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."

Friday, June 17, 2016

Concerns About Telstra Health Providing The National Cancer Screening Registry Just Rumble On. I Am Not Sure Why.

This appeared last week:

Government-Telstra cancer register deal needs screening

  • Antony Harrowell
  • The Australian
  • 12:00AM June 7, 2016
Stumbling down rabbit holes can lead to unexpected places; just ask Alice, she found herself in a Wonderland of strange characters and odd situations.
Her fall may be fictional, but it reflects the same rabbit hole in which Australians may find themselves if the latest deal between the federal government and Telstra is allowed to see the light of day without intense scrutiny. Like Alice, this is a dark comedy that may have severe consequences.
Telstra was recently awarded a $220 million contract by the government to establish a Cancer Register, which is unclear in its objective. That is, to provide “a robust IT solution-based support system for the expanded National Bowel Cancer Screening Program and the renewed National Cervical Screening Program” or a full “National Cancer Screening Register”.
Why is the federal government limiting the solution to just two and not all cancers? Is it an IT platform to assist the screening program for those cancers or is it a national register?
This needs to be answered by the government because these are two totally different outcomes, with substantially different implications: one being effectively a contact database, linked to electronic or paper-based reminders not containing sensitive information; and the other being a full personal “cancer” health record containing test results, treatments and other highly sensitive information.
It has been assumed for the federal government to award the $220m contract to Telstra, that it is only a contact database/notification platform. It’s something telcos do routinely.
Everyone receives paper-based, email or SMS notifications to inform them they are near their limits, exceeding their limits or anything else they believe is pertinent to their daily lives, so it makes sense this service be expanded to let us all know when we should be undertaking our cancer screening.
The rabbit hole we potentially find ourselves in occurs if the government deems it appropriate to place our personal medical data, cancer screening results, in the hands of a telco.
Telstra as an organisation has experienced serious data breaches and continues to struggle to operate a stable communications network, which is its core business. There will be no solace in free data days or $25 credits if this environment is breached and the personal health data pilfered.
More here:
We also had this appear.

Privacy concerns over cancer register

Australia June 9 2016
Telstra Health has won the tender to manage the National Bowel Cancer and Cervical Screening data register. The company will be responsible for collating and amalgamating the data currently stored on separate State databases into one national register and overseeing the register’s operations.
Concerns have arisen over the potential for inadvertent and unauthorised breaches of private information, heightened by recent instances of data released by Telstra.
While the exact nature of the privacy protections outlined in the tender are unknown and it remains unclear whether sufficient avenues will be available to allow consumer actions against Telstra Health as an incentive to strengthen the company’s privacy policies, the Commonwealth privacy legislation will apply to the register and any misuse of data could be an offence under the Criminal Code.
More here:
My view on all this concern is that wherever there is a database of sensitive information there is risk of breach. That being the case I would far rather have my personal information managed by professional health IT staff - as they will be with Telstra Health - rather than small public sector organisations scattered all over the country  in State-Based Registries.
To imagine Telstra Health does not understand how important it is they get this one right simply defies common sense. Be assured they will be doing their very best to get this working safely, securely and well.
David.

p.s I notice that the MD of Telstra Health (Shane Solomon) also has a strong take on why every-one should take a deep breath. See here:

http://www.theaustralian.com.au/business/technology/opinion/telstras-national-cancer-screening-register-a-big-step-forward/news-story/137eed93336bf21f6b264b616cef3d52

D.

Thursday, June 16, 2016

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

June 16  Edition
The big discussion of the week has been trying to figure out which of the major parties can do the better job balancing our national budget. Hard to say who is winning.
I also note concerns on economic growth,  the changes to superannuation as well as continuing cuts in other areas. It will be a while yet before it is clear just what the final outcomes of policy in both parties will be - maybe in the next week or two.
Lots this week on aged care and health insurance!
More worryingly, globally there seems to be increasing worry  about the global economy.

Bill Gross says negative rates are like 'supernova' that will explode

Date June 10, 2016

John Gittelsohn

Legendary bond investor Bill Gross has warned central bank policies that pushed trillions of dollars into bonds with negative interest rates will eventually backfire violently.
"Global yields lowest in 500 years of recorded history," Gross, 72, wrote this week on the Janus Capital Group Twitter site. "$US10 trillion of neg. rate bonds. This is a supernova that will explode one day."
A supernova is a star at the end of its life that suddenly increases greatly in brightness because of a catastrophic explosion that ejects most of its mass.
Gross, who manages the $US1.4 billion ($1.9 billion) Janus Global Unconstrained Bond Fund, has argued for some time that the economy is at the end of a decades-long cycle of expanding credit that has culminated in negative interest rates, a situation he said is unsustainable.
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Not sounding all that good…..

General Budget Issues.

  • Updated Jun 7 2016 at 11:45 PM

Election 2016: Labor pledges short-term budget pain for long-term gain

Labor will all but confirm on Wednesday that it will allow the budget deficit to worsen over the next four years when it presents its policy agenda as a 10-year economic growth plan that is fairer than the Coalition's.
In a concession sure to be leapt upon by the government, Labor leader Bill Shorten and shadow treasurer Chris Bowen will rationalise leapfrogging the four-year budget cycle by arguing that "fiscal repair should be achieved over the medium term and backloaded so as not to hurt our economy".
They will recommit to releasing figures before the election, reconciling their spending and taxing measures over four and 10 years, and an estimate of when they would return the budget to balance. They will only commit to "have more saving than spending over a decade".
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Federal election 2016: Labor to release its 10-year economic blueprint, Shorten refuses to reveal how it’s to be funded

June 8, 2016 12:00am
Simon Benson National Political Editor The Daily Telegraph
BILL Shorten will chart a 10-year course for Australia’s economy that relies on education, renewable energy, a gold-plated NBN and a revival of manufacturing industries to generate the country’s long-term growth.
But the Labor leader is still refusing to reveal how he or taxpayers would fund his plan in government.
Mr Shorten will today release Labor’s 10-year economic blueprint as he seeks to blunt the Coalition’s election campaign attacks on his economic and budget credentials.
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Federal election 2016: Shorten shifts focus to the economy as Morrison highlights company tax benefits

Date June 8, 2016 - 12:00AM

James Massola

Chief Political Reporter

Bill Shorten will shift Labor's focus to the economy with the launch of a "Ten-Year Plan for Australia's Economy", in a move to neutralise the Coalition's concerted attack over economic management.
The 32-page "Ten-Year Plan" booklet contains no new policies and amounts to a summary of the opposition's promises to date, while the ALP's final election costings are still weeks away, leaving it open to further government attacks over their economic program and a so-called funding "black hole".
Treasurer Scott Morrison will return fire with new modelling prepared by Independent Economics' Chris Murphy to claim that keeping the company tax rate at 30 per cent will act as a drag on economic growth and hurt consumers.
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Federal election 2016: Shorten’s plan guarantees deeper deficits

  • The Australian
  • 12:00AM June 9, 2016

David Crowe

Labor will go to the election promising deeper budget deficits throughout the first term of a Shorten government in a high-risk political play that asks voters to accept bigger commonwealth debt in the hope of a brighter outlook over 10 years.
Bill Shorten was battling to justify the decision last night as economists rejected his claim that the higher spending was needed to spur demand and shore-up growth, turning his budget plan into a key test on economic management.
The government seized on the move to declare that Labor “could not be trusted” to balance the budget amid warnings from economists that growing debt and deficit would threaten the ­nation’s valuable AAA credit rating. In a sign of the political danger around his decision, Mr Shorten described the new stance as a delay to a “fiscal contraction” rather than stating directly that the deficits would be bigger under Labor.
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Australia's badge of honour at risk

June 9, 201612:32pm
Colin Brinsden, AAP Economics Correspondent AAP
The world's major credit rating agencies didn't cover themselves in glory during the global financial crisis.
Anyone who has seen "The Big Short" was reminded how their actions prompted overly-zealous investors to throw money at debt instruments that ended up being worthless.
But agencies like Standard & Poor's, Moody's Investors Service and Fitch Ratings still wield huge power and their analyses decide whether a country is the top dollar or an also-ran.
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Election 2016: Who has the better economic plan? Don't ask an economist

June 11 2016
Michael Gordon
Bill Shorten took his big target strategy to win government to a new level this week, injecting a mix of relief and relish into a Malcolm Turnbull campaign that has so far struggled to capture the attention, much less the imagination, of the electorate.
Having warned that the Coalition's  projected deficits over the next four years represent a threat to Australia's AAA credit ratings, Shorten and shadow treasurer Chris Bowen announced that their numbers would be even higher over the very same period.
Predictably, Treasurer Scott Morrison dubbed it a "recipe for fiscal chaos", declaring: "If you vote Labor, you are voting for higher deficits and you are voting for higher debt, a higher debt burden on future generations."
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Labor, Coalition show a deficit of fiscal policy

June 12, 2016 12:00am
Terry McCrann Sunday Herald Sun
THE very first words in Bill Shorten and Chris Bowen’s economic policy document are “We’ll put people first”.
Well, you are certainly not doing that if your whole policy framework is built around reckless spending which could condemn them ultimately to a “Greece future” — or worse, a Venezuelan one.
The bottom line of the “four years of bigger budget deficits”, which Shorten and Bowen announced midweek — to borrow a phrase from the treasurer in the Rudd and Gillard governments, Wayne Swan — is that it would turn the likelihood of Australia losing its Triple-A credit rating into a rolled-gold certainty.
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Health Budget Issues.

Election 2016: Patients may pay less for diagnostic scans as radiologists scrap campaign

Date June 5, 2016 - 5:43PM

Jane Lee

Patients could pay less for diagnostic scans such as mammograms and ultrasounds, with radiologists abandoning their public campaign against the Turnbull government's planned cuts to bulk-billing incentives at the last minute in exchange for a review of the sector.
The Australian Diagnostic Imaging Association planned to launch a public campaign on Saturday, warning that thousands of Australians with cancer would avoid getting tested if the cuts went ahead, because scans would become more expensive. 
Radiologists were going to ask patients to sign a petition opposing the cuts in the final weeks of the federal election campaign, similar to the pathology sector's own campaign against the cuts, which are expected to save $650 million in total over four years.
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Medicare: diagnostic imaging sector trades bulk-billing cut for rebate rise

Sector agrees to Coalition’s $650m cut over four years, but up to $50m more will be spent after review of Medicare rebate
The Coalition has agreed to review the freeze on the rebate for diagnostic imaging, and the sector wants Labor to do the same. Photograph: Alamy Stock Photo
The diagnostic imaging sector has accepted a cut to bulk-billing incentives in return for a review expected to increase the Medicare rebate and a promise the rebate will be unfrozen in future.
In December the Coalition government announced a plan to cut the bulk billing incentive for diagnostic imaging and scrap it for pathology services, saving $650m over four years.
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Health system cares for big insurers, big pharma

  • Doron Samuell
  • The Australian
  • 12:00AM June 7, 2016
Australia spends around $150bn a year on healthcare.
Although there are some differences between the major parties on health policy, all sides embrace the concept of universal healthcare.
But beyond the simpler slogans that dominate the public debate, very few of us who deal with the system are happy with the way it’s working.
In reality, it is riddled with lopsided and illogical arrangements that benefit a small number of vested interests, and militate against the interests of the great majority of the population.
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Federal election 2016: ‘ending Medicare freeze is top priority’

  • The Australian
  • 12:00AM June 8, 2016

Sean Parnell

Michael Gannon hopes the AMA could play a positive role in future funding talks.
The new Australian Medical Association president Michael Gannon believes he has to be mindful of the budget deficits and not ask for “more, more, more” funding for public hospitals.
But the Perth obstetrician, who took over from Brian Owler last month, is ­focusing his efforts on ending the Medicare freeze, which the Turnbull government extended in the budget to save another $1 billion.
Dr Gannon said yesterday the freeze on GP rebates, in particular, was the “number one issue” for the AMA. He expressed concern GPs would be forced to charge vulnerable patients or move to areas where patients could afford to pay.
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McGorry says mental health care becoming a field of broken dreams

  • Patrick Mcgorry
  • The Australian
  • 12:00AM June 10, 2016
Is it time to question the dogma that mental health care should be fully integrated and unprotected within mainstream healthcare?
At a recent mental health forum, I heard a story that crystallised the issue for me. A father ­described how his 17-year-old daughter — let’s call her Lily — gradually had become withdrawn and taken to her bed. She became anxious and depressed.
She was taken to GPs, emergency departments and a range of other professionals and, though she had been functioning extremely well before becoming ill, was responded to negatively by health professionals, even given a label of personality disorder. Her parents were confused and overwhelmed and got no support.
Then Lily had a seizure. This was investigated and, after a lumbar puncture and brain scans, viral encephalitis was diagnosed. The fact she now had a “medical” (genuine) illness rather than a psychiatric one transformed not only her treatment but also the attitude of health professionals. She was now a “deserving” patient.
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Health Insurance Issues.

  • Jun 8 2016 at 11:45 PM
  • Updated Jun 8 2016 at 11:45 PM

Election 2016: Health funds must change or face 'disaster' says Graeme Samuel

by Ben Potter
A new way of calculating health insurance premiums that could limit increases to 2.5 per cent a year and an official website to grade health policies from "junk" to "platinum" are being pushed by Graeme Samuel, an adviser to the government's private health insurance review until a few months ago.
Mr Samuel will call for wholesale deregulation of government-dictated rebates for medical implants or "prostheses" in a speech on Thursday. 
Health insurers estimate they are overcharged by about $800 million a year by medical implant makers and Mr Samuel will argue that the best way to impose competitive discipline on the healthcare market is by "empowering consumers to make informed decisions".
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Federal election 2016: Health reforms to force insurers to send single bill

Samantha Maiden, national political editor, Herald Sun
June 12, 2016 12:00am
PRIVATE health insurers will be forced to offer patients a single bill listing all out-of-pocket charges to avoid bill shock under government ­reforms to rank cover as gold, silver and bronze.
Health Minister Sussan Ley will announce the changes today also confirming that plans to charge smokers and the overweight more for health insurance have been shelved.
The announcement follows consultation with the public over how to fix “junk” health cover after families complained of feeling ripped off and confused by private health insurance.
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Government promises to create a tiered private health system that's fairer

June 12, 2016
THE Coalition Government has pledged to simplify private health insurance by creating three categories of health policies consumers can easily understand.
The government will establish gold, silver and bronze health policy categories if re-elected on July 2 and set minimum standards for the 40,000 private health insurance products on the market. Patients will also retain the current private health insurance rebate.
The coalition said on Sunday that it conducted surveys in which 70 per cent of its 40,000 respondents said they struggled to make changes to their private health insurance policy.
Two-thirds of respondents also said they were not getting value for money from their plans.
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Aged Care Issues.

Estia hit as sector scrutinised

  • The Australian
  • 12:00AM June 8, 2016

Kylar Loussikian

Sarah-Jane Tasker

Estia Health has been forced to allay market concerns about the possibility it will come under ­increasing federal government scrutiny, a day after The Australian revealed health bureaucrats were eyeing the rapid growth in the company’s patient funding.
In a statement to the Australian Securities Exchange, Estia said it was “regularly audited” but had “materially more accurate claims than the industry average ... over the last two years”.
Estia shares fell nearly 11 per cent yesterday following reports of a government move to clamp down on funding.
The company attracted the ­attention of short-selling hedge funds, with Sydney-based VGI Partners confirming it was one hedge fund involved.
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Aged-care providers ‘maxing’ on funding: HammondCare head

  • The Australian
  • 12:00AM June 9, 2016

Sarah-Jane Tasker

Kylar Loussikian

The head of a not-for-profit aged-care provider has warned that many in the sector are “maxing out” on the federal government’s funding system, amid confusion over warnings about over-­claiming in the sector.
Stephen Judd, chief executive of HammondCare, said while he was not defending providers that over-claimed, he thought those ­accused of the practice were not “rorting” but maxing out on a system the government had given them. Dr Judd said the aged-care funding model rewarded pro­viders for keeping residents frail, rather than promoting wellness.
“I don’t think ... there is any fraud going on, but I do ­believe people are maxing out on a system they have been given by the Australian government,” he said.
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  • Updated Jun 11 2016 at 8:08 AM

Aged Care in Australia: someone's going to pay

The collapse in the share price of Australia's biggest aged care provider, Estia Health, over the past fortnight has raised serious questions about how profitable and realistic growth prospects are for a sector so reliant on the country's aging population and government funding. 
The demand for aged care led to the completion of $1.5 billion worth of new construction in 2014 – an increase of 69 per cent on the previous year, according to the Department of Health. Net assets in the sector were up 10 per cent on the previous year to $11.2 billion and revenues have also grown to $14.8 billion a year. Some analysts estimate that close to $22.5 billion worth of aged-care facilities will need to be built before 2031 to accommodate the growing demand.
The big listed providers Estia Health, Japara Healthcare and Regis Healthcare have all floated on the stock market in recent years, enjoying plenty of investment support and government funding.
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Aged care and fast money an unhealthy mix

  • The Australian
  • 12:00AM June 11, 2016

Andrew White

Kylar Loussikian

It took Quadrant Private Equity less than a week after the federal budget to get out of the aged-care business.
Quadrant had formed the Estia Health business barely five months before it floated on the stockmarket in December 2014 and had been entitled to sell the rest of its shares, which came out of escrow in November last year.
But such was the performance of the stock — it reached almost $8 a year later — and so rosy the outlook for a largely government- funded industry serving an ageing population that Quadrant, one of the sharpest operators in the local venture capital market, held on.
Last month’s budget, however, appears to have changed its view.
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Superannuation Issues.

  • Updated Jun 6 2016 at 8:18 PM

How the Labor and Liberal plans to tax retirement balances will affect you

Liberal and Labor both plan to restart taxing wealthy retirees' superannuation. 
Analysis by actuarial consulting firm Rice Warner shows that voters with $2 million or more in super savings will be better off under Labor's policy in years when investment market returns are 6 per cent or less, but could pay more than three times as much tax when returns are more than 8 per cent. 
The research also shows that under Labor, retirees with super balances of about $1 million could be hit with a tax on their earnings in years when their investment returns were 8 per cent or higher. 
However, Labor's approach to taxing big super balances in retirement also provides more flexibility for self-funded retirees to rebuild their pension balance if markets tank, Rice Warner head of superannuation research Nathan Bonarius said. 
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As super takes a hit, family trusts rise again

  • Will Hamilton
  • The Australian
  • 12:00AM June 7, 2016
The proposed changes around superannuation and the ensuing erosion of faith in the savings system have led to discussion about alternatives to superannuation. With this comes consideration of the increased use of family and discretionary trusts as a vehicle through which to hold and accumulate wealth.
Many advisers are witnessing increasing demand from clients seeking advice about investment strategies that are effective alternatives to superannuation — or that may sit beside a superannuation investment strategy — one of which is indeed trusts.
Another is property investment, which can be approached as a direct investment that might be negatively geared or through investment in a real estate investment trust (REIT). Whatever the approach, there are alternatives to superannuation that can enable investors to build and manage wealth.
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Federal election 2016: QC’s group lobbies for super changes

  • The Australian
  • 12:00AM June 8, 2016

Glenda Korporaal

Leading Melbourne QC Jack Hammond is expected to launch a lobby group today to campaign against the Coalition government’s proposed superannuation law changes.
Mr Hammond will speak at a Melbourne meeting of lawyers and judges tonight and is expected to announce the formation of a group called Save Our Super which will call on the government to “grandfather” the impact of proposed superannuation changes on existing superannuation account holders.
The changes announced on budget night include imposition of a $1.6 million cap on the amount of money that can be moved into a tax-free super account, an immediate lifetime cap of $500,000 for post-tax contributions to superannuation, cutbacks in the attractiveness of transition to ­retirement schemes, higher taxes on super contributions for people earning more than $250,000 and higher taxes on payouts under ­defined benefit superannuation schemes above $100,000 a year.
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Government will ‘look at’ deals signed before changes to super

  • The Australian
  • 12:00AM June 10, 2016

Glenda Korporaal

Kelly O'Dwyer has called on the Greens to announce the full details of their superannuation policy.
The federal government would look at situations where people had entered into binding legal contracts who might be hit by the proposed superannuation changes when it was drafting the legislation, Assistant Treasurer Kelly O’Dwyer said yesterday.
“We will have a period of consultation to make sure there are no unintended consequences from the legislative changes,” she said.
“If someone has made a binding legal agreement before budget night, the government will look at that situation in the design of the legislation.’’
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Pharmacy Issues.

PM makes commitment to community pharmacy

Prime Minister Malcolm Turnbull has expressed his support for community pharmacy in a letter to the Pharmacy Guild, saying a returned Coalition government would ensure funds allocated under the Pharmacy Trial Program and 6CPA will deliver the best health outcomes.

The PM says the Coalition supports the current model of pharmacy ownership, and supports reforms that will allow pharmacists to take on a greater role in allied health.
Mr Turnbull says that the Coalition is “proud Australia’s community pharmacy sector is considered world-leading.
“It is a truly public-private partnership that is underwritten by the capital investments made by small business pharmacy owners around Australia and the commitment and hard work of their staff.
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Xenophon attacks 'flawed' co-payment

8 June, 2016 David Rowley 
Senator Nick Xenophon has condemned the $1 PBS co-payment as "flawed" and future co-payments as "damaging and unnecessary".
In a letter to pharmacists, addressed to the Pharmacy Guild, the South Australian independent says the $1 discount, introduced in January, misleads pensioners and concession card holders into thinking they're getting cheaper medicine when in reality they’re having their access to the safety net delayed.
This comes at the expense of their local pharmacy, he says, adding that it also breaches the universality of subsidised medicine, with rural and regional pharmacies unable to pass on the discount.
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I look forward to comments on all this!
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David.

Wednesday, June 15, 2016

I Have Heard Of Some Health IT Fiascos But This One Is Right Up There!

Dr Terry Hannan spotted this amazing yarn.

Nanaimo doctors say electronic health record system unsafe, should be shut down

By Cindy E. Harnett, Victoria Times Colonist May 27, 2016

Nine weeks after rolling out the paperless iHealth system, Nanaimo hospital’s intensive-care and emergency departments have reverted to pen and paper “out of concern for patient safety.”

Photograph by: Sherry Yates Young , Vancouver Sun

Implementation of a $174-million Vancouver Island-wide electronic health record system in Nanaimo Regional General Hospital — set to expand to Victoria by late 2017 — is a huge failure, say senior physicians.
After a year of testing, the new paperless iHealth system rolled out in Nanaimo on March 19. Island Health heralds the system as the first in the province to connect all acute-care and diagnostic services through one electronic patient medical record, the first fully integrated electronic chart in the province.
But nine weeks after startup, physicians in the Nanaimo hospital’s intensive-care and emergency departments reverted to pen and paper this week “out of concern for patient safety.”
Doctors said the system is flawed — generating wrong dosages for the most dangerous of drugs, diminishing time for patient consultation, and losing critical information and orders.
“The whole thing is a mess,” said a senior physician. “What you type into the computer is not what comes out the other end.
“It’s unusable and it’s unsafe. I’m surprised they haven’t pulled it. I’ve never seen errors of the kind we are now seeing.”
Doctors are so concerned, they want Island Health to suspend the implementation.
“Take it away and fix it and test it before you bring it back — stop testing it on our people,” said one doctor. “Why wasn’t this introduced in Victoria first? If they went live in Victoria first, they would have a riot.”
The doctors, who fear reprisals, spoke to the Times Colonist on condition of anonymity.
The $174-million system started with a 10-year, $50-million deal for software and professional services signed in 2013 with Cerner Corporation, a health information technology company headquartered in Kansas City. Thus far, the company has been paid close to $12 million. The remaining $124 million is to be spent by Island Health for hardware, training and operating the system.
The system is being used in Nanaimo’s hospital, Dufferin Place residential care centre (also in Nanaimo), and Oceanside Health Centre in Parksville.
Since March 19, mobile touch-screen computer console carts have been rolling around hospital hallways. Voice-recognition dictation software immediately transcribes a doctor’s verbal notes into a patient’s electronic record, and scanners track each bar-coded patient bracelet around the hospital.
But doctors complain the new technology is slow, overly complicated and inefficient.
“The iHealth computer interface for ordering medications and tests is so poorly designed that not only does it take doctors more than twice as long to enter orders, even with that extra effort, serious errors are occurring on multiple patients every single day,” wrote one physician at the Nanaimo hospital.
“Tests are being delayed. Medications are being missed or accidentally discontinued.”
Doctors can’t easily find information entered by nurses, the physician wrote.
There are also complaints about the pharmacy module of Cerner’s integrated system — the only joint build between Island Health and Cerner.
Lots more here:
It’s hard to know what one can add. It seems pretty clear that the implementation testing phase just did not deliver the warning that more work was needed before going live.
It also seems clear that the engagement with clinicians in terms of education might have been a little weak - to say the least.
David.

Tuesday, June 14, 2016

This News Has Two Aspects To It And Needs A Quality Response From The New ADHA.

This appeared a few days ago.

Announcement of NEHTA’s Transition to the Australian Digital Health Agency

Created on Monday, 06 June 2016
On 1 July 2016 NEHTA’s assets and liabilities will by law become the assets and liabilities of the Australian Digital Health Agency (Agency), a new Commonwealth corporate entity.
The Agency is created by the Public Governance, Performance and Accountability (Establishing the Australian Digital Health Agency) Rule 2016 (PGPA Rule). The transition will occur by operation of Section 74 of the PGPA Rule. In accordance with Section 73 of the PGPA Rule, the Commonwealth Minister for Health has specified the “transfer day” for the transition to be 1 July 2016. On 1 July 2016 all the assets and liabilities of NEHTA will statutorily vest in the Agency.
A link to this PGPA Rule can be found at https://www.legislation.gov.au/Details/F2016L00070
A link to the Ministers notification of the “transfer day” can be found at http://www.health.gov.au/internet/ministers/publishing.nsf/Content/5973595577926D9DCA257FA800231933/$File/SL034.pdf
Here is the link:
So it seems we are in the last few days of an organisation I have to say I will certainly not miss!
On the positive side there is now an opportunity for the new Australian Digital Heath Agency to do better.
For this to happen the following is needed in my view.
First we need an honest, in depth review (as opposed to the joke NEHTA published a few weeks ago - see here http://aushealthit.blogspot.com.au/2016/05/nehta-delivers-itself-its-own-scorecard.html ) to establish what is useful out of what has been done by NEHTA, what should be retained, what needs to be redone and improved. Additionally we need to ensure all the relevant stakeholders are properly represented by competent and experienced representatives to ensure the maximum value is preserved while the strategic errors are corrected where needed.
Second - after this is done a full report and new strategy for the ADHA should be published - after proper consultation - which defines exactly what the ADHA should be involved in and do and what they should not do - as well as how the ADHA interacts with the private sector, the clinical sector, HI experts, the consumers and the jurisdictions and federal government. There should, of course, be an evidence based review of the myHR program - not that I expect that to happen.
Third we need a total cultural transformation in those staff who come over from NEHTA so they understand just who it is they work for and to whom they are accountable and what they should be doing to advance quality use of technology within the health sector. (That the ADHA is subject to FOI might help - but I would much prefer prompt publication of working papers and minutes so FOI is hardly ever needed). I would also like the see the CEO producing a public monthly summary of just what is happening within ADHA so we can all understand the progress on each agreed work streams and so on.
Fourth I think we need a permanent CEO to be appointed ASAP.
Last I would like to see all meetings of reference and advisory committee committees (as well as the Board meetings) be made available via recorded web-casts so we can all understand just what is driving the decision making if we are concerned.
The response to these suggestions will drive how I judge the ADHA in making the cultural shift from NEHTA.
David

Monday, June 13, 2016

Weekly Australian Health IT Links – 13th June, 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

A very quiet week with the Election dominating the news. Only a few more weeks and normal service will be resumed I hope.
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Poll results: pharmacy supports MedsASSIST

The AJP’s poll on codeine monitoring tool MedsASSIST have shown that Australian pharmacy strongly supports the program.

Last week we asked, “Is your pharmacy using MedsASSIST?” after posters in our forum section suggested some owners were unenthusiastic about the clinical decision support tool because of the possibility of lost sales.
Sixty-five per cent of our respondents – 140 readers – ticked, “Yes, it’s a great initiative” in the poll.
A further 8% said that while they had some reservations about MedsASSIST, it had been rolled out in their pharmacies; and another 5% said their pharmacy is planning to implement it.
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Overdoses lead to warnings about opioid painkillers such as Oxycontin, Fentanyl

Date June 4, 2016

Stephanie Wood

Senior Writer

Prescription painkillers: treatment and addiction

When the cure becomes the problem, the rise of prescription opioids.
It gives him a reason to get out of bed and shave. It makes a change from a doctor's surgery. Even though he might not feel like going, David Johns turns up once a month at a bright Surfers Paradise cafe for a chronic pain support group meeting.
No one's required to be at the top of their game for this occasion and Johns is a mess despite his painkillers: Endone, a short-acting version of the synthetic opioid oxycodone hydrochloride, and Targin, a long-acting form. "It's just another day," he says. He's mostly a mess, these days.
For Jenny, a slim and elegant 63-year-old member of the group who prefers not to give her last name, it's a good day; last night she took a sleeping pill, which gave her respite from the nightly ravages of her crumbling spine. Four Endones helped Gaynor Kemmett, a 56-year-old former graphic designer with pearly skin and black waist-length hair, get out her Chevron Island front door. Opioids such as Endone and Targin are on the national Poisons Standard list of Schedule 8 drugs, drugs of addiction. They belong to a group of medications, along with morphine, that are either derived from opium or are opium-like compounds that act on the brain's central nervous system to reduce pain.
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Vodafone to link exoskeletons

  • The Australian
  • 12:00AM June 11, 2016

Chris Griffith

Exoskeletons can make a huge difference to people suffering severe illness and disability.
And by connecting them to the internet, they can transmit data about a wearer’s activities, download self diagnostic software, and where needed, access patient data.
So it’s no surprise that an international communications company such as Vodafone is seeking a major role in providing mobile communications for such a device.
As a result, Vodafone in the US says it will connect up the world’s first and only exoskeleton approved by the US Government’s Food and Drug Administration (FDA).
Because the agreement is global, it means Vodafone Australia can offer communications should the Ekso GT sell here.
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Doctor versus robot

6 June, 2016 
A British startup claims it has created a smartphone app that’s as good if not better than a doctor at recognising common health problems.
The firm, Babylon Health, says it will put its “artificial intelligence” doctor app up against the real thing this week in a head-to-head contest.
The app’s developers told the Daily Mail on the weekend they were “100% confident” they would come out on top.
Known as Check, the app acts like a triage nurse, asking a series of questions to advise users whether their problem is nothing to worry about, something they should see their GP about, or a triple-0 emergency.
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  • Updated Jun 8 2016 at 12:15 AM

Oneview Healthcare closes in on aged care contract

Hospital software provider Oneview Healthcare is close to signing its first contract with an Australian aged care provider.
The Irish company, which joined the ASX in March after raising $62 million, has developed a technology platform for hospitals that does away with paper charts for activities like monitoring medications, ordering meals and patient education. 
The bedside service is available on screens that are leased to the facilities, although in future it will likely be delivered to patients' smartphones.
The company is focused on getting into hospitals in Australia, the United States and the Middle East, although aged care is also seen as a lucrative opportunity to diversify.
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ACT Health starts the chase for new CIO

CIO will oversee the development of a ten year ICT strategy
Jennifer O'Brien (CIO) 08 June, 2016 09:16
ACT Health is officially on the hunt for a CIO, six months after the departure of Judy Redmond, who was in the post for five years and was pivotal in the implementation of an e-health strategy.
The ACT government’s health directorate is offering up to $228,000 to fill the role, which is currently held by acting CIO Warren Prentice, who was formerly a program manager for the Australian Department of Defence.
Prentice has been directly contracted as a public service, senior executive to plan the transition of the organisation to a more mature ICT operating model, according to a LinkedIn post.
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Tech moguls declare era of artificial intelligence

Date June 3, 2016

Liana B. Baker

Artificial intelligence and machine learning will create computers so sophisticated and godlike that humans will need to implant "neural laces" in their brains to keep up, Tesla Motors and SpaceX CEO Elon Musk told a crowd of tech leaders this week.
While Musk's description of an injectable human-computer link may sound like science fiction, top tech executives repeatedly said that artificial intelligence (AI) was on the verge of changing everyday life during a discussion at a tech industry conference in California this week.
It is no secret that tech companies are diving into AI analytics research, an industry that is forecast to grow to $US70 billion ($96.9 billion) by 2020 from just $US8.2 billion in 2013, according to a Bank of America report.
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The first eHealth platform in the world to combine IHE and openEHR

Article posted on: June 7, 2016
Story highlights: 
  • Open and agile architecture with a health data platform as its cornerstone is required to build a Postmodern EHR.
  • Marand’s Think!EHR PlatformTM is the first health data platform to offer interoperability based both on IHE and openEHR.
  • World-class clinics and eHealth systems have opted for Think!EHR PlatformTM: Moscow’s eHealth system, NHS England, Sirio-Libanes, Sao Paolo and others.
AMSTERDAM, THE NETHERLANDS - (HealthTech Wire / News) — Tomaž Gornik, CEO of Marand says that postmodern EHR is the next stage in the development of EHRs. A vendor-neutral health data layer is required to connect all the apps and applications into one coherent system. Postmodern EHR is a modular clinical information system wherein data is decoupled from applications, and where all applications are required to use (capture, store, retrieve, analyse) health data in a standardised, vendor-neutral format. Most healthcare organisations are beginning to realise that their data is more valuable than their applications. In the Postmodern EHR approach, introducing, renewing and replacing apps, devices, and cloud services is far easier and faster compared to legacy monolithic EHRs due to a multivendor environment built on an open and agile architecture.
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Computer Vision Syndrome could be damaging your eyes

Date June 7, 2016

Jane E. Brody

Joanne Reitano is a professor of history at LaGuardia Community College in Queens, New York. She writes wonderful books about the history of the city and state, and has recently been spending many hours – sometimes all day – at her computer. But while sitting in front of the screen, she told me, "I developed burning in my eyes that made it very difficult to work."
After resting her eyes for a while, the discomfort abates, but it quickly returns when she goes back to the computer. "If I was playing computer games, I'd turn off the computer, but I need it to work," the frustrated professor said.
Reitano has a condition called computer vision syndrome. She is hardly alone. It can affect anyone who spends three or more hours a day in front of computer monitors, and the population at risk is potentially huge.
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E-communication key to cutting Medicare costs, says new AMA vice-president

Kathryn Ryan | 7 June, 2016 | 
The rebate freeze aims to cut Medicare costs, but if the government is really looking to make savings then it needs to invest in e-communications, according to the new GP vice-president of the AMA.
Digital communication between GPs, hospitals and other health services needs to be front and centre of future conversations with government on health funding, says Victorian GP Dr Tony Bartone (pictured).  
The new AMA vice-president will push for more investment in e-communications as a way to save money in the long run, and he wants to see major improvements in computerised hospital discharge systems and real-time prescriptions monitoring.
All political parties have to stop looking at general practice as a soft target for savings, says Dr Bartone, citing the current Medicare rebate freeze as a case in point, and start concentrating on making the health system more efficient.
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Avoiding ransomware is not that hard

Ransomware is the big, scary infosec threat of 2016, but stopping it in its tracks is easier than you think.
By Chris Duckett and Stilgherrian | June 6, 2016 -- 05:54 GMT (15:54 AEST) | Topic: Security TV - Video Series
Ransomware has been labelled as the biggest threat in information security today, and while there are more variants and a lot more attempts to get it onto systems than ever, some basic hygiene goes a long way towards preventing it from messing up your computer.
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Announcement of NEHTA’s Transition to the Australian Digital Health Agency

Created on Monday, 06 June 2016
On 1 July 2016 NEHTA’s assets and liabilities will by law become the assets and liabilities of the Australian Digital Health Agency (Agency), a new Commonwealth corporate entity.
The Agency is created by the Public Governance, Performance and Accountability (Establishing the Australian Digital Health Agency) Rule 2016 (PGPA Rule). The transition will occur by operation of Section 74 of the PGPA Rule. In accordance with Section 73 of the PGPA Rule, the Commonwealth Minister for Health has specified the “transfer day” for the transition to be 1 July 2016. On 1 July 2016 all the assets and liabilities of NEHTA will statutorily vest in the Agency.
A link to this PGPA Rule can be found at https://www.legislation.gov.au/Details/F2016L00070
A link to the Ministers notification of the “transfer day” can be found at http://www.health.gov.au/internet/ministers/publishing.nsf/Content/5973595577926D9DCA257FA800231933/$File/SL034.pdf
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3 June, 2016

Top eight medical technologies that will change the world

Posted by Felicity Nelson
Human history can be reduced to moments of discovery – and leaps in medical technology are among the most significant
Medicine is undergoing similar revolutions today but the full impact of many of these advances remains to be seen. This is our selection of the most transformational technologies shaping medicine today.
1. Sharpening the genetic scissors
In the past, gene therapy has used relatively crude mechanisms, with new strands of DNA being injected into human cells using harmless viruses as vectors. This strategy has worked for some diseases that are caused by a missing gene, but not for those requiring a genetic sequence to be snipped out or replaced. The discovery in 2007 of CRISPR, a nifty pair of genetic scissors, has opened up a new era of genetic engineering by giving scientists the ability to edit human DNA. Potentially, this powerful new technology could allow abnormal genes, such as those for cystic fibrosis, to be deleted.
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  • Updated Jun 6 2016 at 8:04 PM

Amazon Web Services storm outages serve as a warning of cloud risk to businesses

Australian businesses have been warned they need to spread the risk in their cloud computing operations across different regions after the Sydney storms on Sunday knocked out the operations of numerous Amazon Web Services customers.
The ferocious storms that hit NSW, left AWS clients including Domino's Pizza, Foxtel, The Iconic, Stan and Domain without websites or key systems for hours.
It served as a warning that sending systems to the cloud, rather than hosting them on-premise did not remove the risk of costly failures.
The failure represents a major embarrassment for the company, which generated $US2.57 billion revenue in the latest quarter, based largely on the fact that it is perceived as being hugely reliable.
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Government-Telstra cancer register deal needs screening

  • Antony Harrowell
  • The Australian
  • 12:00AM June 7, 2016
Stumbling down rabbit holes can lead to unexpected places; just ask Alice, she found herself in a Wonderland of strange characters and odd situations.
Her fall may be fictional, but it reflects the same rabbit hole in which Australians may find themselves if the latest deal between the federal government and Telstra is allowed to see the light of day without intense scrutiny. Like Alice, this is a dark comedy that may have severe consequences.
Telstra was recently awarded a $220 million contract by the government to establish a Cancer Register, which is unclear in its objective. That is, to provide “a robust IT solution-based support system for the expanded National Bowel Cancer Screening Program and the renewed National Cervical Screening Program” or a full “National Cancer Screening Register”.
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Telstra Health to help improve patient care in China

Nurdianah Md Nur | June 7, 2016
Hospitals in China are now able to use Telstra's analytics tools to improve patient care.
The move is the result of a five-year agreement between Telstra Health — the e-Health division of Australian telco Telstra — and the Shanghai Institute of Medical Quality, a non-profit organisation that aims to improve hospital management efficiency and patient satisfaction through data analysis and business intelligence.
As part of the collaboration, clinicians and hospitals managers will be able to access Telstra Health's Quality Investigator programme to easily measure and analyse mortality, re-admission rates, and length of stay. This will help healthcare organisations improve clinical quality and patient safety.
In addition, Shanghai General Hospital has joined Telstra Health's Global Comparators network, which brings together senior clinicians and managers from leading hospitals worldwide to share knowledge and best practice to improve patient care. The hospital is the first Asian participant in the network, which carries out research collaborations to tackle problems encountered by healthcare systems worldwide, according to Telstra.
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Privacy concerns over cancer register

Australia June 9 2016
Telstra Health has won the tender to manage the National Bowel Cancer and Cervical Screening data register. The company will be responsible for collating and amalgamating the data currently stored on separate State databases into one national register and overseeing the register’s operations.
Concerns have arisen over the potential for inadvertent and unauthorised breaches of private information, heightened by recent instances of data released by Telstra.
While the exact nature of the privacy protections outlined in the tender are unknown and it remains unclear whether sufficient avenues will be available to allow consumer actions against Telstra Health as an incentive to strengthen the company’s privacy policies, the Commonwealth privacy legislation will apply to the register and any misuse of data could be an offence under the Criminal Code.
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25Mbps NBN is 'good enough': Barnaby Joyce

The minimum speed provided by the NBN is sufficient for those in rural areas, the deputy prime minister has said.
By Corinne Reichert | June 7, 2016 -- 04:55 GMT (14:55 AEST) | Topic: NBN
Internet speeds of just 25Mbps are "good enough" for those living in regional and remote parts of Australia, according to Deputy Prime Minister Barnaby Joyce.
Joyce, speaking on the ABC's Q&A program on Monday night, admitted that those living in remote areas won't get the highest-quality internet service on the federal government's National Broadband Network (NBN), but said the speeds provided are sufficient for their needs.
"It's a bit of a slip to say that well 25Mbps is fine for us," questioner Elizabeth Wakeford argued back.
"Just because you are remote, Barnaby, you still need more than 25Mbps," added National Farmers' Federation vice president Fiona Simson.
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Western Sydney Local Health District creates permanent CTO role

Until now the chief technology officer position has been temporary
Rohan Pearce (Computerworld) 09 June, 2016 14:24
Western Sydney Local Health District (WSLHD) has begun accepting applications for the role of chief technology officer.
“This role has been temporary to date and has been filled in an acting capacity,” a spokesperson told Computerworld Australia.
“Over the past year, the Western Sydney Local Health District has undertaken a major transformation of its IT services and is now seeking a permanent chief technology officer,” the spokesperson said.
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Five hidden Windows 10 tricks you should use

Date June 6, 2016 - 1:50PM

David Nield

Windows 10 has officially been with us for close to a year now, but even if you've spent a lot of time with the OS since its launch, you may not have found everything it has to offer. Here are five of our favourite hidden features that we've discovered over the course of the last year, and why you might want to start using of them.

1. The hidden battery report

If you're using Windows 10 on a tablet or laptop, then you're going to want to keep an eye on battery levels — something you can do with a quick glance down at the notification area. There's a more detailed and thorough battery report available too, giving you useful information on its overall health and how much use you're getting between charges.
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Enjoy!
David.