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, May 26, 2016

This Feels Like The Future Is Coming Towards Us At Pretty High Speed.

I spotted these two reports last week. First:

Telstra-backed haptic medical robots transmit doctors' touch from city to country

  • May 20 2016 at 12:58 PM
Robots are on the verge of bridging the gap between the city-based doctors and regional patients.
Robots with a sense of touch, known as haptically enabled, developed by Deakin University's Institute for Intelligent Systems Research (IISRI), with funding and technical support from Telstra, could bring ultrasound patients up to 1000 kilometres away into the offices of medical professionals in city centres.
The remote technology will allow practitioners to conduct abdominal ultrasound imaging to look at patients' kidneys, gall bladder, liver, spleen, pancreas, abdominal aorta and blood vessels.
It can also alert the medical professionals who are operating the equipment hundreds of kilometres away to patient discomfort, and assess tenderness in the examination area.
Telstra, which has some claim on the project's intellectual property, has trialled the technology across its network, the results of which are beyond initial expectations, Telstra chief technology officer Vish Nandlall​ said.
IISRI director Professor Saeid Nahavandi​ said trials performed over connections between Melbourne and a number of rural and regional Australian cities had been successful.
"It will increase the availability of ultrasound diagnosis for regional patients, which is incredibly important, but it will also minimise potential errors, saving time that might be spent having the patient re-scanned or transported to a regional hub," Mr Nahavandi said.
"A principal advantage of this system is the ability to translate the sense of touch to the operator. Haptic feedback allows an operator to feel and experience the remote environment, through the robotic system, as though they were interacting with it directly."
More here:
Second we have:

Deakin Uni, Telstra create remote ultrasound robot

Can check a patient's organs from far away.

By Andrew Sadauskas
May 20 2016
12:13PM
Deakin University has developed a robotics technology with force feedback that can allow clinicians to remotely create ultrasound images of their patients.
The HER (haptically-enabled robotics) technology was developed by Deakin University’s Institute for Intelligent Systems Research and Innovation (IISRI), and received funding and technical support from Telstra’s research partner program.
The use of haptics allows medical professionals to remotely monitor patient discomfort by probing an examination area, which can be collected and compared to historical data.
Along with haptic force feedback and robotics, the technology incorporates 3D vision and full two-way audio visual communications.
The ultrasounds can be used to examine a range of organs and in abdominal blood pressure. Symptoms that can be diagnosed using the machine include abdominal pain, abnormal liver function and enlarged organs.
The device could potentially be used to provide medical imaging services to remote and regional communities. It can be operated by a sonographer up to 1000 kilometres away from their patient.
Researchers have already conducted remote trials using the technology, where clinicians in Melbourne have examined patients in several regional and rural cities.
More here:
This really is the stuff of Star Trek to me. Just amazing stuff!
David.

Wednesday, May 25, 2016

This Is A Real Issue That Deserves Much More Coverage As Well As A Lot More Thought.

This appeared a last week:

Goodbye Digital Divide, Hello Digital Equity (and why we need to go the extra mile to get it)

Editor: Dr Ruth Armstrong Author: Lareen Newman and Mike Gurstein on: May 17, 2016
In the third annual Gavin Mooney Memorial Essay Competition, entrants were asked to answer the question, “In the digital era, whose voices are being heard?”
The winning essay in the competition, by Amin Ansari, was published in Inside Story earlier this year, and it is Croakey’s privilege to post here a runner-up essay by Lareen Newman and Mike Gurstein.
As well as honouring the work and writings of Professor Mooney, the competition seeks to draw public attention to the topic he was most passionate about: social justice and health equity.
Newman and Gurstein’s thesis is therefore particularly pertinent when they ask, “whose voices are not being heard?” and introduce the concept of “digital equity, where everyone is able to get online according to their need and to achieve what is meaningful to them in their daily life, and where all unfair and avoidable differences are eliminated.”

Lareen Newman and Mike Gurstein write:

This essay will argue that in the digital era, the question “whose voices are not being heard” is as important as asking whose voices are being heard. We will suggest that we need to go the Extra Mile to achieve digital equity so that everyone’s voice has a chance to be heard.
We commonly hear the voices of some (particularly those in positions of power or privilege) claiming that “everyone is online these days”.  We will show that this is a First Digital Myth and moreover a myth which is increasingly being used as justification for moving to a whole range of activities (often exclusively) to the online environment.

The First Digital Myth: Everyone’s online

Whether it be national government services, local government information, research surveys, personal and community support programs, education and health services and more, everyone (that is people like “us”) seems to be jumping onto the “apps and websites bandwagon” – so it must be good!
In many cases, the First Myth provides the rationale for removing the physical counterpart to the digital service or for not providing easy and quality options for those who are not online or who, for whatever reason, do not wish to go online.

Many kinds of Divide

Despite the First Myth, national and survey data show that sharp inequities in Internet access persist in Australia even in the midst of the current “digital plenty”. People have talked about the “Access Divide” (people technically connecting to the internet—or not) and the “Use Divide” (whether people having access are able to make effective use of this access).
We are now seeing a “Speed Divide” emerge along predictable (and hence avoidable) socioeconomic and geographic lines as Australia’s National Broadband Network rolls out; those who are online variously take up faster speeds, and Internet-based services are designed based on higher (and thus more costly) internet speeds. New inequities are also to be expected based on faster and more complex (and thus in many instances more costly or necessarily upgraded) devices.
Of course, none of these “divides” would be a problem if offline opportunities were equal in quality and timeliness to their online counterparts. But as many aspects of life go online in the digital age, it is well to remember that those who are on the wrong side of one or another of these “divides” are almost inevitably the same people who are on the wrong side of other social and economic divides.  They are thus often in greater need of services, information and other supports.
Vastly more reading is found here:
The points made are really valid. The madness of the myHR, which will be inaccessible to many of the patients who might be helped by it, is only the start.
The whole move to moving so many services on line, when so many can’t use them is a real problem for which I have seen no solution - other than retention of the ‘steam’ measures of access.
The list of potentially blocking issues are pretty wide and overcoming them will be very hard indeed:
“People in focus groups since 2008 have indicated a wide range of reasons why they aren’t online, including:
  • Literacies – technical and digital
  • Low levels of trust of telecommunications companies (feeling “ripped off”, experiencing bill-shock)
  • Inability to comprehend or compare digital costs and contracts
  • Having unstable or unpredictable income
  • Lacking motivation, confidence, cognition, and feeling anxious online
  • Having little or no social connections to help get them online, fix problems
  • Having only basic reading and writing ability (even for native English speakers)
  • Having a disability and physical inability (eg dexterity, eyesight)
  • Having neighbours and/or friends who might steal their device
  • Inability to “keep up” with devices (compatibility/functions)”
Has anyone seen the DoH plans on how the disempowered and internet deprived are going to be supported.
I haven’t.
David.

Tuesday, May 24, 2016

Here Is The Approach That Is Going To Make The myHR Totally Obsolete - And Soon.

This release appeared a few days ago:

MedicalDirector Helix: The new cloud-based platform for Australian medical practices

Australia’s largest medical software and information provider, MedicalDirector, has announced its next generation cloud-platform, MedicalDirector Helix, delivering a new approach for patient-centred care.
“The Australian health sector is on the cusp of major change as it moves to using cloud-based software. We have developed MedicalDirector Helix to help practices adapt to this anticipated change, and with this platform we aim to transform their everyday patient and clinical interactions,” says Phil Offer, Executive Director at MedicalDirector.
“We’ve listened to clinicians and designed the new platform from the ground up to provide world-class useability and agility, while ensuring efficacy, patient safety and privacy,” Mr Offer says.
The new platform reflects a simple principle to let doctors be doctors and spend more time with patients during consultation. It will cover the needs of the entire practice, enabling significantly faster performance of recurrent clinical processes.
“Good technology allows practitioners to focus more on the patient and deliver more directed care. Through MedicalDirector Helix, all aspects of the patient’s interaction with the practice, from booking to consultation, to payment, will be integrated,” Mr Offer says.
According to Mr Offer the agility of the new platform will provide doctors with unprecedented flexibility in their work.
“Using the new system, a clinician can see a patient in their practice and update that patient’s record through a web browser on their desktop computer. Another patient might be seen in an aged care facility, with their records updated using a mobile device or tablet. The clinician could later be at home reviewing urgent results from laboratories and specialists,” he added.
With security of patient data the organisation’s highest priority, MedicalDirector has used world-class bank-grade security and advanced levels of threat management to ensure data is protected. All data will be stored and backed up in Australia and will be encrypted using the highest levels of data encryption.
The platform will provide seamless practice management support; with automatic software updates taking the hassle and worry away regarding server storage and backups.
Moving forward, customers will have a choice of using the current on-site version or MedicalDirector Helix. Existing MedicalDirector customers will easily be able to migrate to the new platform. MedicalDirector Helix will be previewed at this month’s General Practice Conference & Exhibition in Sydney (May 20-22).
For more information or to register your interest in the new platform and be one of the first to participate in the first release program visit www.medicaldirector.com/helix.

The release is found here:
There is commentary on all this found here:
19 May, 2016

Let the cloud games begin!

Posted by Jeremy Knibbs
Medical Director has declared itself a starter in the race for the future of the connected health ecosystem
The company, one of the country’s major patient management system providers, announced today that they are going to launch a “cloud” version of their iconic desktop management system – Medical Director Helix.
If it is a properly architected cloud version they intend to launch – truly non-device dependent, mobile and with seamless communication and data exchange features though a secure cloud environment – then Medical Director is putting a stake in the ground that indicates an intent to take on disruptive cloud patient-management start-ups head on, and in the very near future.
The timing of the announcement, at the precise date of the formal launch of much mooted cloud based start-up, MediRecords, at GPCE today, is not likely to be a co-incidence. It looks targeted directly at their customer base to at least put some doubt in the minds of anyone who is thinking of switching to the MediRecords system in the near term.
MediRecords, which has had been secretly building their system with a development team of over 30 people for the past three years, has a sophisticated cloud offering which they claim has all the functionality of both Medical Director and Best Practice, plus a swathe of new features associated with its key differentiating feature – it’s connectivity. It also has a fully integrated back-office billing system.
It’s a high-risk strategy on the part of Medical Director to announce they, too, have a cloud version, but one that they probably needed to pursue. By declaring they have a cloud version, they are going to need to deliver that product quickly to their customers or face the sort of cynicism and backlash that affected the long-standing market leader in the SME accounting software market MYOB, when they were caught off guard by the launch of XERO, a fully functional cloud offering for small business.
Lots more here:
Additionally we have this provider of health cloud based services:
With all this activity we will surely see a market shake-out as well as seeing that once you have your records in the cloud it is possible to make the records accessible for the individual patient - as is happening in the UK. With the appropriate controls agreed with the patient just where does myHR fit?
And of course, once this happens why would anyone - other than the Government - need the myHR.
This is especially so when you consider the money being spent on the myHR and the model being used to implement it - brute force.
Times are changing and the myHR is looking more and more like a ‘white elephant’.
David.

Monday, May 23, 2016

Weekly Australian Health IT Links – 23rd May, 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

Another quiet week with the very long election campaign just dragging on. Pity the myHR isn’t an issue that can be raised and then hopefully fixed. Right now it is a financial black hole as well as a project of totally unproven benefit.
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  • May 20 2016 at 12:58 PM
  • Updated May 20 2016 at 12:58 PM

Telstra-backed haptic medical robots transmit doctors' touch from city to country

Robots are on the verge of bridging the gap between the city-based doctors and regional patients.
Robots with a sense of touch, known as haptically enabled, developed by Deakin University's Institute for Intelligent Systems Research (IISRI), with funding and technical support from Telstra, could bring ultrasound patients up to 1000 kilometres away into the offices of medical professionals in city centres.
The remote technology will allow practitioners to conduct abdominal ultrasound imaging to look at patients' kidneys, gall bladder, liver, spleen, pancreas, abdominal aorta and blood vessels.
It can also alert the medical professionals who are operating the equipment hundreds of kilometres away to patient discomfort, and assess tenderness in the examination area.
-----

Deakin Uni, Telstra create remote ultrasound robot

Can check a patient's organs from far away.

By Andrew Sadauskas
May 20 2016 12:13PM
Deakin University has developed a robotics technology with force feedback that can allow clinicians to remotely create ultrasound images of their patients.
The HER (haptically-enabled robotics) technology was developed by Deakin University’s Institute for Intelligent Systems Research and Innovation (IISRI), and received funding and technical support from Telstra’s research partner program.
The use of haptics allows medical professionals to remotely monitor patient discomfort by probing an examination area, which can be collected and compared to historical data.
-----

WA govt launches hospital waiting times app for Perth

Enabled by open data.

By Juha Saarinen
May 16 2016 6:06AM
Perth residents now have the option to use an app on their Apple iOS and Google Android devices to check which hospital has the shortest waiting times.
The WAED app collects Perth hospital emergency department waiting times published by the Department of Health, along with traffic data, device geolocation, and local maps to give app users an estimate of travel time and the ability to identify which nearby hospital can see them sooner.
The app is hosted on Microsoft's Azure cloud computing platform and covers hospitals including the Sir Charles Gairdner, Rockingham, Royal Perth, Armadale, King Edward Women's, Princess Margaret Children's, and Fiona Stanley.
-----

Fears practices will lose e-PIP payments

Tessa Hoffman | 19 May, 2016 | 
Around 100 practices are at risk of losing e-PIP payments worth thousands of dollars due to confusion over upgrades to practice software.
Under rules introduced this month, practices have to upload a set number of health summaries to the MyHealth Record system  to receive ehealth Practice Incentives Program payments.
There are more than 4870 practices signed up to the incentive which is worth up to $50,000 a year.
However, there are fears a small number of practices could miss out follownig a recent Microsoft Security upgrade that had rendered software unable to upload, or download documents from the MyHealth Record.
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Ventura Health and Fred IT Group join forces

Retail pharmacy specialist Ventura Health and Fred IT are partnering to implement the Fred NXT cloud solution nationally, providing Ventura with long term competitive gains while also catering to the individual needs of its pharmacies.

As a multi-brand pharmacy resource centre, Ventura Health supports the diverse retail management and technology needs of more than 80 pharmacies, including Cincotta Discount Chemist, Mega Save Chemist, You Save Chemist, Max Value Pharmacy, Better Buy Pharmacy, and My Medical Pharmacy.
According to Mario Capanna, CEO, Ventura Health, the group embarked upon the partnership to embrace digital changes in retail pharmacy.
“Our partnership with Fred was driven by the need for greater flexibility and future-proofing. We wanted to match the contemporary landscape facing pharmacy and provide much greater flexibility and individualised support for our pharmacies,” Capanna says.
-----

The human factor: the untold impact of data breaches

Tracking the data from Australia’s iDcare.

By Allie Coyne
May 17 2016 11:00AM
Eighteen months on from the establishment of Australia’s national identity theft support service, the country is for the first time starting to get a picture of the impact data breaches have on their victims.
The not-for-profit iDcare was formally established in October 2014 to offer those affected by data breaches practical response plans to mitigate the effect of a compromise.
The joint government-industry organisation splits itself down two lines. Specialists and counsellors within its case management centre build a tailored response for people who have had their personal details stolen. The centre operates online and phone-based contact services, and national reporting mechanisms like ACORN and ScamWatch refer victims to iDcare for help dealing with a breach.
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Digital Health Chair plans new wave of innovation for SA

Professor Anthony Maeder is one of Australia's leading experts on digital health technologies.
Australia's first Chair in Digital Health Systems says he will make South Australia a world leader in healthcare innovation by spearheading Flinders University research into a mind boggling array of smart and interactive technologies.
And with the recent signing of the Inter-Governmental Agreement (IGA) on Digital Health, which establishes ongoing financial support for the Australian Digital Health Agency, Professor Anthony Maeder has joined Flinders at an opportune time.
Professor Maeder, whose position is supported by a South Australian Government Premier's Research and Industry Fund is the brains behind the Western Sydney University's TeleHealth Research and Innovation Laboratory (THRIL).
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You will have an electronic health record unless you opt out

May 16, 2016, 5:33 p.m.
A FORUM last Wednesday informed Hawkesbury residents about new online health records about to be implemented in our area. 
My Health Record will mean you don’t have to repeat your medical history and medications every time you visit a doctor or other healthcare professional.
The Hawkesbury is part of a trial where residents will be automatically given a My Health Record unless they choose not to have one. 
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North Queensland healthcare providers get behind My Health Record

Over 300 health care providers have jumped at the chance to get more familiar with the Australian Government’s digital health initiative My Health Record.
Northern Queensland Primary Health Network (NQPHN) and NEHTA (National E-Health Transition Authority) will deliver 2-hour accredited training sessions in Cairns, Innisfail, Mackay and Townsville this week to support healthcare providers in their understanding of My Health Record.
NQPHN’s Chief Executive Officer, Robin Moore, acknowledges the important role that GPs, practice managers, pharmacists, medical specialists and other allied health professionals will play in the rollout and utilisation of My Health Record.
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My Health Record

Austin Health is participating in the My Health Record system, formerly known as the Personally Controlled Electronic Health Record  (PCEHR).
Austin Health clinicians are now able to access your My Health Record.
In addition to being able to view your record, all inpatient discharge summaries will be uploaded to your My Health Record (if a record exists).
You have the right to withdraw consent to have your discharge summary uploaded to their My Health Record.
Please let us know at your next visit if you have any concerns about this.
-----
MEDIA RELEASE
19 MAY 2016

MedicalDirector Helix: The new cloud-based platform for Australian medical practices

Australia’s largest medical software and information provider, MedicalDirector, has announced its next generation cloud-platform, MedicalDirector Helix, delivering a new approach for patient-centred care.
“The Australian health sector is on the cusp of major change as it moves to using cloud-based software. We have developed MedicalDirector Helix to help practices adapt to this anticipated change, and with this platform we aim to transform their everyday patient and clinical interactions,” says Phil Offer, Executive Director at MedicalDirector.  
-----
19 May, 2016

Let the cloud games begin!

Posted by Jeremy Knibbs
Medical Director has declared itself a starter in the race for the future of the connected health ecosystem
The company, one of the country’s major patient management system providers, announced today that they are going to launch a “cloud” version of their iconic desktop management system – Medical Director Helix.
If it is a properly architected cloud version they intend to launch – truly non-device dependent, mobile and with seamless communication and data exchange features though a secure cloud environment – then Medical Director is putting a stake in the ground that indicates an intent to take on disruptive cloud patient-management start-ups head on, and in the very near future.
-----

Goodbye Digital Divide, Hello Digital Equity (and why we need to go the extra mile to get it)

Editor: Dr Ruth Armstrong Author: Lareen Newman and Mike Gurstein on: May 17, 2016
In the third annual Gavin Mooney Memorial Essay Competition, entrants were asked to answer the question, “In the digital era, whose voices are being heard?”
The winning essay in the competition, by Amin Ansari, was published in Inside Story earlier this year, and it is Croakey’s privilege to post here a runner-up essay by Lareen Newman and Mike Gurstein.
As well as honouring the work and writings of Professor Mooney, the competition seeks to draw public attention to the topic he was most passionate about: social justice and health equity.
------

Cancer big data project eyes worldwide reach

Sees treatment patterns in individuals’ e-health record data.

By Ry Crozier on May 18 2016 5:05PM
A big data project designed to aggregate and learn from the treatment of cancer patients is looking to expand internationally after a successful first year of operation in the United States.
CancerLinQ – which counts the oncology operations of major pharmaceutical companies among its sponsors – already has access to the de-identified, anonymised health data of one million US cancer sufferers.
It hopes to grow that number worldwide to identify patterns in the way different cancers are treated and to help medical practitioners compare and search symptoms and treatments in near real-time.
“Cancer isn’t an abstract topic,” CancerLinQ CEO Kevin Fitzpatrick told SAP’s annual SapphireNow conference.
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#FHIR Meeting Report – Montreal, May 2016

Posted on May 20, 2016 by Grahame Grieve
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Healthdirect charts path to Docker containers

Starting small.

By Ry Crozier
May 18 2016 6:30AM
Healthdirect is emerging as another Australian early adopter of Docker containers, revealing the strategy it used to win the business over to the technology.
The company, which is fully government-funded and provides health services via web applications, “started really small” in its approach to Docker and has incrementally built upon early successes.
“We didn’t pitch Docker as if we were going to use it everywhere,” DevOps solution architect Scott Coulton said in a recent Docker webinar.
Docker provides a way to package and ship a Linux application or service into "containers" that can be easily moved between clouds or virtual machines.
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Real time monitoring best chance to curb codeine misuse

ASMI and the Pharmacy Guild say real-time monitoring of OTC codeine containing analgesics, in addition to a range of other targeted measures including mandatory warning statements, reducing pack sizes and educational materials, provides the best chance to curb potential misuse.

This was in response to a report published in Addiction titled “Codeine Misuse in Australia”.
ASMI welcomed the new report, as it says there is a need for more data on the topic.
“This new report would have provided additional useful insights if the authors had separately examined the prescription and OTC products (instead of pooling them), because it has been reported that misuse and abuse of prescription opiate and psychoactive drugs have escalated significantly over the past several years,” says Steve Scarff, ASMI Director Regulatory and Scientific Affairs.
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Australia's courts to rule on landmark definition of 'personal information'

Privacy commissioner welcomes critical ruling.

By Paris Cowan
May 16 2016 12:22PM
A full bench of the federal court will in August make a landmark ruling on what constitutes ‘personal information’ in the context of Australia's Privacy Act data protection rules.
The move was sparked by former Fairfax journalist Ben Grubb's three-year battle to get a hold of his metadata from Telstra.
Appeals and counter-appeals have meant the case has been bounced from tribunal to tribunal due to differences in the definition of what counts as information about Grubb, as opposed to information about his service or his device.
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Privacy watchdog works on big data guidelines

OAIC seeks feedback on draft guide to big data and Australia’s privacy regime
Rohan Pearce (Computerworld) 19 May, 2016 12:51
The Office of the Australian Information Commissioner is seeking feedback on a draft guide to the interaction between so-called big data and Australian privacy law.
In particular the draft examines how the Australian Privacy Principles (APPs) apply to big data.
“There is no doubt that big data practices challenge us to think about how key existing privacy principles — including notice and consent, data collection, use limitation, and retention minimisation, — work in practice,” acting Australian Information Commissioner Timothy Pilgrim said in remarks prepared for the launch of Privacy Awareness Week.
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The OAIC's tips for big data analytics that won’t break privacy rules

Commission releases draft guide.

By Paris Cowan
May 19 2016 3:00PM
The Office of the Australian Information Commissioner (OAIC) has released its draft checklist for conducting big data activities without breaching the limits of the Privacy Act.
The guide kicks off more than two months of consultation by Privacy Commissioner Timothy Pilgrim, as his office works to iron out the peculiar wrinkles and challenges raised by using big data for business purposes without offending the privacy expectations of consumers.
Unlike the privacy laws, the guide is not legally binding, the OAIC pointed out - but it is an indicator of how it will treat certain circumstances in the event of an assessment or review.
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Researchers easily extract personal details from metadata

US study debunks authorities' privacy claims.

By Juha Saarinen
May 20 2016 6:54AM
Academics from Stanford University in the United States have shown how trivially easy it can be to infer sensitive details about individuals from metadata on their communications.
They set out to test claims by the US National Security Agency that metadata is not personally identifiable information (PII).
Researchers Jonathan Meyer, Patrick Mutchler and John Mitchell collected the data for the study by running an application on Google Android phones used by 823 volunteers.
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Australian Digital Health Agency 

The Australian Digital Health Agency is part of the Health portfolio, and functions in an executive management capacity.
The Australian Digital Health Agency (the Agency) is governed by a skills-based Board which will be responsible for deciding the Agency’s objectives, policies and strategies, and for ensuring the proper and efficient performance of the Agency’s functions. The Agency is the single accountable organisation for national digital health systems in Australia.
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The Internet of Things: it's arrived and it's eyeing your job

Date May 21, 2016 - 12:15AM

Malcolm Maiden

Columnist

With a plan to make them a common sight on the roads.
We have been hearing about the Internet of Things for years, but get ready. It has finally arrived, and it has the potential to unleash economic disruption that makes what the internet has delivered so far look like child's play.
Telstra CEO Andy Penn is better placed than most to watch it happen. Telstra is in the middle of it, through initiatives of its own such as e-health and through its wireless network, which supports a growing universe of apps. A Telstra SIM connection allows Tesla cars to connect to the internet in this country, for example. A new one helps graziers manage stock by alerting them when gates have been left open.
Penn also drives a Tesla, Elon Musk's sculptural electric rocket.
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In Pictures: User guide to Windows 10

If you’re going for an immediate upgrade to Windows 10 from your Windows 7 or Windows 8/8.1 computer, this guide will get you up to speed as quickly as possible.
(I found this quite useful.)
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Time’s up for Jupiter’s secrets

  • Jonathan Leake
  • The Times
  • May 15, 2016 10:30AM
A NASA spacecraft has become the fastest object humanity has yet created, reaching more than 257,000km/h on a five-year journey that is about to see it enter orbit around Jupiter, the solar system’s biggest planet.
Next month the Juno probe will trigger its engines to decelerate into an orbit that will let it skim Jupiter’s cloud-tops and probe an atmosphere thousands of times thicker than ours to see what lies beneath.
Jupiter - 318 times bigger than Earth - was for a long time thought to be just a ball of spinning gas, but scientists now suspect this is wrong. One of Juno’s key tasks will be to find out if its dense clouds of hydrogen and helium might be hiding a rocky planet similar in origins to the Earth.
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Enjoy!
David.

Sunday, May 22, 2016

If All You Have Is A Hammer, Everything Looks Like A Nail - The Story Of myHR Use In Medical Home Trials.

This release appeared a while ago:

A Healthier Medicare for chronically-ill patients

The Australian Government will revolutionise the way we care for Australians with chronic diseases and complex conditions – aiming to keep them out-of-hospital and living happier and healthier lives at home.
Page last updated: 31 March 2016

Joint Media Release

The Hon. Malcolm Turnbull MP
Prime Minister

The Hon Sussan Ley MP
Minister for Health
Minister for Aged Care
Minister for Sport

31 March 2016
The Turnbull Government will revolutionise the way we care for Australians with chronic diseases and complex conditions – aiming to keep them out-of-hospital and living happier and healthier lives at home.
Our Healthier Medicare package is one of the biggest health system reforms since the introduction of Medicare 30 years ago.
Patients with multiple chronic conditions will get a health care package tailored to their needs and that care will then be co-ordinated to help them easily navigate the complex system.
As many as one-in-five Australians now live with two or more chronic health conditions.
The most prominent are diabetes, heart disease, cancer, mental health, eye disease, respiratory conditions and arthritis – requiring a range of health services from their GP through to specialists, nurses, pharmacists, physiotherapists, psychologists, dieticians and weight-loss programs.
This figure is even higher for Indigenous Australians, with a third reporting three or more long-term conditions.
Australians who are high users of the health system see as many as five different GPs per year – triple those with lower-use of the system. Seeing multiple GPs increases a patient’s risk of poor healthcare co-ordination and their likelihood of falling through the cracks and ending up in hospital.
Half of all potentially avoidable hospital admissions in 2013/14 were attributed to chronic conditions. That is one every two to three minutes.
The primary care package will be trialled through creating ‘Health Care Homes’ that will be responsible for the ongoing co-ordination, management and support of a patient’s care.
About 65,000 Australians will participate in initial two-year trials in up to 200 medical practices from 1 July 2017.
The Council of Australian Governments has discussed the benefits of primary care and the Prime Minister on Friday will invite state and territory leaders to partner with the Commonwealth on these reforms. We want to reduce the barriers patients face across fragmented health services, with the aim of keeping them well at home and out of hospital.
Simplifying a chronically-ill patient’s care by allowing them to nominate one GP practice as their ‘home base’, in conjunction with other Turnbull Government reforms such as our new digital MyHealth Record, will empower patients to take better control of their own care.
It will also reduce potentially life-threatening and costly inefficiencies in our health system, including hospitals.
We will provide quality patient outcomes in Commonwealth-funded primary health care services for the chronically ill to keep more Australians healthier, happier and out-of-hospital.
The announcement is a core part of Government’s response to our Primary Health Care Advisory Group review, released today and chaired by former Australian Medical Association President Steve Hambleton.
An extra $21 million will be committed to support the rollout of trials. The remaining balance of the package is expected to be cost neutral, in line with PHCAG recommendations, with further evaluation to continue ahead of a national rollout.
If we don’t act, Commonwealth health spending as a proportion of GDP will increase by over 50 per cent within 50 years because of higher rates of chronic disease.
Key Details
The Turnbull Government’s primary health care reforms, as part of its Healthier Medicare package, will consist of:
    • Tailored patient care plans developed in partnership with patients and their families.
    • The establishment of ‘Health Care Homes’, which will co-ordinate all of the medical, allied health and out-of-hospital services required as part of a patient’s tailored care plan. Health Care Homes will be delivered by GP practices or Aboriginal Medical Services. Patients will be able to enrol with the Home of their choice.
    • Payments for Health Care Homes will be bundled together into regular quarterly payments. This will encourage providers to be flexible and innovative in how they communicate and deliver care, and will ensure that the patient’s health care needs are regularly monitored and reviewed. This signals a move away from the current fee-for-service model for these eligible patients, except where a routine health issue does not relate to their chronic illness.
    • Improved use of digital health measures to improve patient access and efficiency, including the new MyHealth Record, telehealth and teleweb services, remote health monitoring and medication management technologies etc.
    • A risk stratification tool to determine an individual patient’s eligibility for the new packages.
    • Stronger data collection, measurement and evaluation tools to allow a patient’s individual progress to be measured and their care plan to be better tailored to their needs.
    • The creation of a National Minimum Data Set of de-identified information to help measure and benchmark primary health care performance at a local, regional and national level to inform policy and help identify regionally-specific issues and areas for improvement.
    • Processes to empower patients and their families to be partners in their own care and take greater responsibility for the management of their conditions.
    • Greater co-ordination between Primary Health Care Networks (PHNs) and Local Hospital Networks (LHNs) in the planning and procurement of health services for their local communities.
    • Additional training to care coordinators and providers so they are aware of their responsibilities under the new model.
    • A Health Care Home implementation advisory group to oversee the design, implementation and evaluation of the trials ahead of the national rollout.
Here is the link:
There are a few things to be said about all this but the main point I think needs to be made is as the blog title says - if all you have in patient records is myHR then that is what you will use to conduct the trials - rather than actually analyse what is needed in the trials and deploying a proper system to meet those needs.
Without playing favourites there are at least two systems available and implemented in Australia that are much better able to meet the needs of care-coordination and the range of users that need access and share to such information.
Additionally it is important to note that the concept of a Medical or Healthcare Home has been around for years and has not proved to be all that successful.
Here is a review of major trials in the US which really did not turn out all that well.

Patient-centered medical home program results in little improvement in quality

Date: February 25, 2014
Source: The JAMA Network Journals
Summary:
One of the first, largest, and longest-running multipayer trials of patient-centered medical home medical practices in the United States was associated with limited improvements in quality and was not associated with reductions in use of hospital, emergency department, or ambulatory care services or total costs of care over three years, according to a study. The patient-centered medical home is a team-based model of primary care practice intended to improve the quality, efficiency, and patient experience of care. Professional associations, payers, policy makers, and other stakeholders have advocated for the patient-centered medical home model.
See a lot more information here:
All we can do is hope that light will dawn and the trials will be enabled by the best possible technology to give the whole initiative at least some small chance of success. Dream on I guess.
David.

AusHealthIT Poll Number 321 – Results – 22nd May, 2016.

Here are the results of the poll.

With The Election Coming Soon Which Party Do You Think Has The Best Approach To, And Understanding Of, e-Health?

Labor 3% (3)

Coalition 5% (5)

Greens 1% (1)

Other 1% (1)

No-one Has A Clue 57% (59)

All Are Fine 17% (17)

I Have No Idea 17% (17)

Total votes: 103

Pretty clear outcome with trust in our polity hardly strong! At least e-Health is not seen as too much of a politically divisive topic.

Good turnout of votes as well!

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

David.