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

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

May 26  Edition
With the Budget on May 3 now fading in the memory we are now off and rolling in the election campaign. We are seeing a lot of promises with Health from Labor with Medicare well and truly in focus.
As we move further into the campaign I am sure it will become more interesting - with the polls as tight as they are at present.
I note concern on economic growth,  the changes to superannuation as well as continuing cuts in other areas.

General Budget Impacts.

Hard-working Aussies help pay for company tax cut

Date May 16, 2016 - 7:07AM

Ross Gittins

The Sydney Morning Herald's Economics Editor

I often think Scott Morrison does a remarkably good Joe Hockey impression, but in this budget he's performed a Wayne Swan sleight-of-hand that's better than Swanny ever did.
Consider this. Big business has been desperate for a higher goods and services tax. Why? Because this was the only way the government could afford to grant them their longed for cut in company tax.
So when Malcolm Turnbull balked at increasing the GST, it seemed he wouldn't be cutting company tax either.
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The truth about Malcolm Turnbull's Google tax

Date May 18, 2016 - 12:00AM

Ross Gittins

The Sydney Morning Herald's Economics Editor

Australia is considering imposing a levy on big companies who funnel money into offshore bank accounts to avoid paying tax.
So, Malcolm Turnbull and Scott Morrison are introducing a "Google tax" to ensure multinational companies "pay their fair share of tax in Australia". Really? You could be forgiven for being sceptical.
Does the Coalition really want to crack down on their generous mates at the big end of town? And, even if they do, how do we know a Google tax will work?
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  • May 20 2016 at 1:46 PM
  • Updated 37 mins ago

Coalition, Labor told to cut budget spending harder by Treasury and Finance bosses

Australians have a stark choice; cut spending or face the highest level of taxation in more than three decades, say Treasury and the Department of Finance.
In a blunt warning to all sides of politics, the heads of the government's top economic bureaucracies, have also thrown into doubt the Coalition's recent promises to deliver strong surpluses next decade without a sharp surge in taxation.
"The medium-term projections show that, without considerable effort to reduce spending growth, it will not be possible to run underlying cash surpluses, saying the order of 1 per cent of GDP, without tax receipts rising above 23.9 per cent of GDP," the departments said in the Pre-election Economic and Fiscal Outlook.
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Election 2016: Budget update says big spending cuts, or tax rises, needed to reach surplus

Date May 20, 2016 - 5:45PM

James Massola, Peter Martin

Treasury and finance have warned both sides of politics that big spending cuts, or higher taxes, will be essential if the budget is to be returned to surplus.
And in a blunt message to their political masters, departmental secretaries John Fraser and Jane Halton say it is "crucial for Australia to maintain its top credit rating".
The warnings are contained in the Pre-Election Economic and Fiscal Outlook, which is prepared by the two top financial authorities without input from ministers and released shortly after the start of the campaign.
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Budget balancing plan implausible: RBA’s Edwards

  • James Glynn
  • The Australian
  • May 20, 2016 12:57PM
Plans to balance Australia’s federal budget by around 2021 are implausible, says Reserve Bank policymaker and economist John Edwards, adding that the nation risks losing its prized AAA credit-rating status.
Mr Edwards said the plan outlined by Treasurer Scott Morrison in the government’s 2016-17 budget to bring the budget back into balance by 2021 was too slow as it relies on rising income tax collections to be achieved.
“I don’t think we can disregard the possibility that the ratings agencies will lose patience with a fiscal trajectory which is simply not plausible, relying as it does on increased personal tax collections,” Mr Edwards, a Reserve Bank of Australia board member, said in an interview with The Wall Street Journal.
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Low pay growth, price rises and the new normal

Date May 21, 2016

Ross Gittins

The Sydney Morning Herald's Economics Editor

Are we waiting with ever-growing impatience for the economy to get back to normal, or has the economy shifted to a "new normal"?
I think that's the central question in macro-economics today – not just in Oz but throughout the developed world.
To put that question in econospeak, are the changes we see before us "cyclical" – just part of the normal ups and downs of the business cycle – or are they "structural", a lasting change in the way the economy works.
Trouble is, neither I nor anyone else can say with confidence what the answer is.
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Health Budget Issues.

AMA joins fight against Federal Government's Medicare rebate freeze

The Federal Government has rejected calls from the Australian Medical Association (AMA) to overturn its decision to extend the Medicare rebates freeze until 2020.

Key points:

  • AMA says doctors will be forced to pass costs on to patients
  • Josh Frydenberg said Government is doing the right thing by keeping the policy in place
  • Other medical organisations threaten to join the AMA
Under the policy, which was introduced by the Abbott government in 2014, Medicare payments made to doctors would not increase with inflation.
The Royal Australian College of General Practitioners criticised the move on day one of the election campaign, calling on its 30,000 members to put up posters in waiting rooms and speak to patients about lobbying their MPs.
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Doctors warn patients will pay more for GPs

Updated: 11:45 am, Sunday, 15 May 2016
The Turnbull government's decision to extend the Medicare rebate freeze is akin to putting a sneaky new tax on health care, doctors say.
And it's estimated patients will pay an extra $10 per visit as GPs try to keep up with the rising costs of running a medical practice.
The Australian Medical Association is ramping up its fight against the Medicare rebate freeze as the federal election campaign kicks into its second week.
AMA president Brian Owler says the group has been flooded with feedback from concerned doctors after the May budget confirmed the hold on patient rebates would be extended to 2020.
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Election 2016: Rent control, but for pathologists, not for you

Date May 15, 2016 - 8:43PM

Peter Martin

Economics Editor, The Age

Comment
Why on earth is the Coalition controlling rents?
Not for renters of houses or apartments mind you, but for the two big corporations who control three quarters of Australia's pathology industry.
They extracted the concession minutes before the leaders debate on Friday in the same way as they extracted signatures from nearly 600,000 of their customers, many of whom were presented with scary scenarios and asked to sign a petition while giving blood and at their most vulnerable.
The cost of testing has plummeted in recent decades. Former health department head Stephen Duckett says the bulk of tests are no longer done by individuals with test tubes.
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Federal election 2016: doctors lobby on Medicare rebate

  • The Australian
  • May 16, 2016 12:00AM

Sean Parnell

The doctors lobby yesterday ramped up its campaign against the Coalition’s extended freeze of Medicare rebates, a day after pathologists agreed to end their bulk-billing campaign in exchange for regulated rents.
On Saturday, Pathology Australia withdrew its ‘Don’t Kill Bulk-Bill’ petition — which already had about 600,000 signatures — after Malcolm Turnbull announced a deal he said would allow them to keep bulk billing.
Under a $650 million budget cut announced six months ago, pathology and diagnostic imaging clinics were set to lose bulk-billing incentive payments from July. A re-elected Coalition government would hold off removing the incentives for the pathology sector for about three months while it legislated to stop clinics being overcharged rent.
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AMA leads groups flexing poll muscles

Doctors say patients will pay more, motoring groups want more money for roads and public transport while universities are asking all voters to care about higher education.
A string of interest groups are launching campaigns for the Federal election today with the Australian Medical Association’s hardline position the biggest worry for the Turnbull Government.
Posters declaring “Your Health Will Cost More” will appear in surgeries across the nation as the AMA fights for an end to the freeze on the Medicare patient rebate.
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Election 2016: UBS warning on Sussan Ley’s deal with pathology sector

  • The Australian
  • May 17, 2016 2:39PM

Sarah-Jane Tasker

Prime Minister Malcolm Turnbull and Health minister Sussan Ley have done a deal with the pathology sector.
The Turnbull government’s deal with the pathology sector to halt its push to slash bulk-billing incentives could drive down GPs’ income.
Prime Minister Malcolm Turnbull revealed on Friday night during the first live leaders’ debate of the election campaign that health minister Sussan Ley had done a deal with the pathology industry that would allow them to keep bulk billing.
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  • May 18 2016 at 11:45 PM
  • Updated May 18 2016 at 11:45 PM

Election 2016: Labor promises $2.4 billion to end "GP co-payment by stealth"

Labor will use money the Turnbull government has earmarked for business tax cuts to help fund a $2.4 billion promise to lift the freeze on payments to doctors  to stop them passing on higher costs to patients.
In the first big salvo of the federal election campaign Opposition Leader Bill Shorten will announce on Thursday that the freeze on the Medicare Benefits Schedule, which has been successively applied by the Abbott and Turnbull governments, and is supposed to run until 2020, will be lifted on January 1, 2017, and the indexation of the payment restored. 
The promise will cost $2.4 billion over four years and $12.2 billion over a decade. Mr Shorten said the policy would be paid for by not proceeding with all the government's promised tax cuts for business, scrapping the government's plans to introduce a $1000 welfare bonus for single income couples with a child aged under one, and placing an $8000 cap on vocational education loans.
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19 May 2016 - 3:35am

Health to take centre-stage in campaign

Opposition Leader Bill Shorten is set to announce Labor will put an end to the Medicare indexation freeze doctors warn will force patients to pay more.
Source:
AAP 19 May 2016 - 3:34 AM  UPDATED 4 HOURS AGO
Health will take centre stage in the election campaign with Labor set to announce it will lift the Medicare indexation freeze.
Opposition Leader Bill Shorten and shadow health minister Catherine King will make the announcement on the NSW Central Coast on Thursday, committing to lifting the freeze from January 1.
It will apply to all services provided by GPs, allied health and medical specialists.
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Federal election 2016: aged care cuts ‘could hit investments’

  • The Australian
  • May 19, 2016 12:00AM

Sarah-Jane Tasker

The budget measures mean funding levels for services such as physiotherapy and pain management will be reduced.
Private aged-care providers have warned the $1.2 billion cut to the sector announced in the budget­ is fuelling uncertainty in the ­industry and could force a rethink on future investment plans.
The Aged Care Guild, the representative body for large private sector residential aged-care providers, has commissioned Deloitte Access Economics to review the impact of cuts, arguing that the budget measures were more ­severe than anticipated.
The budget measures mean funding levels for services such as physiotherapy and pain management will be reduced and the ­indexation increase in 2016-17 will be halved.
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  • May 20 2016 at 12:00 AM
  • Updated May 20 2016 at 12:00 AM

Labor's Medicare plan is for the Australian Medical Association

by Terry Barnes
In election campaigns, there are two types of opposition policies. The first are populist, "we feel your pain" policies, reflexively promising the opposite of the government. The other identifies real problems and sets out, with an eye to the politics, sensible but not always painless solutions to sustain and improve on what's there.
Unfortunately, Labor's "positive policy for a stronger Medicare" is the former. It is a plan that's good for doctors, not patients.
Labor's proposed  $2.4 billion spend on ending the indexation freeze on Medicare rebates is nothing more than a cynical bribe to win the endorsement of the Australian Medical Association, and the Royal Australian College of GPs.
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Australia's spending on healthcare unsustainable, CSIRO futurist says

Date May 19, 2016 - 7:09PM

David Ellery

Reporter for The Canberra Times.

Healthcare spending will soak up all of Australia's tax take well before the end of the century if it continues to grow at its current rate, a leading futurist has said.
The CSIRO's senior principal scientist for strategy and foresight, Stefan Hajkowicz, told Thursday's National Medicines Symposium in Canberra healthcare had accounted for less than seven per cent of gross domestic product in the 1980s and early 1990s.
It is now running at more than nine per cent of GDP and rising every year.
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Federal election 2016: AMA welcomes Labor Medicare vow

  • The Australian
  • May 20, 2016 12:00AM

Sean Parnell

Bill Shorten’s long-awaited ­com­mit­­ment to lift the freeze on ­Medicare rebates — set to cost the commonwealth an extra $12.2 billion over 10 years — has been ­welcomed by the medical profess­ion, but questions remain over Labor’s ability to manage the health budget.
It is also unclear what impact the move would have on the Medical Research Future Fund, which the Coalition intended to build with $20bn saved through health cuts as part of innovation policies that Health Minister ­Sussan Ley will add to today.
The recent federal budget ­extended a freeze on Medicare ­rebate indexation, ensuring no ­increase in government funding for GPs and other medical prac­titioners for seven years, in an ­apparent effort to curtail bulk-billing and make patients more ­conscious of medical bills.
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Practices hit for $120m under Turnbull's 'backroom' pathology deal

Paul Smith | 17 May, 2016 | 
General practices will lose $120 million a year under Malcolm Turnbull’s (pictured) ‘backroom deal’ to cap rents for co-located pathology collection centres, analysts warn.
The Prime Minister’s agreement with the pathology industry, hammered out last month, is aimed at ensuring pathology giants Primary Health Care and Sonic Health Care bulk-bill patients for pathology tests when the government pulls the plug on the bulk-billing incentives.
But general practice seems to be the sacrifice.
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10:59am May 21, 2016

GPs ramp up campaign against govt freeze

By AAP
Every time Australians get a prescription from their doctor they'll be warned about a federal government plan to slug them more for health services.
The Australian Medical Association has given GPs a template that tells their patients "the government has cut Medicare and wants you to pay for it".
It urges patients to tell their local MPs and election candidates they are not happy and is part of a wider campaign against a freeze on Medicare rebates until 2020.
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Election 2016: Bill Shorten's $1b promise to keep medicine costs down

Date May 22, 2016 - 12:15AM

Adam Gartrell

National Political Correspondent

Labor is promising to keep the cost of prescription medicines down by officially ditching the Coalition's "medicine tax".
Opposition Leader Bill Shorten will seek to keep the election campaign focus on health policy on Sunday by pledging not to increase Pharmaceutical Benefits Scheme copayments beyond regular indexation.
The promise will cost the federal budget $971 million over the next four years and $3.6 billion over the decade, according to costings Labor has obtained from the independent Parliamentary Budget Office.
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Health Insurance Issues.

MOHF to tackle health funds nib, Bupa, Medibank

  • The Australian
  • May 18, 2016 12:00AM

Sarah-Jane Tasker

Australia’s not-for-profit health insurance funds are set to launch a national television campaign to tackle the “big three” companies they argue are fuelling affordability concerns while also enjoying rising profits.
Members Own Health Funds, which represents 15 not-for-profit and mutual private health insurance funds, has warned that Australia’s big for-profit funds must be called to account over their impact on affordability in the sector.
Troy Sheahan, chief executive of MOHF, highlighted that recently released data from the Australian Prudential Regulation Authority showed that the “big three” — Bupa, Medibank and nib — recorded a combined gross surplus of over $1 billion in 2015, up from $947 million in 2014.
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Value of hospital cover on the slide

  • The Australian
  • May 18, 2016 12:00AM

Sean Parnell

Health insurance has been ­dramatically devalued, with ­figures revealing that more than a third of hospital-cover policies are now laden with restrictions and exclusions, compared with only 5 per cent a decade ago.
The proportion of hospital policies requiring an excess or co-payment has also surged to 81.5 per cent in a decade, as members continue to downgrade their levels of cover to limit the cost and premiums rise by about 6 per cent a year.
Health insurers, the Private Health Insurance Ombudsman and consumer groups have called on the federal government to address underlying problems in the private sector to stop members being left with huge unforeseen medical bills or being forced to wait for treatment in the public sector.
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Superannuation Issues.

  • May 15 2016 at 11:45 PM
  • Updated May 15 2016 at 11:45 PM

Super backlash catches Coalition out

Before this year's budget there seemed to be widespread acceptance that Australia's superannuation system was generously disposed towards the nation's wealthiest savers.
The combination of being able to pump large amounts of post-tax earnings into super, pay little tax on so-called concessional contributions and receive a tax-free private pension meant that taxpayers were either supporting comfortable (potentially lavish) lifestyles of retired Australians, or helping them to pass on their wealth to future generations.
But that broad acceptance seems like a long time ago now.
All of a sudden Coalition MPs are apparently threatening to withhold donations, refuse to work on electorate campaigns or not vote for the government because of a series of proposed super changes announced in the budget.
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16 May 2016 - 12:02pm

Millions gain from super change: Morrison

Treasurer Scott Morrison says millions of low-income earners will be better off after the budget superannuation changes.
Source: AAP
16 May 2016 - 12:02 PM  UPDATED YESTERDAY 12:02 PM
Treasurer Scott Morrison concedes some 600,000 rich people will be affected by the government's superannuation changes announced in the budget, but says 3.3 million low-income earners will be better off.
The proposed low income superannuation offset will ensure people earning less than $37,000 won't pay tax on their super accounts, while at the top end changes include paying tax on super balances above $1.6 million in retirement.
"There are swings and roundabouts on this," Mr Morrison told Sydney's 2GB radio on Monday.
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Superannuation tax changes erode trust in system

  • Will Hamilton
  • The Australian
  • May 17, 2016 12:00AM
Since the budget was released on May 3, as a wealth manager I have not had one positive client discussion on superannuation as a result of the proposed changes.
Don’t get me wrong, there is still enormous value in superannuation given the tax rates that exist in a superannuation environment as opposed to outside.
Further, the proposed changes are focused on the long-term sustainability of superannuation.
Still, a key point is that while government figures are insisting the proposed changes are not “retrospective”, the way this has been explained is poor.
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Election 2016: Labor seizes on Peter Costello’s comments about Coalition’s superannuation policy

  • The Australian
  • May 18, 2016 10:04AM

Sam Buckingham-Jones

Former treasurer Peter Costello has questioned the Coalition’s claim that its $1.6m superannuation savings limit is enough to generate four times the age pension.
Labor has seized on comments by Howard government treasurer Peter Costello warning that the federal government’s proposed changes to superannuation transfers will not be as beneficial for retirees as promised.
Mr Costello told a lunch for Women in Banking and Finance yesterday that the changes, which would put a cap of $1.6 million on tax-free superannuation pension transfers, are not as generous as they appear.
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  • May 18 2016 at 6:26 PM
  • Updated May 18 2016 at 6:26 PM

Election 2016: Super doesn't add up for Peter Costello

The latest returns from super funds are further proof of how much financial reality has changed – but they also demonstrate how community and business expectations have failed to catch up.
For the business community, it translates into a stubborn view of what's acceptable as a return on investment. That's still relatively high compared to a global lowering of returns overall.  It means a continued preference for sitting pat in terms of investment in expansion and instead relying on paying out generous dividends as the easiest short-term version of generating acceptable returns to shareholders.
For the community, that financial reality is reflected in the impact of a low interest rate, low wage growth environment on household incomes. That has all sorts of perverse effects as well as demands for ever more taxpayer assistance against a budget least able to afford it.
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Federal election 2016: ‘enter the new world of lower returns’

  • The Australian
  • May 19, 2016 12:00AM

Glenda Korporaal

Adam Creighton

Peter Costello’s warning about a new era of low super fund returns has sparked a fierce debate over assumptions ­behind the government’s budget superannuation changes.
“The 10-year bond rate is the lowest it has ever been and even 30-year bond rates are a bit over 3 per cent,’’ the former treasurer said yesterday. “It is a much lower-­return world than most of us have lived through in our lives.”
Assistant Treasurer Kelly O’Dwyer said the government’s claim that a $1.6 million pension pot would support an income stream of about four times the age pension ($88,000 a year) was based on returns of 3 per cent above inflation, over 25 years.
“Over a lifetime it is assumed that retirees will draw down on the capital in their superannuation ­account — which is why there are minimum drawdown requirements,” Ms O’Dwyer said.
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  • May 18 2016 at 1:53 PM
  • Updated May 18 2016 at 2:34 PM

Election 2016: Roy Morgan tips budget crackdown to cost Liberals votes

Roy Morgan Research shows the government's crackdown on superannuation tax perks for the wealthy will hit its voter base.
Individuals with big retirement savings accounts are the target of the government's plans to raise revenue by restricting access to super tax concessions.
Controversially the government plans to introduce a $1.6 million cap on super savings that can be transferred to tax-free pension accounts.
New limits also include a $500,000 lifetime cap on after-tax contributions to super and a lowering of the annual cap on pre-tax contributions to $25,000. 
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I look forward to comments on all this!
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David.

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.
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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.
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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.
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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.
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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.
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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.  
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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.
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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.
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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.