administrative data”.
That’s right – census data could be linked to health records too. So that the ABS can do things like “(understand) and support … people who require mental health services”.
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Samsung Australia Introduces brainBAND to Help Tackle Concussion Head on

Australia on March 23, 2016
Samsung Electronics Australia has announced the creation of brainBAND, an innovative piece of wearable technology designed to facilitate research into concussion in sports. brainBAND is the work of Dr. Alan Pearce and Braden Wilson.
The prototype has been developed through Samsung’s Launching People program, an initiative that brings together two experts from different backgrounds to demonstrate how technology can investigate and help solve real challenges facing society.
Dr. Alan Pearce, a neuroscientist heavily involved in concussion research and education, and Braden Wilson, an industrial designer, worked with Samsung on the program. Together, they created a wearable technology prototype that can track impacts to the head in contact sports in real-time, with the aim to use this data to better understand concussion in sport and the ongoing impact on the brain.
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GP desktops to display drug compliance info from patient's app

Jo Hartley | 30 March, 2016 | 
Poor medication compliance among chronic disease patients has always been an issue. It’s a difficult problem, but the team at MedAdvisor believes it has come up with a solution.
The patient-held app already provides patients with a real-time view of their medication use, as well as updates and reminders from their connected pharmacy on refills and repeat scripts.
However, it’s being developed to include GPs.
The proposed new function, called ‘GP Link’, will integrate individual patient’s drug information from their app to the surgery’s practice software system, which can then be displayed on screen during a consult.
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Orion Health secures contract with U.S. heathcare insurer

Dual listed Australian and New Zealand heathcare solutions provider, Orion Health (NZX/ASX:OHE) has signed an agreement with a major US healthcare insurer to deliver its Amadeus precision medicine platform for the insurer’s membership base.
The project will commence in April and Orion Health CEO Ian McCrae says the Amadeus platform will give the insurer’s provider partners access to longitudinal patient records that include information from across all venues of care the member has been seen at.

It will be deployed via the SaaS (Software as a Service) model and will incorporate the unnamed insurer’s entire membership, which is over 3 million members.
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Qld Health offers suppliers spot on exclusive e-health panel

Asks for help in big transformation drive.

By Allie Coyne
Mar 30 2016 6:15AM
Queensland Health is asking its IT suppliers to bid for a spot on a limited new panel that will help it move ahead with a mammoth e-health drive.
In the past two years the state government has committed to transforming its procurement in order to make it easier for industry to do business with agencies.
At the same time it has embarked on a significant e-health push, last year bundling the strategic and operational IT functions of its Health department into a new division dubbed eHealth Queensland.
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  • Mar 31 2016 at 12:00 AM
  • Updated Mar 31 2016 at 1:29 AM

Hedge fund traders switch to Silicon Valley to detect heart disease

Heart disease is the world's biggest killer.
A hedge fund trading desk seems an unlikely starting point for a medical technology breakthrough to detect heart disease.
Yet with the help of Australian-founded data scientist start-up Kaggle, American quantitative traders Tencia Lee and Qi Liu have designed a world-first algorithm to analyse heart scans.
The revolutionary machine appears to match the accuracy of highly trained cardiologists.
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Kaggle competition winner diagnoses heart failure from MRIs

  • The Australian
  • March 31, 2016 12:00AM

Damon Kitney

Artificial intelligence could be used by doctors to diagnose heart failure following a breakthrough trial hosted by Silicon Valley crowdsourcing company Kaggle, the American National Institute of Health and consulting giant Booz Allen Hamilton.
Kaggle, which was founded in Melbourne by Anthony Goldbloom and relocated to San Francisco five years ago, uses the internet and social media to operate data analysis competitions for tens of thousands of scientists worldwide to solve problems.
It recently hosted a competition to develop algorithms that could diagnose heart failure from MRI scans.
The winning ­algorithm managed to diagnose the disease in the same way as human cardiologists, for the first time offering the ­potential to slash the time and cost of diagnosis.
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Siloed approach to IT causing inefficiency, higher costs for healthcare providers

March 29, 2016
Much of today’s modern healthcare system relies on large, complex organisations that have grown and expanded their capabilities over time. Comprising a wide range of departments with deep skills and expertise, they provide professional care to large numbers of patients every day.
To support the evolution of these organisations, the IT systems and infrastructures that underpin day-to-day activity have also needed to grow. Departmental capabilities have been added as new requirements emerged with different departments procuring systems to meet their particular needs.
As a result, a large number of major healthcare providers are now faced with what have become very ‘siloed’ IT infrastructures. A range of different systems are in place that serve different areas of the organisation.
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New #FHIR Vital Signs Profile

Posted on March 31, 2016 by Grahame Grieve
Over on the official FHR product blog, I just announced a new release. I wanted to expand on one of the features in the new version here
A new profile to describe vital signs (note: this is proposed as mandatory to enable better data sharing)
One of the emerging themes in many countries is sharing data with patients. And one of the broad set of things called ‘health data’ that is easiest to share is what is loosely called ‘vital signs’. It’s simple data, it’s easy to share with the patients, and we’re starting to see monitoring devices available in mainstream consumer technology. But it’s more than just patients that care – vital signs data is widely shared through the healthcare provision system, and there’s lots of interesting decision support and surveillance that can usefully be done with them.
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NEHTA releases the NASH Organisation Certificate Tracker

Created on Friday, 01 April 2016
The NASH Organisation Certificate Tracker (Certificate Tracker) helps healthcare provider organisations ensure ongoing connectivity to the My Health Record system.
The Certificate Tracker identifies the expiration dates of NASH organisation certificates for healthcare provider organisations (NASH certificates). These currently need to be renewed every two years.
Healthcare provider organisations require an up-to-date NASH certificate to:
  • Access the My Health Record system
  • Register individuals for a My Health Record; and
  • Send and receive clinical information via Secure Message Delivery services.
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14 ASX Stocks on the Road in the New York Spotlight

By Bob Kohut | 29.03.2016
For the past few years the ASX has partnered with international analysts registered to trade on the ASX to offer Spotlight Conferences around the world.  The Spotlight Conference provides company CEO’s and/or CFO’s the opportunity to pitch the growth potential of their companies to institutional and high net worth investors.  Conferences have been held in Singapore, Hong Kong, London, and New York.
Although there are “fat cat” investors all over the world, New York is the place to go for exposure to arguably the fattest cats of all.  When big US investors take a stake in a company, analysts take notice.
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Windows boot-ups disrupted by new encrypting ransomware

Petya modifies hard drive master boot records.

By Juha Saarinen
Mar 29 2016 6:29AM
A new strain of ransomware has taken the holding of user files hostage to the extreme by preventing computers from booting up the Windows operating system, according to security vendor Trend Micro.
Dubbed Petya, the malware crashes computers and reboots them after rewriting the hard disk master boot record.
Upon reboot, the Petya malware masquerades as the Windows CHKDSK file system consistency checking tool and encrypts the entire hard drive. 
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What happens when your robot gets ambitious?

Date April 2, 2016 - 8:30PM

John Elder

Robots are increasingly moving into the workplace. But what happens if they want to form a union or develop a career path?
Microsoft's Tay AI teenage girl chat-bot scandal is but a glimpse of what's in store as robots and people become increasingly involved in each other's lives.
After all, Tay, produced as an ambassador of technological and cultural cuteness, obviously wasn't programmed to be a potty-mouthed, nympho-racist with murderous enthusiasms. She adopted them via her mingling with mischievous human beings.  
So what's going to happen as robots increasingly clock in at the workplace? Will they start demanding rest breaks – not for a cup of tea and sandwich perhaps, but to read up on French poetry, take a stroll around the grounds or mix it up with their human co-workers with some table tennis? By making these demands, they are essentially claiming rights. Do they have any?  
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Enjoy!
David.

Sunday, April 03, 2016

It Seems Some Very Old Chickens Are Coming Home To Roost For DoH And NEHTA. Oh Dear!

Just to point out what I mean:

Chickens come home to roost

If you say that chickens are coming home to roost, you mean that bad or silly things done in the past are beginning to cause problems.
There was too much greed in the past, and now the chickens are coming home to roost with crime and corruption soaring.
From this link:
This is the perfect description of a very old set of decisions made by NEHTA.
In late 2005 I was involved in a consultation for NEHTA that recommended that if we were to put in place a Health Identifier that to do it properly and safely that there would need to be formal re-identification processes and possibly the use of biometrics to guarantee system integrity.
Not surprisingly the costs of such a system was not at all cheap and so it was decided by the powers that be that the Individual Patient Identifier would be based on an already existing Medicare Identity Database and all would be well.
With very little actual external use of the IHI service this has worked until a few months ago.
With the onset of the various opt-out trials the IHI Service is actually going have to be trustworthy and as close to error free as possible - and guess what - it isn’t.
It seems patient match rates are not working properly and tweaks to improve this seem to be leading to a small but significant number of false matches with a wrong IHI being returned.
Of course, if an individual IHI cannot be easily found - and this is a real possibility - the mucking about will drive practitioners crazy and waste their time - which for them we all know is money!
There are two issues around all this.
First we need full public disclosure of what is happening and just what patient risks are being run. Right now we have all sorts of committees and universities being consulted and the public being kept in the dark that there are any issues
Second we need a clear remedial plan that is acceptable and can be demonstrated to be safe and not to have any capacity to link incorrect records to the wrong patient.
Might turn out it was more sensible to do the IHI System once and properly!
David.

AusHealthIT Poll Number 314 – Results – 3rd April, 2016.

Here are the results of the poll.

Are You Expecting That The Planned New Versions Of The myHR Will Deliver Significantly Improved Usability, Clinical Value And Ease Of Use?

Yes 4% (5)

No 93% (109)

I Have No Idea 3% (3)

Total votes: 117

A really decisive poll. Looks like most believe it is unlikely the Government can make the myHR much better.

Again Ms Ley should take careful notice!

Great turnout of votes!

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

David.