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, April 27, 2017

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

April 27, 2017 Edition.
Well it has been a lively few days with a visit from Vice-President Pence (who actually seems to be keeping the US Government running) and a threat to bomb poor old OZ. See here:

North Korea warns Australia of nuclear strike over Julie Bishop's comments

Kirsty Needham
Published: April 23, 2017 - 9:58AM
Beijing: North Korea's foreign ministry has lashed out at Foreign Minister Julie Bishop and warned Australia was "coming within the range of the nuclear strike".
The threats were reported by the North Korean state news agency KCNA as being made on Friday, in response to a radio interview given by Ms Bishop.
According to a translation of the KCNA report, which was dated Friday, the same day US Vice-President Mike Pence arrived in Australia, Ms Bishop had said in the radio interview that North Korea seriously threatens regional peace and she supports the US policy that "all options are on the table".
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Now that would really ruin the week. Thank heavens he can’t make good just yet (we believe)!
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If you want to get really alarmed locally, try this:

'This thing's gonna blow': Top economists' interest rate warning

Michael Koziol, Political reporter
Published: April 18, 2017 - 12:01AM
A dangerously overcooked housing market and rising interest rates are poised to plunge thousands of Australian families into mortgage stress in coming years, top economists have warned.
As the Turnbull government grapples with how to address the housing affordability crisis in its May budget, some experts are predicting a housing correction that cannot and should not be stopped.
Deloitte Access Economics' quarterly business outlook, released today, predicts the official cash rate of 1.5 per cent will climb slowly in 2018 and 2019 to reach 3 per cent in the early 2020s.
The Reserve Bank was well aware "interest rates are now a massively more potent weapon for slowing the Australian economy than they've ever been before", the forecaster said.
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Great click bait this!
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In more local news May 9, 2017 is Budget Day if you are wondering. Really not far away.
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Here are a few other things I have noticed.
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National Budget Issues.

I'll never be able to afford a house - and older generations don't give a damn

Megan Shellie
Published: April 15, 2017 - 11:45PM
Joe Hockey, in trying to justify increased student contributions to higher education, used the quote, "In your twenties you complain and in your forties you explain." It's an easy way to brush away the anxieties and anger of an entire generation of Australians, but it also feels like for the first time, this may not be true. I don't see a future, even in my forties, where home ownership and economic stability are a reality. It is scary, and it is my reality. And the generations before me don't give a damn.
You only have to look at the figures to understand the horror in the eyes of Millennials. Total stagnation of wages growth coupled with the median house price now some 14 times the average income, and growing.
Australians are now saying that a household income of $150,000 would allow for a comfortable existence, and yet with more than half the population of Australia on incomes under $60,000 per year, this seems like a distant reality. Household budgets aren't going to miraculously grow, unless policymakers get serious on fixing the cost of living, or we suddenly embrace polygamy.
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Disadvantaged should rate higher than rich and powerful

Ross Gittins
Published: April 17, 2017 - 12:15AM
I shouldn't say it, but the thing that annoys me most about the readers of this august organ are those who want to consign me to a party-political pigeonhole. "He's only saying that because he's Liberal/Labor/Green/Callithumpian."
Sorry. I have a lot of strong views, and I hope it isn't hard to detect an internal consistency in them, but they're not driven by loyalty to any party.
Like many old journos, the older I get the more disdainful I become of both sides of politics. They're not identical, but they have far too many bad habits in common.
But if my views come from a consistent set of values, where do those values spring from?
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Rise of the machines: robots are coming for middle-class jobs next

Adam Gartrell, industrial relations correspondent
Published: April 15, 2017 - 12:15AM
From the factory floor to the supermarket, the call centre to the video store, it has happened to the working class already: waves of technological change that have rendered many of their jobs obsolete.
But the next advances in automation won't just affect the low-skilled and low-paid. In the years ahead many middle-class professionals - engineers, accountants, journalists and insurance workers to name just a few - will find themselves replaced by computers, robots and artificial intelligence.
Technological change can be liberating but it also breeds anxiety. And if it's not managed properly it could also worsen inequality by further skewing the power balance in the workplace and across society.
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Even Coalition voters believe the minimum wage is too low, polling finds

Adam Gartrell
Published: April 17, 2017 - 12:15AM
Nearly 70 per cent of Australians believe the minimum wage is too low, including a strong majority of Coalition voters, a new poll has found.
Only one in five Australians believe the $17.70 an hour minimum wage is "about right" and just four per cent of people think it is too high, according to the polling commissioned by the peak union body, the ACTU.
Conducted last week, the Essential Research online poll of 1015 people found 69 per cent of Australians want a higher minimum wage, with 33 per cent of those respondents saying it should be "much higher". Nearly 60 per cent of Liberal National voters believe it should be higher, as do 77 per cent of Labor voters.
The ACTU has asked the workplace relations umpire to raise the minimum wage by $45 a week, triple the 2016 $15.80 increase. Such an increase would lift the minimum wage to $37,420 a year. 
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17 Apr 2017 - 3:34am

Hewson questions ditching deficit levy

Former Liberal leader John Hewson says the Turnbull government is about to get rid of the deficit levy even though the budget position has deteriorated.
Source:
AAP 17 Apr 2017 - 3:34 AM  UPDATED 9 HOURS AGO
Former Liberal leader John Hewson has questioned the logic of getting rid of the deficit levy on high-income earners when the budget is in a much worse position than it was three years ago.
The temporary levy - a two percentage point increase imposed on the top marginal tax rate - was introduced in 2014 under former prime minister Tony Abbott when he described it as a 'budget emergency".
Back then the 2016/17 budget deficit was projected to be $10.6 billion.
However, last December's mid-year budget review put it at $36.5 billion.
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The green, amber and red of housing affordability policies

Matt Wade and Jessica Irvine
Published: April 18, 2017 - 12:15AM
It costs $47,880 each year to service a typical loan on a median-priced house in Sydney, research by the Housing Industry Association shows.
Numbers like that have pushed public anxiety about housing costs to an all-time high. The latest Ipsos Issues Monitor poll found 41 per cent of people in NSW now rate housing as one of the most important challenges confronting the community, up from 29 per cent in 2013.
The experience of people such as Daniel Stone is driving the public's apprehension about property.
(This is a really sensible article.)
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ATO data shows inequality is in everything from super to the property market

18.04.2017
Jenni Henderson, The Conversation and Josh Nicholas, The Conversation
The Australian Taxation Office (ATO) has released data for 2014-15 that paints a picture of how much Australians earn and what they claim in tax concessions. We asked our tax experts to tell us what the data says to them. The Conversation
John Daley and Danielle Wood, The Grattan Institute
The latest data from the ATO is consistent with what we’ve seen in the past. It shows that people with high-income occupations – doctors, lawyers, and others – are more likely to use negative gearing than the nurses and teachers on whom Treasurer Scott Morrison focuses when he tries to justify retaining negative gearing. It also shows that negative gearing is typically worth four to five times more for doctors and lawyers than nurses and teachers.
The tax data shows that with falling interest rates, fewer landlords are negatively geared, and the average loss is also falling. Overall the investor property market seems to be concentrating a little, with slightly fewer landlords but more investment properties per landlord.
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Financial distress looms due to spike in negatively geared properties among Australia's poorest: report

Nassim Khadem
Published: April 18, 2017 - 12:00AM
Australia's poorest people are taking on negatively geared property investments, despite their inability to manage the risks, a new report from KPMG shows, putting them at severe risk of financial distress when interest rates begin to rise.
While the proportion of households facing economic hardship has remained static in recent years, the total number of very poor households has risen and reached almost half a million people.
Household incomes have grown, not because of rising wages and salaries, but rather due to higher investment income and government transfers, according to KPMG Economics' report Financial Stress in Australian Households: the haves, the have-nots, the taxed-nots and the have-nothings.
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Tony Abbott: ‘Stop the spending, ScoMo’

KYLAR LOUSSIKIAN, NATIONAL POLITICAL REPORTER, The Daily Telegraph
April 18, 2017 12:00am
FORMER prime minister Tony Abbott has called on Treasurer Scott Morrison to scrap all new spending, cut deeper, and leave housing affordability to the states in yet another provocative intrusion into policy debates.
In his second intervention in as many days, Mr Abbott took aim at Mr Morrison’s 2017 Budget, to be handed down in three weeks.
“Everyone has got to live within their means and government ultimately is no different to businesses and households,” Mr Abbott said.
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  • Updated Apr 18 2017 at 12:01 AM

Budget good news unlikely to last, warns Deloitte's Chris Richardson

The nation's budget continues to deteriorate despite tailwinds from China and the housing market improving the government's revenue outlook, warns budget forecaster Chris Richardson
Cautioning that neither a strong China nor the housing boom are likely to last indefinitely, Mr Richardson said there was still not enough being done to reduce the deficits of recent years.
"Spending continues to climb at a solid clip, and attempts to rein it in remain fruitless vote-losers," he writes in the latest Deloitte Access Economics business outlook on Tuesday.
"Rather, the current improvement in deficit trajectory simply says that the twin engines of chance - a China boom and a house price boom - are both supporting the national tax take at the same time.
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Reserve Bank warns regulators could take drastic action to cool Sydney, Melbourne housing market

Eryk Bagshaw
Published: April 18, 2017 - 2:29PM
The Reserve Bank has warned regulators could take drastic action to slow Sydney and Melbourne's runaway housing markets. 
In the minutes of its April meeting, released Tuesday, the RBA said the Council of Financial Regulators regulators could clamp down on home loans and "consider further measures if needed" to maintain financial stability. 
The council, which includes the Australian Securities and Investments Commission (ASIC), Treasury, and the Australian Prudential Regulation Authority (APRA), would keep a watching brief on the market as it responds to its previous warnings to keep investor loans and interest only loans in check.
"Developments need to be kept under review ... depending on how the system responds to the [previous] measures," the minutes stated.
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  • Updated Apr 18 2017 at 4:40 PM

Capping landlords' properties could make renting worse

Limiting the number and value of negatively geared properties owned by individual landlords could trigger an administrative headache for taxpayers, make renting even more unattractive and have little impact on housing affordability, according to housing experts.
Both the independent economic think tank, the Grattan Institute, and the Housing Industry Association warned the federal government must consider the unintended consequences of putting a limit on the number of properties investors can buy or imposing a dollar-value on the tax deductions claimed on negatively geared properties as part of a federal budget housing package.
The potential limits on multi-dwelling landlords has been an option investigated by the Turnbull government as it looks for a quick-fix housing affordability solution.
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We need a 'soft decline' in house prices before it is too late

David van Gogh
Published: April 18, 2017 - 3:28PM
Intense media focus on housing affordability has primarily focused on the story of the individual; the young person who can't afford a house. But in all of our focus on the individual, we are failing to recognise the greater problem – that when house prices do fall, and they will, they risk taking our banking system and the wider economy with them. We need to induce a "soft decline" before it is too late.
The myth that house prices must continue to rise, and that housing is somehow different to any other asset class, is a dangerous one. Like any other asset class, housing is subject to changes in demand, speculation, and increases and decreases in price. This is obvious when one looks to the house price reductions in the US and Europe during the global financial crisis, and house price declines in Australia in the early and late 1980s.
Are we in a bubble now? Pricing bubbles exist where price growth outstrips demand growth. Population growth has increased by less than 2 per cent per annum over the last five years, while housing prices have increased at an average of 7.5 per cet per annum. To back this up, in March ASIC made the unusually direct statement that the Sydney housing market is in a "bubble" scenario where asset prices are overvalued.
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IMF paints a rosy picture of Australia ahead of federal budget

Peter Martin
Published: April 19, 2017 - 7:45AM
The May budget is set to forecast a surge in economic growth, much lower unemployment and a rebound in inflation, according to a 'sneak preview' released by the International Monetary Fund Wednesday morning in Washington.
The Fund's updated forecasts for Australia contained in its annual World Economic Outlook are much more upbeat than those in its special survey of Australia released in February.
It consults with the Australian Treasury before finalising its forecasts.
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Economic alarm bells beginning to ring

  • The Australian
  • 12:00AM April 19, 2017

Alan Kohler

Donald Trump now says China is not a currency manipulator, which is hilarious on so many levels, while at the same time he is trying to become one himself.
Not that the US President is likely to sell dollars to force it lower. His statement last week that it was too high was more slogan than intention, a bit like the commentary from previous presidents that a strong dollar “is in America’s national interest”. They never did anything to make it so — it was Volcker and Greenspan who did that. China, on the other hand, has long been an active currency manipulator and has lately been intervening to prop up the yuan, or at least cushion its decline.
But the US dollar is now weakening, especially against the yen, not because the President has told it too, but because it’s clear the economy is weaker than expected and the Trump stimulus is unlikely to get up.
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The federal budget deficit noose is being loosened by 'dangerously dumb' house prices

Apr 18, 2017, 9:24 AM
A combination of rising house prices, helping revenue in the eastern states, and demand in China are doing the federal budget favours, according to the latest Deloitte Access Economics Business Outlook report.
However, interest rates will rise again, probably in 2018, and China’s debt poses risks for maintaining economic growth beyond the next couple of years.
Treasurer Scott Morrison will bring down the federal budget in Canberra in three weeks when he is expected to announce plans to make housing, with prices getting further out of reach to first home buyers in Sydney and Melbourne, more affordable.
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We've had a major housing crisis before - and this is how they fixed it

Rae Dufty-Jones
Published: April 19, 2017 - 10:50AM
As politicians across Australia grapple with a fix for housing affordability, you might be forgiven for thinking this was the first time the nation has confronted a crisis in housing. But analysis of documents from the reconstruction period following World War II finds that, as the war was drawing to a close, concern was building about housing availability and affordability.
Some of the issues, arguments and solutions being presented today are extremely similar to those consuming Australian politicians and policymakers three-quarters of a century ago.
Treasurer Scott Morrison recently asserted that the housing affordability crisis was so severe that: "People are putting off when they buy their house. They are even putting off when they have kids so they can save more."
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Investors will be the target of changes in the federal Budget

April 21, 201711:31am
THE FEDERAL government may yet tinker with negative gearing in next month’s Budget.
The most likely scenario would see the introduction of a limit of say two claimable investment properties or alternatively a dollar value cap on how much can be negatively geared by investors.
There are now a record 2.05 million taxpayer individuals with an ownership interest in a rental property in Australia.
This represents a jump of 348,000 investors over six years, increasing at around 1000 every week.
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Fourth industrial revolution, led by disrupters like Amazon, sure to be bloody

  • The Australian
  • 12:00AM April 22, 2017

Alan Kohler

Australian retailers and landlords are rightly shaking in their sensible shoes about the impending arrival of Amazon to these shores, and this week it became a little bit more urgent.
Up to now, the world’s scariest retailer has been too busy laying waste to Europe’s storekeepers to bother with Australia’s measly number of shoppers, so our lot have been granted a little more time to prepare for The Coming.
But that’s now over: this week Amazon confirmed that it’s looking for a place to put one of its $1 billion distribution and fulfilment centres and that it already has 1000 people on the ground here, doing what we don’t know.
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Health Budget Issues.

Reducing Australian obesity to prevent future chronic disease burden

Georgina Connery
Published: April 17, 2017 - 12:00AM
If at risk populations reduced their weight by a little as three kilograms, Australia could avoid 14 per cent of disease related to being overweight and obese in 2020, a new study has found.
The Australian Institute of Health and Welfare report, Impact of overweight and obesity as a risk factor for chronic conditions: Australian Burden of Disease Study, shows relatively small changes can have a big impact.
The new findings look at the health impact of excess weight in terms of years of healthy life lost through living with an illness or injury, or through dying prematurely.
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People in aged care ‘falling off radar’ of public health system

  • The Australian
  • 12:00AM April 18, 2017

Rick Morton

Older people in the $15 billion aged care sector are often “isolated” from the public health system, which should do more to provide cover for them.
Aged Care Minister Ken Wyatt told The Australian that people in residential aged care frequently “fall off the radar” of the health system, especially in rural and remote areas, and ought to be a clearer priority in the eyes of health services. “In some instances this might impact on resources in the health budget but I’m not talking about new money here, it’s about the distribution of resources,” he said. “I’m not looking at this fiscally at all. The fact is we often leave older Australians out of the equation and if you are in residential care I want to make sure you do not become isolated from traditional health services.”
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Patients will be pushed to use ‘generic drugs’ as medicine prices fall in the upcoming federal budget

Sue Dunlevy, National Health Reporter, News Corp Australia Network
April 21, 2017 10:00pm
EXCLUSIVE
PATIENTS and taxpayers will pay less for hundreds of medicines as a result of the May budget as the Federal Government wrings $1.8 billion in savings from big drug companies.
However, many people will be pushed to switch to cheaper generic versions of their medicines under reforms to save the taxpayer money.
And the price of X-rays and scans could rise with the government poised to abandon an election pledge to index the Medicare rebates for these services.
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Health Insurance Issues.

'Dangerous path': Medicare 'seriously threatened' by private health insurance

Adam Gartrell, Health Correspondent
Published: April 20, 2017 - 12:01AM
The Turnbull government is under renewed pressure to tackle the cost, complexity and poor coverage of private health insurance amid warnings the problems are threatening the future of Medicare.
Health leaders, consumer advocates and policy experts have given damning assessments of the state of Australia's private health care regime in a new series of articles published by the Consumers Health Forum.
The authors warn relentless above-inflation premium price rises are threatening the viability of the entire sector, that insurers are failing people with chronic illnesses, and that the current model is contributing to growing inequality.
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Private health insurance attacked for lack of value and transparency by experts

Consumers Health Forum publishes views of 20 experts in latest edition of Health Voices as part of series
Leading medical specialists, health economists, patient advocates and policy analysts have overwhelmingly criticised the value and transparency of private health insurance in a series of articles published on Thursday.
The Consumers Health Forum, which advocates for patients, published the views of 20 experts in the latest edition of its journal Health Voices as part of a series titled: Is Private Health Insurance Worth It?.
The chief executive of the Chronic Illness Alliance Australia, Dr Christine Walker, wrote that many people with chronic illnesses could not afford to pay the gap not covered by their private health policies. Some even refrained from disclosing they had private health insurance so that they could receive fully subsidised care in the public hospital system, she said.
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No Prostheses List healing between insurers and suppliers

  • Shaun Gath
  • The Australian
  • 12:00AM April 21, 2017
Humour me a moment: check your calendar. 2017 right? All good?
But hold on. Not so fast … particularly if you’re in the Australian medical prosthetics business. Over on that side of sleepy swamp the calendar is stuck hard on 2005. George W. Bush is still the US president and they are toe-tapping to the catchy beats of James Blunt and the Pussycat Dolls.
How so, I hear you ask? Well, it’s all down to an arcane government policy called the Prostheses List which right now is raising one hell of a nasty ruckus in the private health sector.
Like many things in that sector, the PL (as it’s known by the inside crowd) is the product of a series of soaring prices, uncontrolled events and panicked politicians … all covered over with a massive sticking plaster.
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Fears ALP to axe $6bn health insurance rebate

  • The Australian
  • 12:00AM April 22, 2017

Simon Benson

The private health insurance ­rebate could face further cuts under Labor after confidential discussions between insurance groups and the opposition sparked fears the $6 billion rebate could be abolished, potentially driving up the average cost of premiums by 40 per cent.
Opposition Treasury spokesman Chris Bowen is understood to have held meetings with members of the private health insurance sector last month, in which industry sources say the prospect of changes to its current policy were not ruled out.
Private health providers have warned that any moves by Labor to scrap the private health insurance rebate would deliver a devastating blow to families and drive up the average cost of premiums.
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Superannuation Issues.

The lower the yield, the higher the cost of fees

Michael Pascoe
Published: April 18, 2017 - 8:22AM
This might sound like a fairy story, but once upon a time investors expected to receive double digit returns and often did. Fat yields and easy money were all the rage, so if various fees were chewing up 3 per cent or so, what the heck – there was plenty to go around.
Of course, money was not growing on trees and inflation was eating up a bigger slice of earnings than most realised, but the structure of the wealth management industry and a mixture of innocence and laziness on the part of average investors meant high fees were the norm and therefore didn't seem so high to most people. In other words, we were mugs.
A quick real-world example from a fairly basic eight-year-old statement of advice provided by a bank financial planner for a $550,000 portfolio: leaving aside the 1 per cent implementation fee, there were annual fees of 0.68 per cent for account keeping, 1 per cent for regular reviews and individual product fees ranging from 0.22 per cent for a cash fund to 0.88 per cent for an imputation fund and 0.89 per cent for an international share fund. Draw a line through the products and keep it simple by saying they averaged 0.72 per cent – thus total annual fees of 2.4 per cent before individual transaction fees. And this is by no means an extreme case.
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  • Updated Apr 21 2017 at 8:30 PM

Super changes push more to family trusts

With dramatic changes to superannuation just 10 weeks away, family trusts are becoming more popular as the "next best" investment vehicle for those who have more to invest than the new super rules will allow. Financial advisers note a marked increase in clients wanting to set one up, either dismayed by how little they'll be able to get into super after July 1 or fed up with government changes to retirement savings.
But who do they suit and what are the potential benefits?
Just like a super fund, a trust is an investment structure into which you put money that's invested for you. But a trust, says HLB Mann Judd wealth management partner Michael Hutton, is tax-neutral in that it pays no tax on earnings and taxable income flows through to beneficiaries — a spouse, children and wider family members — and they pay tax on what they've been paid (their distribution). By comparison, super funds pay tax on earnings, albeit at a low rate (a maximum of 15 per cent).
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International Commentary:

Opinion | Jeffrey D. Sachs

Our misguided ‘wars of choice’

By Jeffrey D. Sachs   April 16, 2017
There is one foreign policy goal that matters above all the others, and that is to keep the United States out of a new war, whether in Syria, North Korea, or elsewhere. In recent days, President Trump has struck Syria with Tomahawk missiles, bombed Afghanistan with the most powerful nonnuclear bomb in the US arsenal, and has sent an armada toward nuclear-armed North Korea. We could easily find ourselves in a rapidly escalating war, one that could pit the United States directly against nuclear-armed countries of China, North Korea, and Russia.
Such a war, if it turned nuclear and global, could end the world. Even a nonnuclear war could end democracy in the United States, or the United States as a unified nation. Who thought the Soviet Union’s war in Afghanistan would end the Soviet Union itself? Which of the belligerents at the start of World War I foresaw the catastrophic end of four giant empires — Hohenzollern (Prussia), Romanov (Russia), Ottoman, and Hapsburg — as a result of the war?
These are terrifying prospects, and they may seem unreal, even preposterous. Yet Trump is impetuous, unstable, and inexperienced. His foreign policies swing wildly from day to day. He makes threats, such as attacking North Korea, that could have horrific, indeed catastrophic, consequences.
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There's only one workable solution to the North Korea problem

Peter Hartcher
Published: April 18, 2017 - 12:00AM
The failure of North Korea's much-anticipated ballistic missile test on the weekend tells us three things.
First, that it is completely undeterred. Donald Trump's missile strike on Syria didn't deter North Korea's "Dear Marshal" Kim Jong Un.  Neither did Trump's threat to attack North Korea. Nor did his talk that the US and China were now working to tackle the problem together.
Second, North Korea remains determined to become the planet's ninth nuclear missile state as soon as possible. It already has nuclear bombs and ballistic missiles. It now needs to marry the two technologies, making nuclear bombs small enough to fit onto a missile tip.
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Trump Mulls U.S. Military Options for North Korea, All Grim

by Nick Wadhams
April 19, 2017, 2:00 PM GMT+10 April 19, 2017, 9:42 PM GMT+10
  • Seoul could be devastated in Pyongyang’s counterattack
  • Donald Trump vows that a nuclear North Korea ‘won’t happen’
Three weeks before becoming president, Donald Trump weighed in on the threat of North Korea developing a nuclear warhead capable of reaching the U.S.: “It won’t happen,” he vowed on Twitter.
Now planners are contemplating what a U.S. strike to prevent that development might look like, and the options are grim.
Analysts estimate North Korea may now possess between 10 and 25 nuclear weapons, with launch vehicles, air force jets, troops and artillery scattered across the country, hidden in caves and massed along the border with South Korea. That’s on top of what the U.S. estimates to be one of the world’s largest chemical weapons stockpiles, a biological weapons research program and an active cyberwarfare capability.
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US stocks should 'terrify' Janet Yellen, says billionaire Paul Tudor Jones

Katherine Burton and Katia Porzecanski
Published: April 22, 2017 - 7:57AM
Billionaire investor Paul Tudor Jones has a message for Janet Yellen and investors: Be very afraid.
The legendary macro trader says that years of low interest rates have bloated stock valuations to a level not seen since 2000, right before the Nasdaq tumbled 75 per cent over two-plus years. That measure — the value of the stock market relative to the size of the economy — should be "terrifying" to a central banker, Jones said earlier this month at a closed-door Goldman Sachs Asset Management conference, according to people who heard him.
Jones is voicing what many hedge fund and other money managers are privately warning investors: Stocks are trading at unsustainable levels. A few traders are more explicit, predicting a sizable market tumble by the end of the year.
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I look forward to comments on all this!
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David.

That Old Paper Transfer Of Private Information Lets Us Down Again! Private Information Leaks Are Usually Caused By Human Error – Not Technology!

This appeared last week:

Patient privacy breach: over 1600 medical letters found dumped in Sydney bin

Kate Aubusson
Published: April 21, 2017 - 4:52PM
More than 700 public patients have had their privacy breached and potential delays in their follow up care after more than 1600 medical letters were found dumped in a Sydney bin.
NSW Health is investigating the incident involving a sub-contractor for a company tasked with transcribing medical letters sent from specialists to general practitioners.
On Tuesday, April 11, a man found piles of follow-up letters containing patient details stuffed into a garbage bin at an apartment block in Ashfield. It is understood there were more than 1600 documents in total. Some of the letters were duplicates. 
The man called in his neighbour, a female health worker, who recognised the documents were out-patient letters and contacted Ashfield police. 
A sub-contractor for Global Transcription Services (GTS) was supposed to take the letters home to post but instead stuffed them into the bin. The young woman had been dealing with personal upheaval and health issues, Health Minister Brad Hazzard said on Thursday, adding it was inappropriate to comment further.
The letters related to 768 public hospital patients from Royal North Shore, Gosford Hospital outpatients and Cancer Centre and Dubbo Hospital Cancer Centre.
There were also 700 letters relating to patients from six private providers: Chris O'Brien Lifehouse, providing services to Dubbo Cancer Clinic, Northern Cancer Institute (Frenchs Forest and St Leonards), Sharp Neurology, Southside Cancer Care Centre, Strathfield Retina Clinic and the Woolcock Institute.
It is not known how many private patients were affected. It is understood that less than one per cent of affected patients were treated by Lifehouse. 
The bulk of the letters were treatment progress reports from specialist consultations in December.
More here:
Other than wondering quite why so much detail about the breach was provided the cause of the problem is pretty clear. A worker simply failed to carry out their responsibilities appropriately for personal reasons.
Such issues can happen with both paper and electronic records albeit often in different ways.
Nonetheless, despite some comment and articles to the contrary, we are all entitled to have our private information kept private unless we choose to disclose it. No ifs or buts as far as I am concerned and I really struggle with the decency and sensitivity of those who think any different.
If you have a use case that validates the unauthorized disclosure of personal identified private information I would love to see it – unless it involves emergency care or the like. I am not expecting many takers!
David.

Wednesday, April 26, 2017

The ADHA Puts A Case For Digital Health. Pity The Evidence Is So Old And Inconclusive.

This blog from the ADHA appeared a few days ago.

Health in an age of information

Thursday, 20 April 2017
"Cause we are living in a material world
And I am a material girl
You know that we are living in a material world
And I am a material girl"[1]
You know these lyrics. Madonna's single "Material Girl" and its accompanying video were huge hits in 1985, and went on to define much of her career. But was she right? Is she really a material girl? And are we living in a material world? More than 30 years after she sang this song, we find that the world we live in is becoming less and less about material things, and more and more about information.
From the perspective of the national and global economy, information technology is a vast and growing sector that is displacing manufacturing in value and influence. A similar trend is apparent in the economy of our daily lives: financial transactions are routinely conducted electronically, and reliance on the physical tokens of notes and coins starts to seem quaint.
The rising influence of information even shows in our understanding of reality itself. We’ve known for some time that the apparently solid objects of our experience are composed of atoms that consist mostly of space. And as physicists probe ever more deeply, even subatomic particles seem less and less substantial. Some theorists go so far as to propose that this gossamer-thin materiality rests on a bedrock of – you guessed it – information. As the science writer James Gleick puts it:
"The bit is a fundamental particle of a different sort: not just tiny but abstract – a binary digit, a flip-flop, a yes-or-no. It is insubstantial, yet as scientists finally come to understand information, they wonder whether it may be primary: more fundamental than matter itself. They suggest that the bit is the irreducible kernel and that information forms the very core of existence."[2]
Healthcare is no exception to these trends. As treatment methods become more sophisticated, we find that the quality of healthcare is increasingly dependent upon the quality of the information available to practitioners and patients.
It may seem like a truism to say that better health information leads to better healthcare, but in some respects the healthcare profession has been remarkably slow in embracing information technologies. Facsimile machines, for instance, are still in regular use to convey messages between medical practitioners, despite having been phased out in most other sectors. And handwritten notes are still commonplace in both large and small clinical practices.
There are good reasons for this conservatism, starting with the Hippocratic injunction to first, do no harm. Obvious as it is that reliance on facsimile messages and handwritten notes is somewhat old-fashioned, it is not so obvious that they are actively harmful. Newer systems for storing and communicating information may be more efficient and promise greater safety, but that promise ultimately needs to be tested in the crucible of daily practice. In such circumstances, a "devil you know" approach has clear attractions.
Network effects are another inhibiting factor. A single telephone is of no use whatsoever – it becomes useful when there is another telephone that it can call. And it becomes more useful still when there are hundreds or thousands of other telephones. Similar issues arise for other communications and storage technologies: they only become useful when both sender and receiver have similar equipment and apply compatible protocols.
The complexity of healthcare information is yet another factor. The financial sector has readily adopted modern information technologies in part because the key data in that sector is numeric information, which is easily represented and thoroughly standardised. In contrast, the underlying information in healthcare is exceedingly complex: it is often difficult to represent and only loosely standardised.
Despite all this, it has been estimated that adopting modern information technologies to Australia’s healthcare sector will save hundreds of lives and millions of dollars each year[3]. Let’s repeat that: hundreds of lives and millions of dollars could be saved each year by adopting modern information technologies to healthcare.
This represents the challenge, the mission, and the promise of the Australian Digital Health Agency’s work. Improving healthcare information may sound abstract, but this is work with very real, practical outcomes in the material world we live in.
Dr Andrew Westcombe is a technical editor at the Australian Digital Health Agency, with a PhD in Philosophy. 
[1] Songwriters: Rans, Robert; Brown, Peter. Material Girl lyrics © Sony/ATV Music Publishing LLC.
[2] Gleick, James, The Information: A History, A Theory, a Flood. Pantheon Books, NY, 2011, pp. 9-10.
[3] See http://www.strategyand.pwc.com/au/home/press/press-releases/displays/48757598
Here is the link:
I have provided the whole blog so as not to mis-state any of the arguments.
First it is really good to see some sensible points being made on the issues and complexity surrounding digital health.
Second it is really sad to see that the best that can be said on the benefits front is so old.

Booz and Company report identifies possible $7.6 billion in annual savings from Government investment in e-health

Sydney, 6 May 2010 — A report released today by leading global management consultancy, Booz and Company, has revealed Government investment in a comprehensive e-health system may generate more than $7.6 billion in annual healthcare savings by 2020.
The Booz and Company report, Optimising E-Health Value, outlines a comprehensive case for national investment in e-health to better connect GPs, hospitals and other points of care, so as to improve sharing of patient information.
The report points to reduced errors in medication as offering the greatest potential for savings ($2.6 billion), followed by improved care programs and prevention measures ($2.3 billion). Adverse drug events from errors in medication are estimated to affect 10.4% of patients currently treated by GPs in Australia each year, of which half are classified as moderate to severe, 138,000 require hospitalisation, and as many as 18,000 may result in death according
to some sources.
Booz and Company says a comprehensive commitment to e-health could help Australia avoid an estimated 5,000 deaths, two million primary care and outpatient visits, 500,000 emergency department visits and 310,000 hospital admissions each year.
Report co-author and Sydney-based Booz and Company Principal, Klaus Boehncke, said the analysis demonstrated clearly the benefits from significant investment in e-health, and the need to build such investment in the health reform agenda.
“E-health is the crucial missing piece of the health reform jigsaw presently, and it must not be allowed to slip from view,” Mr Boehncke said.
“Indeed, the success of some of the Government’s reforms, particularly the local hospital networks and primary care networks, and reduced Emergency Department waiting times, depends largely on the connectivity that a robust e-health system provides,” he said.
The report was based on Booz and Company’s global experience advising Governments and health authorities in countries overseas including the United States, Canada, Germany, Italy, Singapore, Hong Kong and the UAE. The e-health model outlined in the report draws on Australian health data and has been adjusted to reflect the characteristics of Australia’s health system.
The report says existing e-health investment in Australia has been patchwork, limited and often focused on acute care. It calls for a shift in e-health focus from hospitals to networking primary care settings – GP clinics - where the volume of patient interaction is high and the potential for flow-on benefits are greatest.
“GPs are increasingly at the sharp end of providing integrated and chronic care, and their role becomes more important under the Government’s reforms, with their initial focus on diabetes. There is a real opportunity to reap powerful gains by putting them at the centre of the e-health push,” Mr Boehncke said.
“Australia’s GPs – 95% of whom use computers - are among the most highly computerised in the world. However, they are not well connected with each other, or with other points of care such as hospitals, so the valuable patient information they hold is not shared with other care providers or indeed among their own community,” he said.
“With a national e-health infrastructure in place, we estimate an investment in information networking of $3,000 per annum per GP clinic could deliver up to $668,000 in annual savings per clinic, mainly through prevention and avoidable hospitalisation. Up to $5 billion of the total savings from e-health investment in our model would come from improving connectivity and dissemination of information to and from GPs.”
Booz and Company’s analysis argues the case for Federal and State Governments to fund the information networking of GPs, as they would be the beneficiaries of the resulting savings. The firm estimates Governments would share in 68% ($5.2 billion) of annual savings accruing from a national e-health investment.
Other e-health benefits identified within the Booz & Company report include:
  • Better use of healthcare infrastructure
  • Less duplication of diagnostics such as lab tests and X-rays
  • Savings from optimised use of pharmaceuticals
  • Enhanced productivity among healthcare workers
  • Early warning from disease outbreaks
Based on current trends, the estimated total annual savings of $7.6 billion from e-health may represent 3% of total health expenditure. This figure does not include flow-on economic benefits to Australia, such as improved workforce productivity, which are estimated to be considerable.
Mr Boehncke said the health community was watching closely for signs from the Federal Government that it would commit to a significant investment in e-health.
“It did seem obvious that e-health would figure prominently in the reform agenda but there are now concerns it may have slipped off the table. That would be disappointing – there are good reasons why comparable countries overseas are investing heavily in this area, and the arguments for doing so here are irresistible,” he said.
Here is the link:
Even if these benefits were real, and I don’t believe the quantum cited for a moment, with the strides in hospital computing, GP computing and secure messaging in the last 6-7 years surely most of them have been captured. Of course the myHR was not even a twinkle in anyone’s eye in 2010, so who knows what impact it may, or may not, have. Of course its costs of the myHR are also not included.
Before more is spent we need current estimates of costs and benefits. I wonder when they might be produced or is the May Budget just to have more evidence free expenditure, or worse, expenditure based on evidence like this. Really if this is the best evidence the ADHA can put forward frankly we are all doomed!
I hope not!
David.

Tuesday, April 25, 2017

Weekly Australian Health IT Links – 25th April, 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

Rather a quiet week as we count down to the Budget on the Digital Health front. There seem to be a good range of topics this week.
I wonder when SA Health can get their act together – seems like a huge mess at present!
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Are Sonic and Primary sitting on digital health progress?

The wonders of modern digital connectivity are there for the taking, but there are elephants in the e-waiting room
By Jeremy Knibbs

21 April 2017
This is one of those stories that as a GP you won’t, on spec, be interested in. But only because you’ve never been told “what lies beneath” the story: the unnecessary, and potentially significant, retardation of better communication between the various important hubs of health information in this country, and therefore the slowing of delivery of much more efficient healthcare, via GPs, to their patients.
Ask most GPs what they think of the big private pathology providers and your response will be usually be somewhere between indifferent to unusually positive. One GP we asked is literally thrilled with the new mobile results service that Sonic Healthcare now provides through its path labs. To GPs, path results arrive through their patient management system with relative ease. What is there to be bothered about?
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Why are we communicating so badly?

Authored by James Dando
I AM too young to be familiar with fax machines. My parents had one, and I can vaguely remember them making fun of my grandfather’s skepticism of this “new” technology. I didn’t have to use one. That was until I started working in a hospital.
Now I use a fax machine almost daily, as well as other arcane technologies, such as the pager that has to be carried around at all times.
These rather quaint examples make for fun anecdotes to regale non-medical friends with, but they speak to something more profound: the generally abject quality of the communication tools employed by health care practitioners.
This is especially clear in our handling of medical records. It’s ironic, given that our profession takes so much pride in the ability to tell the story in a succinct and a systematic way, that we are so tolerant of platforms that obscure rather than illuminate the important points in a patient’s history.
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Optometry updated on digital health

Thursday, December 29, 2016
By Ashleigh McMillan
Journalist
A roundtable on the future of digital health in Australia has shed light on the implementation of My Health Record for allied health in 2017.
The event held on 7 December was hosted by Allied Health Professionals Australia (AHPA), of which Optometry Australia is a member, with support from the Australian Digital Health Agency (ADHA).
In 2017, pathology and diagnostic imaging will be added to the My Health Record, with Pharmaceutical Benefits Scheme data being used to ensure current medications are included in patient profiles.
ADHA chief executive officer Tim Kelsey announced at the event that his main goal was to assist secure messaging platforms in the health-care sector to communicate with each other.
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New telerehab study shows benefits to cardiac patients

18 April 2017

New Australian research released by the Journal of Physiotherapy again shows that governments and private health insurers should facilitate tele rehabilitation as part of the health system. This is another example of the growing benefit of digital health consultations to patients.
The study, conducted at Brisbane’s Princess Alexandra Hospital and The Prince Charles Hospital, showed that tele rehabilitation is as effective for improving exercise capacity, strength and quality of life in patients suffering chronic heart failure as traditional hospital outpatient rehab. Importantly, it also found that patients were much more likely to attend their rehab sessions when they were delivered by video as opposed to having to come into an outpatient clinic.
Exercise-based rehab increases physical function, improves quality of life and lowers hospital admission rates for people with chronic heart failure. However, cost and the availability of convenient rehab programs often prevents people from undertaking proper rehab.
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Agencies failing to meet cybersecurity norms

  • Anthony Wong
  • The Australian
Cybersecurity issues continue to grab headlines as industry and government focus on developing strategies to build capability and competitiveness.
Reports last week of security flaws in the wireless chips used in a wide range of Apple and ­Android mobile devices came hard on the heels of news that network-enabled toys are being used by hackers to access ­personal data.
At the same time, Gemalto’s latest Breach Level Index ­revealed 1.4 billion data records were compromised last year in 1792 major data breaches, which represented an 86 per cent ­increase in attacks over 2015.
In light of such revelations, it’s concerning to see that two of ­Australia’s three largest government agencies recently failed an audit of their cyber resilience capabilities.
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How we can fix poor quality data in GP software

18 April 2017

IMPROVING PRACTICE SOFTWARE

Less time would be spent on data scrubbing if software flagged problems.

THE ISSUE

Safety, quality and efficiency of care depend on high-quality clinical data.
General practice records are plagued by inferior data that decreases the quality and efficiency of care, and increases risk to patients and GPs.
Poor quality data causes frustration and embarrassment during care planning, clinical audit and research projects, and can lead to loss of incentive payments.
Incomplete or inaccurate data is usually uncorrected in the process of providing care.
Following discovery of poor-quality data during audits, practices spend some of their profit, as well as the time and energy of their GPs, practice nurses and practice staff, to undertake data cleansing.
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Doctors "lost control of ED" after planned EPAS shutdown: union

Doctors lost control of an Adelaide emergency department after the hospital's electronic patient health records system was switched off at the start of the hospital’s busiest day, a union inspection report says.
Bension Siebert @Bension1
Adelaide Tuesday April 18, 2017
A report penned by a doctors’ union inspector, obtained by InDaily, says medical staff at the Queen Elizabeth Hospital “effectively lost control of the patients and the service” during a 24 hour period late last month.
The crisis was caused by a severely overcrowded emergency department, a lack of available staff and hospital beds, and a planned shutdown of e-health system EPAS, which occurred during “the busiest day for ED’s and hospitals generally” says the report, by South Australian Salaried Medical Officers’ Association senior industrial officer Bernadette Mulholland.
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EPAS failings highlighted by death of former Socceroo Stephen Herczeg, inquest told

By court reporter Rebecca Opie
April 19, 2017
Questions surrounding the traumatic death of a patient whose oxygen tube was connected to his catheter may never be answered because of failings with South Australia's new electronic patient record system, a coronial inquest has heard.
Former Socceroo Stephen Herczeg, 72, died in the Queen Elizabeth Hospital (QEH) last September.
The chronic lung disease patient was admitted to hospital after a fall to treat a suspected urinary tract infection.
South Australian coroner Mark Johns started an inquest 35 days after Mr Herczeg's death amid concerns for patient safety.
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SA Health leadership turmoil due to recruiting wrong people

20 April, 2017
SA Health has admitted it recruited the "wrong people" to leadership positions after the Australian Medical Association (AMA) questions the "revolving door" of staff during a time of "immense change" within the public healthcare system.
On Tuesday it was revealed Central Adelaide Local Health Network interim chief executive Len Richards had quit after only two months in the job.
Mr Richards was appointed to replace previous CEO Julia Squire, who was sacked in January following an industrial dispute with the nursing union.
At the time, SA Health said Mr Richards would continue until after the opening of the new Royal Adelaide Hospital (NRAH), which is now only weeks away.
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SA Health executive roles "impossible"

The SA head of the Australian Medical Association has suggested SA Health's senior roles should be carved up after the under-fire department's boss admitted the high turnover rate of executives was damaging morale and leading to staff ignoring executive directions.
Bension Siebert @Bension1
Adelaide Thursday April 20, 2017
Interim Central Adelaide Local Health Network CEO Len Richards resigned yesterday after just two months in the role – the latest in a long series of resignations from top positions in Health in recent years. He replaced Julia Squire, who was sacked in January.
Speaking on ABC Radio Adelaide this morning, SA Health boss Vicki Kaminski said that the high turnover rate among executives at the department was affecting staff morale, and part of the problem was that the department was recruiting “the wrong people”.
She said some lower-level staff had stopped following executive directions because they did not expect the same individuals to be in their roles for long enough to make a difference.
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Patients to get live access to health summaries

21 April, 2017 Heather Saxena  
Patients at 180 GP practices will soon have access to their medical history via a $5.99 app.
The Australian-developed Meditracker app, which is being rolled out at IPN practices, gives live access to health summaries and medications.
Patients can also show their medication list to pharmacists to help avoid drug interactions or adverse events.
The app has been trialed at several IPN medical centres since January. It also links to various fitness trackers.
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Online psychology for bush a much-needed advance

MEDIA RELEASE THURSDAY, 20 APRIL
The introduction of Medicare cover for online consultations with psychologists for people in rural Australia is a welcome development, the Consumers Health Forum says.
“The expansion of telehealth services for country people is timely and appropriate particularly for psychological services when so many rural Australians currently miss out on this often critically-needed therapy,” the CEO of the Consumers Health Forum, Leanne Wells, said.
“The announcement by the Health Minister Greg Hunt and the Minister for Regional Development, Fiona Nash, provides a valuable signpost to making the most of telehealth in semi remote and remote Australia where a full array of multidisciplinary health services are often inadequate and rates of untreated illness are significantly above those in urban areas.
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Telehealth boost for rural psychological services hailed

21 Apr 2017, 10:30 a.m.
FARMERS and medical professionals have praised moves to enhance the delivery of virtual mental health support services into regional and remote areas of Australia, where standards are lower and suicides rates higher.
Regional Development Minister Fiona Nash unveiled the telehealth boost for rural psychological services that will cost $9 million over four years from 2017/18 to 2020/21.
Senator Nash said it was the first outcome from the Coalition’s Regional Australia Ministerial Taskforce that met for the first time last month of which Health Minister Greg Hunt is also a member and also backed the improved access to psychologists in rural areas through the introduction of a new Medicare rebate.
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New telehealth rebate for rural psychology consults

Antony Scholefield | 20 April, 2017 |  
Rural patients on GP-written mental health plans will soon receive Medicare rebates for teleconsults with psychologists.
From November, patients in select rural areas will be able to claim subsidies for seven video consults per year.
That's three fewer than the 10 face-to-face consults that presently attract subsidies under mental health plans.
Rebates will be available to patients in regions four to seven of the Modified Monash rural classification scheme.
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When patients slam you online, here's what to do

19 April 2017
These days, it is very common and quite easy for people to comment online about any experience they have, be it a meal at a restaurant or a holiday destination. This concept is being extended to patients rating doctors and medical practices through a growing number of websites and social media platforms — including through numerous online forums such as RateMDs, Truelocal and Whitecoat, on Google or Facebook.
It is never pleasant to read negative comments about yourself, particularly if you think they are unfounded. Sometimes, a negative online review is the first you know about a patient’s dissatisfaction with you during a consultation, with the staff at your practice or some other aspect of the care you provided. It doesn’t help that comments are often posted anonymously or under a pseudonym so you may not be able to identify the person to know if they were even a patient of yours.
Generally speaking, people are free to publish what they like, but subject always to the laws relating to privacy, defamation and, for example, sexual discrimination and racial vilification. Most websites and social media platforms will have privacy policies and terms of use that outline acceptable content and how to contact them if you want something removed.
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Tax Office commits to stop sharing personal data of its public servants

Noel Towell
Published: April 18, 2017 - 12:15AM
The Tax office has assured its 19,000 public servants that their sensitive employment data will no longer be shared with external private sector polling companies.
The pledge comes as further progress is made towards ending three years of industrial stalemate at the revenue agency.
Fairfax revealed last month that Tax Office secretly handed sensitive employment details on its own workforce to a private firm in an attempt to voter-profile an all-staff industrial ballot.
The ATO covertly supplied its contractor with the names, email addresses, locations of work and pay grades of each of its 19000 employees without their knowledge or consent.
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DHS challenges agencies to cyber wargames

By Paris Cowan on Apr 19, 2017 11:50AM

September battle heats up.

The Department of Human Services has laid down the challenge to Canberra’s biggest IT shops to go head-to-head in simulated cyber wargames this September.
The department’s CISO Narelle Devine says this is likely the biggest and first-of-its-kind security training exercise the government has staged.
The Australian Taxation Office, Department of Defence, and Department of Immigration and Border Protection have agreed to field teams of between five-to-ten of their best security professionals to battle it out over two days. A handful of other agencies are still waiting to opt in.
“If you learn how to attack you can defend well. If you can think like the cyber adversary then you’re going to be in a good place,” says Devine, a former Navy commander who joined the department in October last year.
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Virtual care at the cutting edge of digital health

By Australian Hospital + Healthcare Bulletin Staff
Friday, 14 April, 2017
Our Industry Comment guests for Autumn are HISA CEO Dr Louise Schaper and Nurse practitioner Matiu Bush, presenting at the Australian Telehealth Conference 2017 where they will be exploring trends and innovations in digital health technology.
Nurse practitioner Matiu Bush takes his passion for creative innovation to the next level — as a patient experience consultant co-designing with patients.
Matiu was the former nurse manager at Peter MacCallum Cancer Centre where he transformed the patient experience from waiting room through to consultation and rehab.
As the new Design Integration Lead at RSL Care, he is now revitalising service delivery for aged care patients across the country.
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Patient privacy breach: over 1600 medical letters found dumped in Sydney bin

Kate Aubusson
Published: April 21, 2017 - 4:52PM
More than 700 public patients have had their privacy breached and potential delays in their follow up care after more than 1600 medical letters were found dumped in a Sydney bin.
NSW Health is investigating the incident involving a sub-contractor for a company tasked with transcribing medical letters sent from specialists to general practitioners.
On Tuesday, April 11, a man found piles of follow-up letters containing patient details stuffed into a garbage bin at an apartment block in Ashfield. It is understood there were more than 1600 documents in total. Some of the letters were duplicates. 
The man called in his neighbour, a female health worker, who recognised the documents were out-patient letters and contacted Ashfield police. 
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#FHIR Testing is Coming

Posted on April 20, 2017 by Grahame Grieve
The FHIR Team has been working with the HL7 Education Work Group to introduce FHIR certification testing so that members of the FHIR community can demonstrate their knowledge of the specification. There’s going to be 2 levels of certification test.
FHIR Proficiency Test
This test ascertains whether a candidate has basic knowledge of the FHIR specification – what areas it covers, what resources, data types, and profiles are, some basic overview of the way RESTful interfaces work. This test is open to anyone, and it works very much like the existing V2 and CDA tests – though it’s a little easier than them.
Anyone can sit – and pass – this closed book test.
FHIR Professional Credentials 
This is a much harder test – it explores the functionality of the FHIR specification deeply, and to pass it requires considerable experience working with the specification. The idea of this test is that if you pass it, you’ve met our expectations for being an expert and providing advice to other implementers about how to implement the specification properly.
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Australian CEO stresses significant role of digital healthcare

  • By Constance Williams
  • Approval 2017.04.17 11:57
Modern, efficient data management not only benefits doctors and patients in overseeing individual cases but also promises a wealth of data that can be anonymized and aggregated for analysis and diagnosis.
Which is why healthcare experts such as David Hansen, CEO of the Australian e-Health Research Center, stresses the importance of the role of information and communication technologies in digital healthcare.
“A lot of people consider digital health to be from electronic medical records, but it’s much bigger than that; it’s about digital disruption of the healthcare system,” he said in an interview with Korea Biomedical Review on Wednesday.
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National Blood Authority recruits new CIO

Simon Spencer leaves Australian Public Sector Commission for NBA
Rohan Pearce (Computerworld) 21 April, 2017 12:30
The National Blood Authority has recruited Simon Spencer to take charge of IT at the government agency.
Spencer comes to the authority from the Australian Public Service Commission. He had been deputy CIO at the APSC since June 2015.
“He is an experienced ICT leader with nearly 20 years of experience across public sector organisations, including as a consultant and contractor,” NBA CEO John Cahill said in staff notice.
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Health in an age of information

Thursday, 20 April 2017
"Cause we are living in a material world
And I am a material girl
You know that we are living in a material world
And I am a material girl"[1]
You know these lyrics. Madonna's single "Material Girl" and its accompanying video were huge hits in 1985, and went on to define much of her career. But was she right? Is she really a material girl? And are we living in a material world? More than 30 years after she sang this song, we find that the world we live in is becoming less and less about material things, and more and more about information.
From the perspective of the national and global economy, information technology is a vast and growing sector that is displacing manufacturing in value and influence. A similar trend is apparent in the economy of our daily lives: financial transactions are routinely conducted electronically, and reliance on the physical tokens of notes and coins starts to seem quaint.
The rising influence of information even shows in our understanding of reality itself. We’ve known for some time that the apparently solid objects of our experience are composed of atoms that consist mostly of space. And as physicists probe ever more deeply, even subatomic particles seem less and less substantial. Some theorists go so far as to propose that this gossamer-thin materiality rests on a bedrock of – you guessed it – information.
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Enjoy!
David.