Quote Of The Year

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

or

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

Thursday, February 09, 2017

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

February 9  Edition.
Well I think it will be agreed the last week or so with President Trump has been both amazing and deeply worrying!

Thursday Update: The only thing I can usefully add at this point is that things do seem to have calmed down in the last day or so - as more of the Trump Cabinet is confirmed. Maybe there are now a few more adults in the room to stabilise things a bit. We can only hope so!
This says it all.

Donald Trump promised disruption, and that's exactly what he's delivering

Chris Cillizza
Published: January 30, 2017 - 12:09PM
Donald Trump is who we thought he was.
The 45th President campaigned as a radical break from both politics and policy as usual in Washington, promising to restore strength to the White House and the country while ignoring all tradition and political correctness.
He spent the first week of his presidency doing just that - beginning with an executive order triggering the United States' withdrawal from the Trans-Pacific Partnership, continuing through a midweek executive order to begin the process of building a wall along the US' southern border and culminating on Friday with Trump's executive order temporarily halting refugees from entering the country and instituting a full entrance ban on visitors from seven predominantly Muslim countries.
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Enough said – this won’t end well I still fear.
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On more local news we see it has started again! And it sure has been feisty.
2:19pm February 3, 2017

Parliament returns after summer of scandal

By AAP
The Turnbull government faces scrutiny over Centrelink, pensions, politicians' expenses, trade and Donald Trump when parliament resumes next week.
There's been little time off from politics over the summer break, with Malcolm Turnbull losing his health minister Sussan Ley to an expenses scandal, Labor querying Centrelink's debt-chasing approach and the Trump election throwing US-Australia relations into chaos.
The Senate has not been without its dramas, with Senate President Stephen Parry to kick off Tuesday's sitting with a statement on Rod Culleton.
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Here are a few other things I have noticed.
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Trump Material.

Clever or craven: Malcolm Turnbull's soft-shoe shuffle around Donald Trump

Mark Kenny
Published: January 29, 2017 - 4:11PM
Australians are probably wondering what it will take? What breach of national values or irresponsible strategic posturing by Washington will be damaging enough to get a rise out of Canberra?
It's a serious question. Axing a long-held joint commitment to free trade after leading a 12-nation process in good faith? Demanding a Chinese retreat, from territory to which the United States makes no claim, on pain of military action? Abandoning a non-discriminatory immigration policy, and thus being seen to inflame religious tensions with direct implications for Australia and the rights of its citizens? 
As the Turnbull government feels its way forward with the unpredictable, amateurish presidency of Donald Trump, the answer seems to be none of the above.
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A Clarifying Moment in American History

There should be nothing surprising about what Donald Trump has done in his first week—but he has underestimated the resilience of Americans and their institutions.
I am not surprised by President Donald Trump’s antics this week. Not by the big splashy pronouncements such as announcing a wall that he would force Mexico to pay for, even as the Mexican foreign minister held talks with American officials in Washington. Not by the quiet, but no less dangerous bureaucratic orders, such as kicking the chairman of the Joint Chiefs of Staff out of meetings of the Principals’ Committee, the senior foreign-policy decision-making group below the president, while inserting his chief ideologist, Steve Bannon, into them. Many conservative foreign-policy and national-security experts saw the dangers last spring and summer, which is why we signed letters denouncing not Trump’s policies but his temperament; not his program but his character.
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Trump’s Refugee Bonfire

A blunderbuss order sows confusion and a defeat in court.

Jan. 29, 2017 7:10 p.m. ET
President Trump seems determined to conduct a shock and awe campaign to fulfill his campaign promises as quickly as possible, while dealing with the consequences later. This may work for a pipeline approval, but the bonfire over his executive order on refugees shows that government by deliberate disruption can blow up in damaging ways.
Mr. Trump campaigned on a promise of “extreme vetting” for refugees from countries with a history of terrorism, and his focus on protecting Americans has popular support. But his refugee ban is so blunderbuss and broad, and so poorly explained and prepared for, that it has produced confusion and fear at airports, an immediate legal defeat, and political fury at home and abroad. Governing is more complicated than a campaign rally.
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Trump's Travel Ban Is Un-American and Unwise

Jan 29, 2017 3:54 PM EDT
Leave aside the moral, legal, economic, political and practical objections -- and it's quite a list -- and instead consider just the security implications of the executive order President Donald Trump issued late Friday: Will temporarily banning the entry of all refugees and nationals from seven countries make the U.S. safer?
Regrettably and emphatically, the answer is no. First, if the goal is "Protecting the Nation From Foreign Terrorist Entry Into the United States," as the order is titled, then it would make sense to focus on countries from which terrorist attackers have entered. Of the seven countries on the administration’s list (Iraq, Iran, Libya, Somalia, Sudan, Syria and Yemen), only one (Somalia) comes close to fitting that bill. Meanwhile, several countries that do (Egypt, Pakistan, Saudi Arabia) don’t make the list.
Nor does the order convey any acknowledgment that refugees are the most vetted group of travelers to the U.S. That is even more true after they apply for their green cards and undergo another round of biometric screening.
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Donald Trump's folly is a once-in-a-century opportunity for Australia

Peter Hartcher
Published: January 31, 2017 - 12:00AM
Donald Trump has created a mess with his  immigration hit list. A great outcry of Australian voices is demanding that Malcolm Turnbull denounce the US President's move.
There is a better response. Expressing vicarious outrage through the medium of the Prime Minister might be emotionally satisfying but it's fated to be futile. 
The leaders of Germany, Britain and France, some of the most powerful Republicans in the US and the greatest US technology corporations have all criticised Trump for the decision. Some countries are considering a retaliatory ban on Americans – foremost among them is Iraq, a key ally in the struggle against Daesh, the so-called Islamic State. What would a Turnbull statement accomplish that all this has not?
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The danger of Steve Bannon on the National Security Council

David J. Rothkopf
Published: January 31, 2017 - 1:51AM
While demonstrators poured into airports to protest the Trump administration's draconian immigration policies, another presidential memorandum signed this weekend may have even more lasting, wide-ranging and dangerous consequences. The document sounds like a simple bureaucratic shuffle, outlining the shape the National Security Council will take under President Donald Trump. Instead, it is deeply worrisome.
The idea of the National Security Council (NSC), established in 1947, is to ensure that the president has the best possible advice from his Cabinet, the military and the intelligence community before making consequential decisions, and to ensure that, once those decisions are made, a centralised mechanism exists to guarantee their effective implementation. The NSC is effectively the central nervous system of the US foreign policy and national security apparatus.
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The Republicans' deal with the devil

David Brooks
Published: February 1, 2017 - 5:38AM
Many Republican members of Congress have made a Faustian bargain with Donald Trump. They don't particularly admire him as a man, they don't trust him as an administrator, they don't agree with him on major issues, but they respect the grip he has on their voters, they hope he'll sign their legislation and they certainly don't want to be seen siding with the inflamed progressives or the hyperventilating media.
Their position was at least comprehensible: How many times in a lifetime does your party control all levers of power? When that happens you're willing to tolerate a little Trumpian circus behaviour in order to get things done.
But if the last 10 days have made anything clear, it's this: The Republican Fausts are in an untenable position. The deal they've struck with the devil comes at too high a price. It really will cost them their soul.
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With Donald Trump in power, Australia urgently needs to re-evaluate its US bases

Margaret Beavis
Published: February 1, 2017 - 12:59PM
Recent changes to the US National Security Council should be ringing loud alarm bells in Canberra.
By demoting the highest-ranking military officer and the highest-ranking intelligence officer, and appointing political adviser Stephen Bannon as a permanent member of the NSC, Donald Trump has seriously escalated the risk of the US launching into ill-advised conflicts. Bannon comes from a role as chairman of the racist, Islamophobic website Breitbart.com, and is reported as having been in charge of writing the recent executive order that has banned US entry for refugees and citizens from seven Muslim-majority nations.
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Petraeus Warns That Divisive Actions on Muslims Strengthen Extremists

The former general appeared to undercut President Trump's early national security moves.

President Donald Trump has faced criticism from across the political spectrum after signing an executive order last Friday restricting travel from seven majority-Muslim countries. On Wednesday, one of Trump's favorite military minds appeared to add his voice to the public condemnation.
General David Petraeus, a finalist for secretary of state in the Trump administration despite his disgraced exit from the CIA, told the House Armed Services Committee that broad-brush statements from Trump and others in his administration about Islam and Muslims complicate the fight against groups like ISIS.
"We must also remember that Islamic extremists want to portray this fight as a clash of civilizations, with America at war against Islam," Petraeus said at a hearing on national security threats and challenges. "We must not let them do that. Indeed, we must be very sensitive to actions that might give them ammunition in such an effort."
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No ‘G’day, mate’: On call with Australian prime minister, Trump badgers and brags

 Greg Miller  Philip Rucker February 1 at 7:13 PM 
It should have been one of the most congenial calls for the new commander in chief — a conversation with the leader of Australia, one of America’s staunchest allies, at the end of a triumphant week.
Instead, President Trump blasted Australian Prime Minister Malcolm Turnbull over a refu­gee agreement and boasted about the magnitude of his electoral college win, according to senior U.S. officials briefed on the Saturday exchange. Then, 25 minutes into what was expected to be an hour-long call, Trump abruptly ended it.
At one point Trump informed Turnbull that he had spoken with four other world leaders that day — including Russian President Vladi­mir Putin — and that, “This was the worst call by far.”
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Wake up Australia: the US alliance has never been our security 'guarantee'

Peter Hartcher
Published: February 3, 2017 - 12:15AM
This is a case of alliance shock for Australia. Donald Trump's rough treatment of Malcolm Turnbull is about more than their personalities, more than the refugee deal, and more than relations between two leaders.
It's about the reliability of the US alliance. "It's not unprecedented for the leaders of the US and Australia to have a tough, difficult, robust conversation," says Sydney University's alliance historian, James Curran.
"But it is unprecedented for this sort of private conversation to be leaked." And it was a leak, according to Turnbull, that leaves him feeling "very disappointed".
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Trump’s wake-up call to our starry-eyed leaders

  • Bob Carr
  • The Australian
  • 12:00AM February 3, 2017
We know where we stand. Donald Trump’s angry dismissal of Malcolm Turnbull is a damned healthy thing for gallant, gullible little Australia. It clears the air.
So much, for example, for the silly view that the Trump administration is an opportunity for Australia to “get closer” to the US, as if the election of a loudmouth nationalist to the White House was an invitation for us to become an even more rusted-on ally, signing up to send our forces into whatever conflict the new President chooses to dream up.
So much, too, for the romantic view of the ANZUS treaty that has elevated the “alliance” as the only expression of Australia’s international personality.
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National Budget Issues.

Scott Morrison to lift credit limit as Australia's debt hurtles towards $500 billion

Adam Gartrell
Published: January 29, 2017 - 12:15AM
The federal government will be forced to lift its own self-imposed credit limit in the coming months as debt hurtles towards half-a-trillion dollars - almost double the number the Coalition inherited from Labor.
Gross commonwealth government debt has reached more than $474 billion after a sharp jump in recent weeks, leaving it just $26b short of the $500b debt ceiling set by former treasurer Joe Hockey three years ago.
Total government debt is now rising by $5.3 million an hour - or $126m a day - according to calculations performed by David Lawson, a commentator who runs the Australian Debt Clock website.
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Treasury says tax expenditures cost $150 billion

Peter Martin
Published: January 31, 2017 - 5:38AM
The family home has eclipsed superannuation as Australia's biggest tax break, with new figures showing the capital gains tax exemption on family homes cost the budget a record $61.5 billion in 2016-17, well in excess of the $33 billion lost to superannuation tax concessions.
The $61 billion is made up of $27.5 billion the government believes it would have got if it taxed profits made on the sale of family homes at the present capital gains tax rate, plus an extra $34 billion it would have got if the capital gains tax rate were the same as the marginal tax rate instead of being discounted by 50 per cent.
Treasury's annual Tax Expenditures Statement, required as part of the charter of budget honesty and released quietly on Monday afternoon, identifies 25 tax breaks each costing more than $1 billion, which between them cost close to $150 billion.
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Scope 2017 economic survey: Forecasting panel predicts steady rates in a slightly better year ahead

Peter Martin
Published: February 4, 2017 - 8:23AM
The Reserve Bank faces no pressure to adjust interest rates at its first meeting for the year on Tuesday and very little pressure to adjust them at any time during the year as the 2017 BusinessDay Scope forecasting survey predicts a rarity – an entire year of unchanged rates, something that hasn't happened since the survey successfully forecast a year of steady rates in 2014 and before that 2004.
Approaching its 40th year, the exclusive BusinessDay survey is made up of forecasts from 27 leading economists in the diverse fields of financial markets, academia, consultancy and industry. Over time its average predictions have proved to be more accurate than those of any of its individual members.
All of the forecasts are displayed in a table in the print version of BusinessDay and in a click-through interactive graphic on line.
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Mining's economic contribution not as big as you might think

Ross Gittins
Published: February 4, 2017 - 12:15AM
With Malcolm Turnbull desperate to keep burning coal for electricity, just how important is the mining industry to our economy? Short answer: not nearly as much as it wants us to believe, and has conned our politicians into believing.
Because people like me have spent so much time over the past decade and more banging on about the resources boom, we've probably left many people with an exaggerated impression of the sector's importance.
It's true that, thanks to a quadrupling in the value of its physical capital, mining now accounts for about 7 per cent of our total production of goods and services (gross domestic product), compared with less than 5 per cent in 2004, at the start of the boom.
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Turnbull government looks to trim funding growth for 'over-funded' schools

Matthew Knott
Published: February 5, 2017 - 6:48AM
The Turnbull government is examining how to curtail the funding growth of "over-funded" private schools in a new deal to take effect next year, a move that would free up funds to distribute to needy public and non-goverment schools. 
The move comes as new Education Department data shows the glacial speed at which schools are currently moving towards their appropriate funding level – a process Education Minister Simon Birmingham wants to speed up.  
Fairfax Media understands Senator Birmingham's school funding proposals have been discussed in detail during cabinet meetings over recent months, but a final position to present to state governments and the Parliament has not been approved.
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Audit office rips into Tony Abbott’s signature indigenous strategy

  • The Australian
  • 12:00AM February 4, 2017

Stephen Fitzpatrick

The national audit office has found the federal government’s signature $4.8 billion indigenous affairs funding regime, announced in 2014, was poorly planned, badly implemented, lacked adequate performance assessment and had a “below standard” grants administration process.
The scathing review of Tony Abbott’s Indigenous Advancement Strategy follows similarly negative findings last year by a Senate committee and the Prod­uctivity Commission.
A Centre for Independent Studies survey of the strategy found that only 8 per cent of 1082 indigenous programs nationwide, worth $5.9bn annually and funded from all sources, had been properly evaluated.
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Health Budget Issues.

Health and healthcare: what Greg Hunt must do

23 January 2017
A strong minister will look beyond doctors and hospitals to improve Australians’ health
Malcolm Turnbull’s appointment of Greg Hunt to the vacancy created by the resignation of Sussan Ley has prompted more than the usual opinions and suggestions about the health minister’s role and priorities. The portfolio is always a key one for voters, but concerns among consumers and health organisations are more potent than usual for several reasons: a growing awareness that significant changes are needed to the delivery, integration and funding of health and healthcare services; frustration at the failure of the Abbott and Turnbull governments to propose and implement coherent policies; and suspicions that the government’s stealth agenda is to undermine the universality of Medicare through further privatisation and higher out-of-pocket costs.
Minister Hunt comes to the task with a mixed record in his previous portfolios and has already sent mixed messages about his new portfolio. He has a substantial task ahead, and little time to get up to speed on the issues. Ley left many issues in the too-hard basket, work on the 2017–18 budget is already under way, decisions must be made about increases in private health insurance premiums for 2017, and public trust in the ability and willingness of the Turnbull government to protect Medicare is eroding.
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If GPs pass on cost from rebate freeze, poorer, sicker patients will be hardest hit

January 31, 2017 6.07am AEDT

Authors

Rosemary Elkins
Research Assistant - School of Economics, University of Sydney
Stefanie Schurer
Associate Professor, University of Sydney
Not even a fortnight in the job and the newly appointed health minister, Greg Hunt, is already facing pressure from medical organisations to scrap the controversial freeze on Medicare rebate indexation.
Most Australians will remember the series of ill-fated co-payment policies proposed by the Abbott government. The “$7 co-payment” and its short-lived successors were abandoned in the face of sustained public backlash. Though Abbott eventually declared the policy “dead, buried and cremated”, the Medicare rebate freeze has been labelled a GP co-payment “by stealth”.
The freeze, first implemented by Labor and twice extended by the Coalition, means bulk-billing doctors will receive the same reimbursement for a consultation in 2020 as they did in 2014, despite the increasing year-on-year cost of delivering services.
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Sick Aussies delaying visits to GP due to cost

index&t_product=NTNews&td_device=desktopLANAI SCARR, Senior writer, News Corp Australia Network
January 31, 2017 10:00pm
index&t_product=NTNews&td_device=desktopEXCLUSIVE
AUSTRALIANS are increasingly delaying visits to the doctor and putting off filling prescriptions as out of pocket costs for a trip to the local GP skyrocket.
The cost of visiting a general practitioner is now at its highest ever, increasing 7.1 per cent from 2014-15 to 2015-16.
Sick Australians are paying on average $58.49 in out of pocket expenses to visit the doctor, compared to $54.60 in 2014-15 and $44.98 in 2011-12.
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Indigenous health program loses funding

January 31, 20178:03pm
Paul Osborne, AAP Senior Political Writer Australian Associated Press
An indigenous health program which has been running in Queensland for 21 years is set to close this year when federal funding stops.
The federal health department gave the Queensland AIDS Council a 12-month funding extension to keep the 2 Spirits sexual health program operating.
During that time, the department expected the council to "explore more sustainable funding alternatives".
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Here is a failsafe proposal to slash health costs: start spending now

  • Tony Cunningham
  • The Australian
  • 12:00AM February 2, 2017
New federal Health Minister Greg Hunt has set an admirable goal for Australia: he wants our ­nation to have the best health system in the world. This is achievable and we should all support it. But with healthcare costs growing year on year, we will need some different thinking if we are to get there.
It may sound counter-intuitive but one way we can reduce the long-term health inflation pressures is to invest more in health and medical research. Deloitte ­Access Economics has calculated that investing in health and medical research delivers at least a $3 return for every dollar invested. This return comes from improved diagnostics, new drugs and other treatments, vaccines and the evidence needed to give effective ­advice on how to prevent medical conditions from occurring in the first place.
Preventive medicine is an area in which Australia has had tremendous success. Skin cancer rates are improving dramatically thanks to people following evidence-based advice, and vaccines developed here — such as Gardasil, which prevents cervical cancer — are saving lives and money.
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Health Minister Greg Hunt has unveiled $125 million of funding into medical research projects

LANAI SCARR, EXCLUSIVE, News Corp Australia Network
February 3, 2017 10:00pm
RESEARCH into cancer, dementia and even sports concussions will be the big winners from a $125 million cash splash unveiled by the federal government
News Corp Australia can exclusively reveal Health Minister Greg Hunt will award federal funding to 110 medical research projects as his first act in the new portfolio.
Among the grants include $38.9 million for cancer, $30.5 million for dementia, $12.6 million for indigenous health, $9.7 million for mental health, $3.1 million for cardiovascular diseases, $1.47 million for injury, $958,000 for obesity, $392,000 for diabetes and $177,000 for arthritis-related illnesses.
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Greg Hunt’s priority: clear direction to save health

  • The Australian
  • 12:00AM February 4, 2017

Sean Parnell

The Turnbull government will move to reclaim the health policy debate after new minister Greg Hunt identified the need for a long-term strategy to strengthen Medicare, support hospitals, facil­itate world-class medical research and encourage people to take ­better care.
After a first term dominated by budget cuts and reviews, the Coalitio­n was savaged at the polls, not only because of Labor’s contentious “Save Medicare’’ campaign but also a lack of overarching policy direction.
An expenses scandal then prompted the resignation of Sussa­n Ley as health minister and gave Malcolm Turnbull the opportunity to reset relations with the sector under Mr Hunt, the adept former minister for industry, innov­ation and science and, before that, environment.
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Drug game-changer for thousands suffering from cystic fibrosis headed for the PBS

LANAI SCARR, News Corp Australia Network
February 4, 2017 10:00pm
AUSTRALIA’S youngest cystic fibrosis sufferers will this week get a massive reprieve when the government lists a life changing medication on the pharmaceutical benefits scheme.
News Corp Australia understands Health Minister Greg Hunt will this week approve the drug Kalydeco on the PBS for 2-5 year-olds.
The medication will be listed from May with the government in negotiations with drug manufacturer Vertex about how to best to ease the burden on families until then.
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Health Insurance Issues.

Assistant health minister Dr David Gillespie on easing the concern of health insurance

1 Feb 2017, 10 a.m.
CHANGES are being considered that could save up to $800 million a year on health insurance, according to Assistant Minister for Health and federal Member for Lyne Dr David Gillespie.
Dr Gillespie agreed that the rising costs of health insurance is a source of concern for many Australians. 
He added the federal government was looking at ways to cut health insurance costs with ‘a review into prosthesis’.
He explained a committee was looking into the price of prosthesis, as there appeared to be a ‘arbitrage’ between the market price and the goverment listed price of the artificial body parts.
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I look forward to comments on all this!
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David.

I Have To Say This Looks Like A Pretty Interesting Session. I Am Sure It Will Be Recorded.

This appeared a few days ago.

The future of digital health in Australia: a social policy discussion

By Australian Digital Health Agency

03.02.2017
As Australia moves towards a digital health system, important social policy discussions are needed about how future developments will affect Australians. Join us and a panel of policy experts to have your say.
Emerging technologies are changing the global economy and Australian society. This is largely being driven by consumers who are demanding personalised wrap around services, most notably in banking, shopping and social networking. In healthcare the demand for consumer-centred services is driving the demand for new digital models of care – which follow patients, their carers and family through the health system.
On Monday 13th February from 2.00pm – 3.30pm (AEDT) the Australian Digital Health Agency is delivering a national webcast which will inform Australia’s next Digital Health Strategy.
The open Q&A webcast is especially relevant to all government agencies with an interest in digital health and an important next step in advancing discussions between the public, stakeholders, industry and those developing and implementing policy.
Digital Health Agency chief executive Tim Kelsey wants to know what you think.
As digital health traverses all jurisdictions, communities and a myriad of stakeholder and professional groups, this up-front online discussion is a pivotal opportunity to find out more and ask questions about developments that will soon touch all Australians.
It follows an extensive community consultation that has received over 1050 online submissions and attracted 2,500 people to meetings, forums, workshops, webcasts and town halls across Australia.
Facilitated by Ellen Fanning, the webcast and discussion will be focused on digital health, including trends, public policy considerations, emerging technologies and overarching themes.
Key public sector leaders and experts at the coalface of delivering digital health will also be actively be participating and answering questions.
All the needed details are found here:
This seems to be a useful discussion to listen in to.
David.

Wednesday, February 08, 2017

This Is An Interesting Look Into The Digital Health Future From The Perspective Of Pharmacy.

This appeared last week:

What’s Trending: Technology in Pharmacy

After another busy year in pharmacy, now is a good opportunity to pause and reflect on some of the macro technology trends that are driving change in the industry

New Internet developments have been transforming the pharmacy experience from the 1990s on, when the Internet first hit our shores. This year will be no exception, with the Internet continuing to deliver new services in the form of cloud computing.
In 2017, pharmacy will see three trends become increasingly visible, relating particularly to medications reconciliation and business agility as well as the move towards the purchase of pharmacy software services rather than expenditure on capital items.

Medications management apps: improving your clinical data

The most significant trend in community pharmacy technology in 2017 will be the provision of apps that improve medications management in clinical practice in Australia, making it faster and easier, with greater accuracy and coordination of data. Medication reconciliation in particular is one of the key services that will be strengthened as a result.
Industry has been calling for this ability for decades, and the ramifications will be huge. Pharmacists will have greater access to patient medication information than ever before, and as a result will be in a stronger position when conducting medication reviews and compliance checks.
There are many scenarios where this will be useful, for example, reducing possible confusion as patients transition between different points of care, or when a GP has de-prescribed one drug, and another practitioner has re-prescribed this without knowing the background. The ability to provide practitioners and patients with a complete list of their current medications, and with records of all medication reconciliations completed, will be a significant step forward.
This change is occurring as a result of two related developments. The first is the continuing investment by the federal government in the My Health Record. This should deepen the pool of patient medication data available to health professionals, which provides an ever more accurate diagnostic picture for professionals.
The second is the launch of complementary apps which bring together a patient’s medication data from multiple sources, such as GPs, hospitals, pharmacy and the My Health Record. Fred’s new medications list will be the first cab off the rank here with the launch of our new web-based app MedView early this year. MedView evolved out of the early MedView trials in the Barwon Region of Victoria in 2012 which tackled the lack of visibility of clinical data between different sectors.
As a result, you will be able to view a single consolidated medication list for patients from within your dispensing software. Because these are web-based apps, you will have the same clinical diagnostic ability in-store and on patient visits, whether these are in the home or in a hospital or aged care setting.
The macro technology trend here is about data. The nature of the cloud means that we can use data to deliver new services and solve age-old problems faced by health professionals, with the obvious caveats regarding patient consent and compliance with privacy requirements. This ability to use the cloud to deliver new data-based services is where the most significant opportunities for innovation in pharmacy and health will occur. Significantly, the results of services can also be added back to the patient’s MyHR.
Thanks to pharmacy’s successful adoption of electronic transfer of prescriptions over the past seven years, the amount of data available is growing exponentially, with community pharmacies and GPs contributing 4,000-6,000 new data records per second around Australia – not a number to be sneezed at.
Numbers will continue to soar as hospitals around Australia begin to transition to electronic transfer of prescriptions. Victoria’s Royal Children’s Hospital was the first to integrate with eRx and they are now sending all discharge prescriptions to eRx to make them available to community pharmacies across their large catchment. More hospitals are following this lead.
Further technology changes are discussed here:
In the context of the ADHA work on Medication Safety I found it interesting to read the perspective from Pharmacy on the myHR and the progress that has been made with consumer apps.
Well worth a browse.
David.

Tuesday, February 07, 2017

This Has To Be Pretty Good News For Patients In Western Australia. Some Lives Should Be Saved.

This appeared last week:

WA moves to cut doctor shopping

Western Australia is introducing real-time monitoring of controlled drugs in a move lauded by the Pharmacy Guild

The Western Australian Branch of the Pharmacy Guild says it strongly supports new measures being rolled out in the state to curb “doctor shopping” and self-harm caused by inappropriate use of controlled drugs.
New regulations for the sale, supply and manufacture of medicines and poisons came into effect this week, which are aimed at not only reducing business compliance costs, but also promoting the safe dispensing of controlled drugs.
West Australian Health Minister John Day says the regulations will give force to the Medicines and Poisons Act 2014, bringing Western Australia into line with other States and Territories, reducing duplication and making it easier for national operators to comply with the rules.
“For example, one of the changes means a pharmacist will no longer need to obtain a licence from the Department of Health in addition to meeting the assessment and regulation criteria of the Pharmacy Registration Board of WA,” Mr Day says.
“The new legislation also establishes the legal framework for the transfer of information about the prescribing and dispensing of controlled drugs such as morphine and dexamphetamine, through the use of real-time reporting systems.
“It has enhanced powers to deal with ‘doctor shoppers’ and the ability to better assist doctors manage patients with addiction issues.
“However, the legislation also includes strict safeguards over the use and sharing of this sensitive data and maintains controls around high-risk medications.”
More here:
There was additional coverage in the professional press.

WA to get real-time reporting system

2 February, 2017  
WA pharmacists can look forward to a new state-funded system that will enable them to spot doctor shoppers.
The $1 million program will be rolled out in stages until late 2018. It will enable real time reporting when prescriptions are filled in pharmacies.
WA Pharmacy Guild National Councillor Lenette Mullen says the system is long overdue.
“It is high time for an effective real time recording system to be in place everywhere across Australia, and in that regard Western Australia has taken a very significant step forward,” she says.
More here:
Just co-incidentally this appeared as I was preparing the blog:

DORA makes a difference in saving Tassie lives

CHRIS PIPPOS, Sunday Tasmanian
AN average of 40 patient red-flag “interventions” are being made in Tasmania every day by doctors, pharmacists and health regulators to stop the potential fatal misuse of prescription drugs.
Tasmania’s chief pharmacist Peter Boyles says the state’s real-time reporting system has stopped the prescribing and dispensing of opioid analgesic drugs, such as morphine, to between 30 and 50 prescription drug users daily.
This has helped slash the fatal overdose rate from an average of 25 to about 17 deaths a year, the Sunday Tasmanian can reveal.
And the number of interventions — of varying degrees of significance — initiated by pharmacists and doctors was growing, Mr Boyles said.
The Drugs and Poisons Information System Online Remote Access (DORA) system, which only operates in Tasmania but is being considered nationally, is successfully tackling the problem of doctor shopping, where users can play two doctors off against each other to obtain medication.
Lots more here:
So not only do we have a system that seems to be saving lives but now people in WA can take advantage once the system is up and rolling. We also need to see all the other States get their act together and get the system up and running - as when I last checked there were a few laggards as well as WA which is now acting.
David.

Monday, February 06, 2017

Weekly Australian Health IT Links – 6th February, 2017.

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

Well Google seems to have taken an interest in the Australian health consumer. Good on them and what they are doing seems pretty reasonable. The Mayo Clinic is a reasonably reliable information source!
Otherwise it seems that the ‘silly season’  is well and truly over and we are now seeing much more news. Enjoy!
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Dr Google makes Australian house calls with launch of new Health Condition Cards

Kate Aubusson
Published: February 1, 2017 - 6:00AM
You're sick. Your head is pounding, the sunlight is too bright, you're nauseated and vomiting and feeling very sorry for yourself.
What do you do? You grab your smartphone and through blurred vision you Google 'migraine'.
When we're sick, when our children develop a strange red rash or when we catch a news story about a lactose intolerant cow, we start Googling. And the search engine savant knows it.
Google has launched its health condition cards in Australia, designed to answer users' health-related questions, queries and curiosities.
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Google health cards ‘long-overdue’: AMA

1 February, 2017 
Doctors groups are giving a cautious thumbs up to Google’s latest foray into the health sphere with the launch of verified medical information for Australians.
The search engine will now feature more than 900 printable health condition cards, vetted by doctors, mostly from the Mayo Clinic in Minnesota.
The move follows a similar initiative launched in the US that has been well received by doctors, according to Google product manager, Isobel Solaqua.
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A doctor reviews Google's new 'health cards'

2 February 2017
Google’s new health cards became active in Australia just a few hours ago, so I figured I’d be among the first to give them a test run.
Health cards are Google’s attempt to give the lay public sensible and evidence-based results on searches for medical conditions.
The cards appear as a stand-alone box to the right of the usual Google search results, and contain a few sentences and a picture.
For example, when I type in ‘cold’, the usual, familiar results appear – first is my local weather (despite today being decidedly warm!) followed by the hits from more than a billion search results.
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Move over white cane — Australian engineers have developed a device that can help the blind and vision impaired navigate the world

February 1, 20178:31pm
IT ALL sounds a bit X-Men. Giving people extra powers and senses to control the world around them.
But researchers at the University of Melbourne think they may have just done that with a new device they say could revolutionise daily life for blind and vision-impaired people.
It’s so effective the new technology could become as every day a sight as the white cane.
Engineers have developed a prototype for an electronic device that can identify the obstacles white canes can’t pick up.
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Health sector database key to benefits of data sharing

  • Robert Wells
  • The Australian
  • 12:00AM February 1, 2017
We are swimming, some would say drowning, in data. It has even been speculated that data will one day become more valuable than money. But while the amount of data being created and stored grows exponentially, the rules surrounding its sharing and use are set by a hodgepodge of regulations and agencies.
While privacy and security concerns must remain paramount, too much information that could be used to improve our wellbeing is not accessible to the researchers or agencies that could make the best use of it.
That’s why the Productivity Commission was asked to undertake an inquiry into the benefits and costs of improving access to public and private sector data. Towards the end of last year it handed down its draft report and invited additional submissions ahead of delivering a final report to the government by March 21.
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Carers identified as priority for Australia’s digital health plan: agency chief

By Natasha Egan on February 3, 2017
Using digital technology to enable and empower informal carers is a priority of the digital health agency and its forthcoming national strategy, says the agency’s CEO Tim Kelsey.
The Australian Digital Health Agency this week completed a three-month national public consultation on the new National Digital Health Strategy, which is due out later this year.
Speaking during a national webcast on Monday, Mr Kelsey said many people were dependent on informal support and it was important to ensure Australia’s 2.7 million carers were supported.
“It is a really important priority for me and for the agency,” Mr Kelsey said.
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eHealth Records

Healthscope Hospitals are part of Australia’s eHealth record system so please register prior to or during your admission so your doctors and health professionals can have access to your health information for your hospital stay and treatment.

What is an eHealth record?

An eHealth record is an online summary of your health information. You control who can see each piece of your information. Going forward it is proposed to contain personal health information such as your current medications, immunisations, allergies, adverse reactions, advanced care directives and emergency contact details.

Why have an eHealth record?

An eHealth record will allow you to take control of your health records and enable your GP and Specialists to have access to information about your health which will assist them to deliver better care and treatment. In an emergency situation this access may be very important to doctors being able to quickly treat the medical problem you present with.
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Report into leak-plagued DHHS looks to cut down breaches of clients' privacy

Beau Donelly
Published: February 3, 2017 - 4:33PM
Victoria's goliath Department of Health and Human Services has no policy for notifying vulnerable clients when it breaches their confidentiality, an investigation by the state's privacy watchdog has found.
The leak-plagued department – which oversees public health, child protection, housing, aged care, disability and family services – also fails to regularly audit the security of client information held by the various organisations it outsources to.
Commissioner for Privacy and Data Protection, David Watts, has identified "a number of information governance risks" in the embattled department's privacy and data security protocols.
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Can machines really tell us if we’re sick?

January 27, 2017 2.47pm AEDT

Author

Anton van den Hengel
Professor of Computer Science, University of Adelaide
This week US scientists announced they have developed an algorithm, or a computerised tool, to identify skin cancers through analysis of photographs.
Rather than relying on human eyes, the new method scans a photo of a patch of skin to look for common and dangerous forms of skin cancer. The authors report their approach performs on par with board-certified dermatologists to distinguish two forms of cancer, keratinocyte carcinoma and malignant melanoma, from benign skin lesions.
The skin cancer diagnostic tool is based on a powerful type of machine learning that extracts information from images. The critical factor in achieving the accuracy and reliability required for a medical diagnostic tool is the large volume of training data the authors have used. This data consists of 129,450 skin images, and a label for each which indicates whether it contains a cancerous region. The machine is trained on this data to make the distinction automatically.
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WA moves to cut doctor shopping

Western Australia is introducing real-time monitoring of controlled drugs in a move lauded by the Pharmacy Guild

The Western Australian Branch of the Pharmacy Guild says it strongly supports new measures being rolled out in the state to curb “doctor shopping” and self-harm caused by inappropriate use of controlled drugs.
New regulations for the sale, supply and manufacture of medicines and poisons came into effect this week, which are aimed at not only reducing business compliance costs, but also promoting the safe dispensing of controlled drugs.
West Australian Health Minister John Day says the regulations will give force to the Medicines and Poisons Act 2014, bringing Western Australia into line with other States and Territories, reducing duplication and making it easier for national operators to comply with the rules.
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WA to get real-time reporting system

2 February, 2017 
WA pharmacists can look forward to a new state-funded system that will enable them to spot doctor shoppers.
The $1 million program will be rolled out in stages until late 2018. It will enable real time reporting when prescriptions are filled in pharmacies.
WA Pharmacy Guild National Councillor Lenette Mullen says the system is long overdue.
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What’s Trending: Technology in Pharmacy

After another busy year in pharmacy, now is a good opportunity to pause and reflect on some of the macro technology trends that are driving change in the industry

New Internet developments have been transforming the pharmacy experience from the 1990s on, when the Internet first hit our shores. This year will be no exception, with the Internet continuing to deliver new services in the form of cloud computing.
In 2017, pharmacy will see three trends become increasingly visible, relating particularly to medications reconciliation and business agility as well as the move towards the purchase of pharmacy software services rather than expenditure on capital items.
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Qld Health replaces long-vacant CIO role

By Allie Coyne
Feb 2 2017 5:35PM

Mal Thatcher reveals successor.

Queensland Health has hired a permanent executive to the role of departmental CIO and head of its e-health arm after seven months of searching.
The agency's acting CIO and eHealth Queensland chief Mal Thatcher today revealed that Dr Richard Ashby, head of the Metro South Hospital and Health Service, would take over his joint roles.
The CIO of Queensland Health also serves as the chief executive of the department's $485 million tech arm, eHealth Queensland, reporting to director-general Michael Walsh.
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Fears over DR shortcomings at Queensland hospitals

Audit unearths inadequate disaster recovery preparations
Rohan Pearce (Computerworld) 03 February, 2017 06:00
Three out of a group of four health services whose disaster recovery preparations have been assessed by the Queensland Audit Office have only basic DR measures in place.
Only Metro South Health in South-East Queensland’s DR maturity was assessed as ‘Established’, which means the audit office considers it to have a comprehensive disaster recovery plan covering all its critical processes and that its DR plan is reviewed and tested annually.
Cairns and Hinterland Health and Hospital Service, Mackay Hospital and Health Services, and South West Hospital and Health Service only achieved a score of 1 (‘Basic’) on the capability maturity model used by QAO.
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Radiologists want clinical info on all referrals

Hugo Wilcken | 2 February, 2017 | 
Medicare should mandate that all referral requests for imaging include detailed clinical information and a diagnosis, according to proposals being considered by radiologists.
A position paper drawn up by Professor Alexander Pitman of the University of Melbourne notes that current Medicare regulations don’t specify what clinical information referrers need to provide when making imaging requests.
And yet this information is a “powerful factor” in how the images are interpreted, according to the paper published in the journal of the Royal Australian and New Zealand College of Radiogists (RANZCR).
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Patient landed with a defamation writ over 'greedy' online review

Rachel Worsley | 30 January, 2017 | 
A dentist has launched defamation action against a patient who allegedly called him “greedy” in a Google review.
Mark Robert Bradbury allegedly gave Smile Solutions a one-star rating on the practice’s Google listing page under the alias “Kangajazz”, saying he was quoted $1200 for a filling that would take only 45 minutes.   
He then allegedly launched a personal attack on the business’ owner and director, Dr Kia Pajouhesh.
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Privacy fact sheet 49: Health information and your privacy

January 2017
When you visit a doctor or other health service, they may need to ask for health information about you.
Australian privacy law governs how they can collect, use and share your health information. It also requires them to protect, correct and give you access to your health information. So please take a moment to read this fact sheet and understand the rules and responsibilities in place to protect your health information.

What is my ‘health information’?

Health information includes information about your health or a disability. It also includes any personal information collected while you are receiving a health service. This means that information such as your name, billing details, your Medicare number, or personal details about your race, sexuality or religion, may also be considered ‘health information’ in this context.
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Privacy fact sheet 50: Accessing and correcting your health information

January 2017
Australian privacy law[1] gives you a general right to access and correct your health information. Please take a moment to read this fact sheet and find out when and how you can access and correct your health information.

Can I access my health information?

Generally, a doctor or other health service provider must give you access to your health information if you request it.
You can ask for access to be provided in a particular way. Your provider should generally give you access in the way you request — such as giving you copies or letting you view it, or giving a copy to another provider. However, if you ask for access to your health information in a way which is unreasonable or not practical, they can give it to you in another way — such as on a disc or USB stick rather than giving you hard copies of the whole record.
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Unravelling the RACGP's mysterious role in a controversial pharmacy trial

1 February 2017
When it recently emerged that pharmacists would be taking on a vastly expanded role as part of a pilot trial designed to reduce unnecessary GP visits, it caused big ructions in general practice.
Many were indignant at the news that pharmacists, working under a GP shared care plan, would be empowered to issue repeat scripts, alter doses, and carry out INR, lipid, spirometry and blood pressure tests.
The outraged parties included, apparently, the RACGP.
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Is the pharmacy trial sincere or a sham?

Staff writers | 3 February, 2017 | 
The Victorian Pharmacist Chronic Disease Management pilot, due to begin later this year, will allow pharmacists to adjust medication dosages within parameters set by the patient’s GP.
The pharmacists will carry out in-store INR, lipid, spirometry and BP tests, and if the results hit the threshold set in the patient’s GP care plan, the pharmacist will adjust the patient’s medication regimen accordingly. Every patient interaction will be reported back to the GP.
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Telstra Health to roll out WA health information system

Telstra’s health business to roll out $10 million Community Health Information System
Rohan Pearce (Computerworld) 02 February, 2017 13:12
The Western Australian government has tapped Telstra Health for a $10 million Community Health Information System.
The system is intended to boost community health outcomes in rural WA.
The state government said it will record information about child health and development including vaccinations, public health, chronic disease management and pharmacy information to deliver community-based clinical services.
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Telstra Health wins WA government contract for AU$10m health info system

The WA government will implement a health information system to track the provision and management of health services in seven regional areas, with Telstra Health to roll out the system.
By Corinne Reichert | February 2, 2017 -- 04:40 GMT (15:40 AEDT) | Topic: Telcos
The Western Australian government has awarded a contract to Telstra Health to roll out a AU$10 million Community Health Information System in an effort to "close the gap" in access to health information between metro residents and those living in rural areas.
The health information system is designed to record data on children's health, including their vaccinations, as well as providing information about public health issues, management of chronic diseases, antenatal health, and pharmacies that provide community-based clinical services.
It will also monitor health reforms, allowing the system to improve the provision of health services in these areas.
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Webinar: Update on My Health Record Release 8 and New Developer Engagement Program

Created on Thursday, 02 February 2017
Join Rachel De Sain, Rupert Lee and Dr Steve Hambleton, to learn more about the upcoming Release of My Health Record, and the launch of a new Developer Engagement Program.

About the Webinar

The Australian Digital Health Agency invites you to attend this important webinar, to hear about our new Developer Engagement Program, and information about the upcoming release of My Health Record.
Executive General Manager Rachel De Sain will present the Release 8 plans and then seek questions from webinar participants. Dr Steve Hambleton, Co-Sponsor Medicines Safety Program, and Industry Engagement Lead Rupert Lee will also be on hand to provide any answers or insights for participants.
When: Friday 10th February 2017
Time: 2:00 pm - 2:45 pm AEDT
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The future of digital health in Australia: a social policy discussion

By Australian Digital Health Agency

03.02.2017
As Australia moves towards a digital health system, important social policy discussions are needed about how future developments will affect Australians. Join us and a panel of policy experts to have your say.
Emerging technologies are changing the global economy and Australian society. This is largely being driven by consumers who are demanding personalised wrap around services, most notably in banking, shopping and social networking. In healthcare the demand for consumer-centred services is driving the demand for new digital models of care – which follow patients, their carers and family through the health system.
On Monday 13th February from 2.00pm – 3.30pm (AEDT) the Australian Digital Health Agency is delivering a national webcast which will inform Australia’s next Digital Health Strategy.
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Tenders and Offers

Here you will find information on current tenders and offers from the Australian Digital Health Agency.

Community Pharmacy Software Industry Partnership Offer

We recognise the place of quality medicines information for people’s health and wellbeing in the day-to-day, and in the transfer of care between settings. This is why we want to ensure community pharmacists can access people's health records, and also share the vital information they hold with patients and their other clinicians.
The Agency is partnering with community pharmacy dispensing software providers, to enhance their products to allow viewing and uploading to the My Health Record system. We also want this sector to use Australian Medicines Terminology to enhance the quality and interoperability of medicines information.

Secure Messaging Proof of Concept Projects Request for Tender

The Australian Digital Health Agency invites industry providers delivering secure messaging, clinical information system/applications suppliers and end users to collaborate with the Agency on national implementation projects. The projects will prove the concept and demonstrate a working model for three key use cases to progress the adoption of secure messaging capabilities across the health sector in Australia.
Suppliers and partners will need to establish and work within a consortium to deliver secure messaging capabilities across different healthcare settings.
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Cynthia Whelan ‘ideal chairman’ as Foxtel lifts subscribers despite Netflix effect

  • The Australian
  • 12:00AM January 30, 2017

Mitchell Bingemann

Telstra’s new businesses boss Cynthia Whelan has been appointed Foxtel chairman, becoming the first woman to hold the position at the pay-TV operator.
Ms Whelan replaces current chairman and former Telstra executive Robert Nason, who has served in the role since June 2012 and will step down on February 17.
Mr Nason has held the chairman role despite officially finishing at Telstra — where he slashed more than $4 billion in costs and culled thousands of jobs as its head of business service and improvement — in October 2015.
(Note: She is also in charge of Telstra Health).
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Enjoy!
David.

Sunday, February 05, 2017

What Should We Hope To See In The Initial Draft Of The New Digital Health Strategy From The ADHA?

As most will be aware the official consultation period for the new ADHA Strategy closed  few days ago.
See here:

How do you see the future of digital health?

Your health. Your say.

The 'Your health. Your say.' consultation period closed on Tuesday 31 January 2017, 5PM AEDT. Thank you to the individuals and organisations who contributed to the future of digital health by responding to the survey, sending us a submission, or attending one of the national conversation events. 
The Agency is currently reviewing all feedback. Stay tuned for further updates on the findings of the national conversation and the development of the National Digital Health Strategy, which will be available here on the conversation website. Subscribe here to stay updated.
Here is the link:
Having watched the recent webinar Tim Kelsey made it clear that work was now beginning on drafting the actual plan for COAG’s (Council of Australian Governments) Health Committee.
In discussions with the ADHA I have been told that before the plan was submitted to COAG it was likely there would be a discussion draft released that would permit thorough discussion and review by the rest of us.
With that in mind what would I be hoping to see? Here is my short list.
1. A clear definition of the scope and intended duration of the plan. Additionally discussion of just where the Strategy fits with current and planned Health Policy is critical.
2. An outline of just what the objectives of the plan are and the timeframe over which they are expected to be delivered.
3. A credible assessment of just where we are up to with Digital Health in Australia right now, as well as a needs analysis for optimal health system performance.
4. A thorough review of what has worked and what has not, both here and around the world, and what have been the factors that have led to both success and failure – as well as a realistic capability assessment of the Australian Digital Health Community.
5. A thoughtful analysis of just where the ADHA should fit in the Digital Health ecosystem and what its role should be going forward.
6. An full assessment of available options for moving forward especially in the areas such as overall national digital architectures, Standards, technology, information management, skills etc.
7. A clear sub-strategy for the involvement of the private technology sector and a similar sub-strategy that addresses interactions between the jurisdictions, clinicians and consumers.
8. A pragmatic list of projects that the ADHA might initiate and foster, what the approximate anticipated costs and benefits are and a discussion of why the ADHA is the correct entity to undertake such a project.
9. A focussed review of the myHR program with a realistic assessment of what has been achieved to date, what evaluations have been done and what they have shown. Additionally we need a realistic costed plan for what should (if anything) be done with the program, what benefits can realistically be expected and what costs are likely to be incurred.
I am sure there is a lot more that others might want to mention – and I would love to see them as comments.
Thanks.
David.

AusHealthIT Poll Number 356 – Results – 5th February, 2017.

Here are the results of the poll.

Are You Expecting The New ADHA National Medicines Safety Program To Have A Significant Positive Impact On Medicines Safety?

Yes 45% (65)

No 43% (62)

What Medicines Safety Program? 7% (10)

I Have No Idea 6% (8)

Total votes: 145

I think you would have to call the outcome a draw. It seems confidence in the outcome is pretty balanced.

A good turnout of votes now people are back at work!

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

David.