Quote Of The Year

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

or

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

Saturday, May 28, 2016

Weekly Overseas Health IT Links - 28th May, 2016.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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Google using self-designed AI processors

Published May 19 2016, 2:42pm EDT
Google has begun to use computer processors its engineers designed to increase the performance of the company’s artificial intelligence software, potentially threatening the businesses of traditional chip suppliers such as Intel Corp. and Nvidia Corp.
During the past year, Google has deployed “thousands” of these specialized artificial intelligence chips, called TensorFlow Processing Units (TPUs), in servers within its data centers, said Urs Holzle, the company’s senior vice president of infrastructure, Wednesday at the company’s developer conference. Google declined to specify precisely how many of the chips it’s using, but stressed the company continues to use many typical central processing units and graphics processing units made by other companies.
 “If you use cloud voice recognition, then it goes to TPU. If you use Android voice recognition, then it goes to TPUs,” Holzle said. “It’s been in pretty widespread use for about a year.”
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HHS Office for Civil Rights to release guidance for dealing with ransomware attacks

The cyber-threats are increasingly hitting healthcare organizations with great effectiveness, and the OCR is preparing to assist executives seeking to better protect their data and systems.
May 20, 2016 11:17 AM
The U.S. Department of Health and Human Services Office for Civil Rights is working on official guidance to help healthcare organizations formulate plans to bolster against ransomware attacks and to figure out effective ways to react to such attacks, according to the Bloomberg Bureau of National Affairs.
Deven McGraw, deputy director for health information privacy at OCR, first discussed the ransomware guidance at a recent cybersecurity panel event held by Politico. According to a new report from the Ponemon Institute, ransomware, denial-of-service attacks and malware are the top threats facing healthcare organizations today.
The OCR guidance additionally will look to shed light on when a ransomware attack is considered a breach, thus requiring healthcare organizations to inform the OCR and patients, according to Bloomberg BNA. To date, healthcare organizations have not been reporting ransomware attacks as breaches.
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How to Protect Your Entity from Healthcare Phishing Attacks

By Lysa Myers of ESET on May 19, 2016

It is becoming more common for data breaches to be triggered through healthcare phishing attacks, which are not always easy to protect against.

We read with horror about healthcare organizations getting hacked, spilling personal health details that no one wants to find dumped out onto the public internet. The origins of these attacks are all-too-frequently healthcare phishing attacks, stemming from emails that a staff member has unwisely opened.
While in theory, the obvious advice to give is that one should not click on strange links in email, that directive may not be as easy to follow as one might hope.
Phishing emails are becoming increasingly convincing, in part by targeting specific individuals via “spear phishing.”
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Only three states require e-prescribing of narcotics despite its benefits

Jayne O'Donnell, USA TODAY 9:39 a.m. EDT May 19, 2016
Electronic prescribing of controlled substances reduces fraud and keeps patients from getting multiple prescriptions for the same drug, but only three states require it and one doesn't even enforce its law.
As much of the country struggles with record overdose deaths, often from opioid painkillers, industry officials say this legislative lapse needs to be remedied as part of a broad drug control policy.
Although paper prescriptions were once considered safer, all states now allow e-prescribing for drugs, including opioid painkillers and other controlled substances. Still, only 7% of doctors do so, according to Surescripts, which links doctors with pharmacies for e-prescribing.
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Healthcare IT budgets expected to rise, but demands even more so

May 19, 2016 | By Susan D. Hall
A majority of healthcare executives expect IT budgets to increase in the next two years, but doing more with less remains a major reality, according to a survey from Peak 10.
The poll of 157 C-level executives and healthcare IT pros found staffing a major worry, whether in dealing with increasing security threats or the increasing need for a data-savvy workforce.
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World Privacy Forum questions adequacy of PMI privacy principles

May 19, 2016 | By Katie Dvorak
The World Privacy Forum says privacy principles set forth for the Precision Medicine Initiative "lack detail and fail to address underlying legal requirements and protections." 
In a research paper published this week, the organization notes that the HIPAA Privacy Rule will not apply to the research, and that the principles "appear to be voluntary and lack important legal and administrative details."
The current privacy principles in place for the initiative were created by the White House with help from experts working both inside and outside the government. They include categories such as transparency to participants and the public; respect for participant preferences; and appropriate data sharing, access and use.
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ICO 'aware' of Google DeepMind and Royal Free app concerns

Lyn Whitfield
17 May 2016
The Information Commissioner’s Office has confirmed that it is “aware” of concerns about a trust’s collaboration with Google DeepMind on an AKI alert system.
Google announced that its artificial intelligence offshoot, DeepMind, had launched a new division to work with NHS clinicians on developing technology to improve patient care in March.
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Integrated care pioneers 'struggling and facing IT issues'

Lyn Whitfield
16 May 2016
The government’s integrated care pioneers have made little progress and are struggling with IT and information governance issues, an official evaluation has shown.
The Integrated Care and Support Pioneer Programme was an initiative championed by Liberal Democrat care minister Norman Lamb during the last Parliament.
It was seen as leading the charge for the kind of ‘whole system’ working that policy makers hope will deliver significant efficiency savings.
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Mayo Clinic: Remote monitoring of low-risk pregnancies boosts patient satisfaction

May 18, 2016 | By Susan D. Hall
Women with low-risk pregnancies reported improved satisfaction with a program called OB Nest that combined a reduced number of in-person prenatal visits with in-home monitoring, according to a presentation this week at the Clinical and Scientific Meeting of the American College of Obstetricians and Gynecologists.
Researchers from the Mayo Clinic compared usual care that involves 12 to 14 visits with an obstetrician to the OB Nest program, in which patients had eight in-person appointments and six "virtual care" visits with a trained nurse by phone or email. Participants also used home monitoring equipment for fetal heart rate and maternal blood pressure. In addition, they could be part of an online community of OB Nest participants and nurses, according to an announcement.
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Researchers: Portals should be more personal, interactive

May 18, 2016 | By Susan D. Hall
Patient portals need to provide more personalized, direct communication with providers and interactivity to fully engage patients, according to research published at the Journal of Internet Medical Research.
The researchers found that portals haven't been as widely adopted as hoped, and sought to find contributing factors to that. They conduced 31 patient interviews, two clinician focus groups and reviewed 142 incidents involving portal use, 102 negative and 40 positive.
They noted a "pronounced" difference in expectations, with providers using the portal to educate and motivate patients for preventive screenings and patients seeking to organize their healthcare overall.
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Business continuity crucial for healthcare IT execs facing rising threats

Published May 18 2016, 2:56pm EDT
Healthcare is becoming increasingly reliant on digital technology and the data it generates. Technology is now integrated into operations at virtually every level—handheld diagnostic tools, tablet-based consultation reports, electronic medical records, automated reconciliation, billing and payment and more. IT is how healthcare works, competes and manages the efficiency and effectiveness of each organization.
As a result, the potential impact of IT outages has increased exponentially. And that makes the discipline of business continuity an imperative for healthcare executives. One clear, simple example of the gravity of this issue: A business continuity plan is required to comply with HIPAA regulations.
But in the course of providing IT managed services to healthcare clients, there is often a lack of clarity and understanding of business continuity in general. So, let’s begin this discussion by defining business continuity in healthcare terms.
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38% of execs want telemedicine programs built onto their EHRs; 6 other survey takeaways

Written by Max Green | May 17, 2016
There are a number of ways for hospitals to implement telemedicine programs. Many systems are beginning to dabble with the technology to determine what works best for them and their patient population, but a new survey suggests that many executives — 38 percent — would prefer a rolling out a telehealth option that could be built out of their existing EHR.
Here are six additional findings from Avizia's "Closing the Telehealth Gap" report.
  • Of respondents, 63 percent say their organization uses telehealth.
  • Of hospitals, 72 percent or healthy systems say they use telehealth. That number drops to 52 percent for physician groups and clinics, and 36 percent for other types of providers.
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Telemedicine's Explosive Growth Rate Belies its Penetration

John Commins, May 18, 2016

Telemedicine has grown tremendously in the past five years in some rural areas. Yet barriers remain, and only a fraction of the population has access.

"Soccer is America's sport of the future," so that old joke goes, "and it always will be."
I am reminded that of that chestnut every four years as I follow the World Cup misfortunes of the U.S. men's team, and whenever the subject turns to telemedicine.
For so many years we've been talking about the potential of telemedicine, how it can improve population health and access and contain costs, particularly in rural America. Still, we've yet to achieve the sort of widespread utilization and population health benefits that many advocates have envisioned.
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Cybersecurity special report: Ransomware will get worse, hackers targeting whales, medical devices and IoT trigger new vulnerabilities

Cybercriminals have set their sights on healthcare. Ransomware is the new normal. And many providers are approaching security all wrong. CIOs, CISOs, ethical hackers and other experts point the way forward. 
May 17, 2016 07:07 AM
Boston Children's CIO Daniel Nigrin, MD said that in the past he thought about cybersecurity related to health IT as safeguarding data. But experience, particularly the Anonymous attack, has since taught him that it is much more than that. 
When it comes to digital security, healthcare provider organizations have the wrong mission and are using outdated approaches, generally failing at securing their organizations from today’s increasingly sophisticated cybercriminals.
That’s according to “Hacking Hospitals,” a two-year study by Independent Security Evaluators of 12 healthcare facilities, two healthcare data facilities, two healthcare technology platforms and two medical devices.
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FDA issues draft guidance on use of EHRs in clinical investigations

May 16, 2016 | By Marla Durben Hirsch
The U.S. Food and Drug Administration has released draft guidance regarding the collection and use of electronic health record data in clinical trials.
The draft guidance is an effort to modernize and streamline clinical investigations, and its goals are to "facilitate use of EHR data in clinical investigations and promote the interoperability of EHRs and electronic systems supporting the clinical investigation."
The FDA notes that EHRs may enable researchers to more easily combine, aggregate and analyze data, both in real-time and longitudinally, as well as facilitate post trial follow ups. The FDA's acceptance of such data depends on the FDA's ability to verify its quality and integrity.
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How to prevent ransomware attacks

Published May 16 2016, 8:32pm EDT
By this time last year, 105 healthcare breaches had been reported to the U.S. Department of Health and Human Services (HHS) for a total of over 92 million lost records, compared with “only” 81 breaches and 3.5 million records so far in 2016. Good news, right? Well, sort of.
Unfortunately, this seemingly positive trend does not reflect the actual threat landscape in the healthcare industry. Ransomware is a type of malware that restricts access to files or systems with encryption until the victim (the hospital) pays the ransom for the key to unlock them.
As a former security operations lead for a hospital network, I responded to numerous ransomware infections following targeted phishing campaigns against the hospital. The incident response team followed the same procedure for each incident: isolate the infected PC and restore the corrupted (encrypted) files on the department shared drive from backup. In such isolated instances, there was no impact to clinical operations and patient care. However, the story would have been different in the case of widespread infection on the network.
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Is ONC putting too much hope on the cloud?

Published May 13 2016, 1:27pm EDT
The Office of the National Coordinator for Health Information Technology (ONC) is pinning its latest hopes for interoperability on the cloud, namely with application programing interfaces, or APIs. But is this hope realistic?
Experts feel it will be a close call to get the API standards ready in time for requirements found in the April 27 release of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) proposed rule. The rule makes it a national objective to achieve health data interoperability by December 31, 2018.
A measure in the MACRA proposal called, “View, Download, Transmit (VDT),” calls for eligible clinicians to help patients:
  • view, download or transmit their health information to a third party;
  • access their health information through the use of an API; or
a combination of both
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Survey: No slowdown in healthcare breaches

Published May 16 2016, 4:09am EDT
Nearly 90 percent of healthcare organizations were the victims of a data breach in the past two years, and 45 percent had more than five data breaches during that same time period.
Criminal attacks are the leading cause of these health data breaches, with 50 percent of healthcare organizations and 41 percent of business associates reporting such attacks, while employee mistakes, third-party snafus, and stolen computer devices are the cited reasons for the other breaches.
Those are among the findings of a new study by the Ponemon Institute, sponsored by software and services vendor ID Experts, in which denial-of-service attacks, ransomware, malware, and phishing are listed as the top cyber threats facing healthcare organizations and business associates.
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5 health issues presidential candidates aren't talking about but should be

Long-term care, out-of-pocket spending and even dental care are among the challenges America faces in the next few years. But Bernie Sanders, Donald Trump and Hillary Clinton are not saying nearly enough about their intentions in those areas. 
May 16, 2016 10:22 AM
References to the Affordable Care Act — sometimes called Obamacare — have been a regular feature of the current presidential campaign season.
For months, Republican candidates have pledged to repeal it, while Democrat Hillary Clinton wants to build on it and Democrat Bernie Sanders wants to replace it with a government-funded “Medicare for All” program.
But much of the policy discussion stops there. Yet the nation in the next few years faces many important decisions about health care — most of which have little to do with the controversial federal health law. Here are five issues candidates should be discussing, but largely are not:
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MACRA focus should be patient outcomes, not 'unnecessary burdens,' John Halamka says

May 16, 2016 | By Dan Bowman
Beth Israel Deaconess Medical Center CIO John Halamka believes that less could be more when it comes to physicians transitioning to the new programs outlined under the Medicare Access & CHIP Reauthorization Act (MACRA).
For clinicians, he says in a post to his Life as a Healthcare CIO blog, less focus on striving toward multiple quality indicators and more emphasis on an important but select few could lead to improved outcomes quality. The post is a follow-up to his earlier commentary on the MACRA proposed rules, which he calls overly complex and burdensome.
He notes, for instance, that forcing doctors like his ophthalmologist to record smoking statuses or send secure messages to patients is not as vital to better care as actually ensuring medications are administered and eyesight does not worsen.
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Telecom companies lag behind Google, Apple in digital health space

May 16, 2016 | By Katie Dvorak
As Apple and Google take a greater role in healthcare innovation, telecom companies fall short of success in the industry, according to a Bloomberg report.
As early as 2009, AT&T, Verizon and similar companies had their sights set on digital health, but according to the report weren't able to obtain the same foothold or put in the same amount of time and money into transforming healthcare as other tech giants.
While the companies had the technical capability to create necessary networks, they weren't able to make the headway as that Google and Apple have with their tools and devices. Hospitals wanted services and devices that would improve workflow, Lee Schwamm, medical director of telehealth at Massachusetts General Hospital, says in the article.
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Boston Children's Hospital creates mHealth development guide

May 15, 2016 | By Judy Mottl
Boston Children's Hospital researchers have created a 14-point mobile app development guideline for bring-your-own-device hospital environments to help developers with system integration, compliance adherence and software deployment strategies.
Once the Mobile Application Development guideline was developed, BCH researchers built the TaskList app, which is aimed at helping medical residents capture, monitor, create and share daily collaborative patient-focused tasks. The guideline's 14 recommendations cover four categories, from authentication and data management to secure app environments and remote enforcement, according to a report detailing the guideline's development, published in the Journal of Medical Internet Research.
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Study of Telemedicine Finds Misdiagnoses of Skin Problems

Online medical services are booming, but physicians remain concerned

By Melinda Beck
Updated May 15, 2016 4:40 p.m. ET
Researchers posing as patients with skin problems sought help from 16 online telemedicine companies—with unsettling results.
Some of the online doctors misdiagnosed syphilis, herpes and skin cancer, and some prescribed medications without asking key questions about patients’ medical histories or warning of adverse effects, the researchers found. Two sites linked users with doctors located overseas who aren’t licensed to practice where the patients were located, as required by state law.
“The services failed to ask simple, relevant questions of patients about their symptoms, leading them to repeatedly miss important diagnoses,” said Jack Resneck, a dermatologist with the University of California, San Francisco, and lead author of the study, published online in JAMA Dermatology on Sunday.
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Prevent Data Breaches with Strong Medical Device Security

With cybersecurity attacks becoming more complex, strong medical device security is an essential aspect when it comes to preventing data breaches.

Patients come to your healthcare facility with a whole host of expectations.
They want personalized, quality care delivery. They want strong medical device security, knowing that all equipment is reliable, effective and safe.
They’re placing an incredible amount of trust in you and your facility. Their health and wellbeing is entirely in your hands.
Patients are also trusting your equipment, systems, and staff to keep their personal health information safe from cyberattacks.
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ONC Task Force: No ‘Show-Stopping’ Barriers to API Requirements

May 15, 2016
by David Raths
Calls existing standards, infrastructure and identity-proofing processes adequate to support patient-directed access via APIs
A task force of the Office of the National Coordinator for Health IT (ONC) has prepared a series of recommendations to address privacy and security concerns around application programming interfaces (APIs), technology that allows one software program to access the services provided by another software program. The task force said it did not identify any “show-stopping” barriers that would prevent the deployment of APIs within the timelines ONC has set for 2015 certification criteria or Meaningful Use stage 3.
 In its 2015 Edition of Health IT Certification Criteria (2015 CHIT), ONC established three new criteria that requires certified health IT to demonstrate the ability provide a patient-facing app access to the Common Clinical Data Set via an API. In parallel, CMS included two objectives in MU Stage 3 that reference the use of APIs involving patient electronic access to health information and coordination of care through patient engagement.
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Enjoy!
David.

Friday, May 27, 2016

I Hope This Is Not True But Rather A Matter Of Poor Expression Or What Is Happening.

I spotted this page the other day from the Austin Hospital in Melbourne.

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.

What is a My Health Record?

My Health Record is the new name of the national digital health record system. Having a My Health Record means your important health information like allergies, medical conditions and treatments, medicine details, test or scan reports can be digitally stored in one place.
This information can be easily and quickly accessed by participating healthcare providers when needed for your ongoing healthcare.

Will My Health Record be useful for me?

My Health Record can help you in a number of ways:
  • Keeping track of your own health history
  • Enabling other health professionals you authorise to see your key health summary so you don't have to repeat it or worry about forgetting important information, like medications. 
  • Helping you and your healthcare providers to better manage complex or chronic conditions
  • You can customise access to your My Health Record by setting access controls including restricting who can see your information, or cancel your record, at any time

For more information or to register for a My Health Record

You can find the page here:
I have to say the claim that Austin Clinicians can access your myHR is a little odd. Surely there needs to be prior consent from the patient to firstly access your record and second to add material to the patient record.
That is certainly not what is implied the way this page is worded. Either the site, the procedures or both need to be updated to reflect how myHR should be used.
David.

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.