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."

Wednesday, November 01, 2017

This Seems Like A Very Interesting Step Forward In Digital Health For Patients And Their Professionals.

This press release appeared a few days ago:

HICAPS Go set to improve cost transparency for patients

Patients can now locate a practitioner, get a quote, pay for their consultation and claim their private health insurance benefit using a new one-stop healthcare app.

HICAPS Go, which has launched in Melbourne, provides patients with a simple and transparent experience which gives them more visibility on their out of pocket expenses before they see their healthcare practitioner and facilitates a completely digital process to pay their bill.
The app also and makes it easy for patients to locate, book and manage a health practitioner appointment.
“We have re-imagined the user experience for a digital age and built an Uber equivalent for Australia’s healthcare ecosystem,” NAB Chief Operating Officer Antony Cahill said.
“Through HICAPS Go, consumers get a better experience, more transparency in the cost process, added flexibility which helps improve the trust between them, their practitioner and their health fund.
“There is no other product in the Australian market at the moment like this, which provides such a smooth end-to-end experience from booking, to cost transparency and payment capability.”
HICAPS Go has been developed in partnership with Medipass, an Australian tech start-up who specialises in connecting patients to their providers and health funders.
Shelley Lampard, a 28-year-old customer experience manager in the leisure industry, said she had used HICAPS Go a number of times as part of the pilot program and found it to be simple and easy.
“I like the convenience of being able to do the whole process, from booking to payment, all through an app,” Ms Lampard said.
“I really like the transparency of being able to see what my healthcare rebate is going to be and how much I’ll be out-of-pocket.
“Then when it’s all done there’s no awkward wait time when checking out to process the rebate and any payment, it’s all done in the app with the click of a button.”
Cameron Hare, Practice Manager at Transform Physio, one of the platform’s early adopters, said the new digital extension of HICAPS would vastly improve transparency for customers.
“The transparency with the gap payment is really fantastic; with this new solution the gap payment is right in front of the customer and they can check before they pay,” Mr Hare said.
“With the old method I’d need to set aside five or so minutes at the end of each session to make sure I get through the billing process. But doing it with the new method means I don’t even have to leave the room.”
HICAPS Go currently has more than 400 practitioners on board the platform – with a focus on physiotherapists, chiropractors, myotherapists and osteopaths across the greater Melbourne area – and is compatible for customers who have private health cover with Medibank and AHM.
More practitioners and health funds will be added to the platform as it rolls out across the country over the next 12 months.
HICAPS Go leverages the current NAB-owned HICAPS payment/claiming terminal system.
As Australia’s largest business bank, NAB has a dedicated Specialised Banking segment which includes NAB Health; a team of health specialist bankers work exclusively with businesses and professionals in the healthcare industry across the country.
Find out more about the HICAPS Go experience here: https://www.hicaps.com.au/go
- How HICAPS Go works -
·         The HICAPS Go app can be downloaded from the Apple App Store and via the Google Play store.
·         Patients simply download the app, enter their private health membership details and credit card payment details.
·         This creates the connection to patient’s health fund via the HICAPS system (the NAB-owned payment and claiming system) and enables patients to get visibility from their fund for any applicable contribution towards their consultation (and any out-of-pocket expense).
·         Post consultation, patients can instantly claim health insurance benefits and pay only the gap portion using the app.
·         For practitioners and health funds, digital bookings and electronic claiming and payments reduce administration burden and manual processing, freeing up time for value-adding activities and more time with patients.
- About NAB Health -
NAB Health is a group of specialised brands (NAB Health, Medfin and HICAPS), financial solutions and dedicated health bankers who partner with healthcare providers to manage challenges and opportunities in the healthcare sector. The NAB Health Digital Hub offers advice and service to practitioners, from buying a practice, running a business, investing, insurance, super and tax requirements to selling a business: www.nab.com.au/health
- About Medipass -
Medipass is an Australian fintech, based in Melbourne. The company was established on the belief that a better health system demands better ways to connect and pay. We build digital health-grade payment solutions, connecting patients, practitioners and payers in ways that drive system efficiency and better experiences of care.  For more information on Medipass, visit www.medipass.com.au.
Here is the link:
There was also press coverage here:

New healthcare app helps claim private insurance benefit online

The National Australia Bank and tech start-up Medipass have launched a health app that enables consumers to locate a practitioner, obtain a quote, pay for consultation and claim private health insurance benefits.
Known as HICAPS Go, the app has launched in Melbourne. It leverages the current NAB-owned HICAPS payment/claiming terminal system.
“We have re-imagined the user experience for a digital age and built an Uber equivalent for Australia’s healthcare ecosystem,” NAB chief operating officer Antony Cahill said.
“Through HICAPS Go, consumers get a better experience, more transparency in the cost process, added flexibility which helps improve the trust between them, their practitioner and their health fund.
More here:
This little extract really sounds great for the Smartphone Generation!
“On your smartphone
HICAPS Go is also an app which makes it easy and simple for patients to find and book an appointment with a practitioner, get an upfront quote and out of pocket payment, as well as manage claiming and payment admin once the appointment is complete. 
As each transaction is completely online, patients no longer need to worry about insurance details, paper claims and other documents.”
The original HICAPS is pretty widely used (even my dentist for example) and I can see pretty side adoption given the apparent capabilities. It might also be a reason to hang on the that Private Health Insurance a little longer?
Good work to make the appointment and payment experience that little more bearable.
David.

Interesting The Things That Go On Largely Under Radar. Not Sure This Is An Optimal Approach?

This appeared last week.

How big data is shaping the future of general practice

25 October 2017

INSIDE STORY

The GPs at Dr Malcolm Clark’s group practice in suburban Melbourne felt confident in their management of diabetic patients. Then they received a data report that got them thinking.
“When we got the data back we could see this smaller group that we could do a better job with,” Dr Clark says. “We were able to identify patients who were good at dealing with their diabetes and those who were not.”
The data in question was in the form of a report produced by MedicineInsight, a data collection, storage and analysis platform provided by NPS MedicineWise (see How it works).
 Dr Clark’s practice is among 600 around the country that share patient consultation data with the network and receive feedback reports.
 In return, MedicineInsight stores the de-identified data for use by third-party researchers.
Dr Clark, a member of the MedicineInsight data governance committee, was among the first to join his practice up to the program.
He says the benefit of using the NPS MedicineWise tool over other practice software is the ability to look at trends in a meaningful way.
“It is good to be able to look at a group of patients and see how we can do better for them,” he says.
“General practice in Australia is funded like an emergency department but over the last 25 years chronic disease management has become  a big part of what we do.
“We are so much better at looking after those sorts of problems but GPs still treat a chronic disease like someone coming in with a cough or cold or a broken arm.
“They don’t get paid to sit around and look at the population group.”
With no fees and minimal additional paperwork, it sounds like a deal too good to be true for practices looking for a measure of performance and ways to improve patient care.
In August last year, however, the CEO of NPS MedicineWise, Dr Lynn Weekes (PhD), was forced to defend accusations that the organisation had sold out to Big Pharma after it was revealed that VentureWise, a commercial subsidiary of MedicineInsight, had  sold access to data to the pharmaceutical company Gilead Sciences.
 In an open letter published on the organisation’s website, Dr Weekes confirmed that two projects to date had received industry funding. These included a grant from GSK for a GP education program on inhaler devices and usage, and a research project funded by Gilead assessing the primary care management of renal toxicity associated with its HIV combination drug Stribild.
Professor Nigel Stocks, from the discipline of general practice at the University of Adelaide, chairs  the MedicineInsight data governance committee, which comprises  GPs and academic researchers, and says the projects were subject to the scrutiny of the committee.
“We are cautious about pharmaceutical companies applying to use the data,” Professor Stocks says. “The key things we consider are that the research question has to be for the public good, and the company has to go through a third party to analyse the data.”
On the question of how the data is used, Dr Clark says he understands the community suspicion surrounding relationships with industry.
“The role of the committee is to ensure that something doesn’t happen to cause reputational damage to NPS,” he says.
 “If you are collecting data on someone’s behalf and you are clear that the data will be used for not-for-profit stuff like academic research, then the altruism of giving data to NPS is understood. If, however, the data is being bought by a third party for profit you have to be crystal clear with the practices.”
Professor Stocks says the committee has rejected many applications, either because of  concerns over identification of the practices involved or because the data is in danger of misinterpretation.
“Any application to access the data needs a well-defined research question,” he says. “We have asked a number of applicants to better define their research question and we give them advice in terms of the difficulties they may have in utilising the data.”
For example, he says, in the consultation records it is not always clear what an antibiotic was prescribed for, or what a patient may have been allergic to, as GPs  use different labels for the same illness.
“Until we understand the variations in the labelling of the illness we have to be cautious of the interpretation that people apply to the results. We are very aware of data quality issues, it is far from perfect but it will improve over time.”
But not everyone is convinced the data from MedicineInsight is useful for the practices involved or for third parties that wish to access it.
Lots more here:
I wondered about consent and here is what I found:
“Practices are required to display information in the waiting room informing patients that data is being collected. The onus is on the patient to opt-out by requesting that their data not be shared.”
 I also looked in the articles for a mention of ethics committee approval. There was none.
Given the issues with data security and anonymization I really wonder just how well conducted all this is and why none of it has yet been published if the info is so valuable.
I think all these studies should really be ethics approved and deliberate conscious opt-in!
David.

Tuesday, October 31, 2017

I Reckon The NBN Jumped The Shark In Its Present Form This Week. The Pressure For Major Change And Improvement Is Enormous.

Rather than bore everyone with a gale of the NBN articles I am going to stick to one which really seems to say it all.

Problems plague transition to NBN for Aussie households: survey

Over one million (45%) Australian households who have connected to the national broadband network experienced issues when transitioning across to the service, according to a newly published research report.
Online comparison website iSelect says a new Galaxy Research study it commissioned to assess the attitudes of Australian households towards broadband services, reveals that 1.3 million Australian households who have connected to the NBN had issues with their transition.
And, according to iSelect, Australians now voice concerns about the speed of their broadband service, not so much about price and data allowance as previously raised.
According to the study, just over a third (36%) of Aussie homes have actually made the move across to the NBN.

And, just 44% of homes with the NBN said their home Internet was meeting their expectations and allowed them to “do everything they want online”, compared to 40% of those using ADSL2+ or other connection types.  
But, once connected, those homes with an NBN connection were slightly more satisfied with their internet service, the research reveals.
iSelect says the research also revealed that many Australians are very confused by NBN speed tiers despite the Australian Competition and Consumer Commission's recommendation for Internet providers to move away from unclear language such as “up to” when describing NBN speeds.
According to Laura Crowden, spokesperson for iSelect, the arrival of the NBN means customers now need to take speed into consideration when choosing the right broadband provider and plan.
“Aussies are used to choosing a home broadband plan based primarily on price and data allowance. For households moving across to the NBN, it can be really confusing to understand what the different NBN speed tiers mean and decide which one is right for them.”  
Crowden welcomed the ACCC’s request for retailers to make it clearer for what speeds customers can expect during peak periods.  
“This is definitely a step in the right direction but there remains a lot of variation between providers in terms of both their speed ranges and the names they use to describe them,” she explained.
“Terms like ‘boost’, ‘max’ or ‘superfast’ do little to clarify what speeds customers can realistically expect during busy times such as evenings.  It’s no wonder that many customers remain bamboozled by what the different NBN speed tiers will actually mean for them in reality.”  
Crowden says Internet providers have designed their plans around the NBN’s four speed tiers (12, 25, 50 & 100 megabits per second) but the NBN Co — the builders of the NBN — “does not consider 12Mbps plans to be superfast broadband”.
And, according to Crowden, many households are automatically opting for the cheaper NBN 12 plans without realising they are likely to be similar – or possibly slower – than what they experienced on ADSL2.  
More here:
The stats cited here are really alarming and if replicated with the rest of the roll out the backlash can be guaranteed to get rid of the present Government quick smart. The Government know that and so must be planning some big improvements – to be announced  I guess  after the Barnaby nonsense is resolved!
To not be seen fix this level of issue and dissatisfaction is electoral suicide in my view! Simply too many of us rely on decent internet these days to make it through the day and mobile won’t be up to the task for a couple of years yet.
David.

Monday, October 30, 2017

Weekly Australian Health IT Links – 30th October, 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

It has all been about the NBN (and Barnaby) during the last week of so… Seems people have noticed it is not turning out as promised. It is actually pretty sad IMVHO.
Lots of other stuff as well.
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How big data is shaping the future of general practice

25 October 2017

INSIDE STORY

The GPs at Dr Malcolm Clark’s group practice in suburban Melbourne felt confident in their management of diabetic patients. Then they received a data report that got them thinking.
“When we got the data back we could see this smaller group that we could do a better job with,” Dr Clark says. “We were able to identify patients who were good at dealing with their diabetes and those who were not.”
The data in question was in the form of a report produced by MedicineInsight, a data collection, storage and analysis platform provided by NPS MedicineWise (see How it works).
-----

My Health Record data breaches caused by “fraudulent behaviour or human error”

Lynne Minion | 25 Oct 2017
Fraudulent behaviour or human error were responsible for My Health Record data breaches, the Australian Digital Health Agency has confirmed, following the release of the Australian privacy commissioner’s annual report containing details of the security failures.
"This year we received six data breach notifications from the My Health Record System Operator,” the Office of the Australian Information Commissioner’s annual report says.
“These notifications related to unauthorised My Health Record access by a third party.”
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Healthier lifestyles for women recovering from cancer

25th October,2017
Increased physical and emotional health benefit for women recovering from cancer has been the outcome of a Griffith University wellness program which is now set to become widely used across Australia.
Led by Griffith’s Menzies Health Institute Queensland, and timely for Breast Cancer Awareness Month October 2017, the nurse-led study aimed to reduce the significant side effects associated with breast, blood and/or gynaecological cancers, whilst also reducing the risk of developing other chronic health conditions.
As part of the Women’s Wellness After Cancer Program, women aged 18 and over with cancer undertook an evidence-based e-health 12-week lifestyle intervention.
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Digital health chiefs demonstrate joined-up thinking as they hold summit in Leeds

Published: 13:12 Wednesday 25 October 2017
Leaders in the digital health field from opposite sides of the world shared their expertise at a summit meeting in Leeds. NHS Digital hosted a delegation from the Australian Digital Health Agency (ADHA) for the talks on how technology can improve health and care.
During the two-day event at NHS Digital’s head office in Leeds, executives from the two organisations discussed topics including cyber security, the NHS’s national digital systems and how to better involve patients in their own health and care.
Officials from NHS England and the Department of Health also attended. Sir Ian Andrews, non-executive director at NHS Digital and co-chair of the summit, said: “This was a really exciting opportunity to explore ways in which we can learn from each other’s experience and to identify opportunities for future collaborative working. It is clear that we face many of the same challenges.”
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Government cancer screening register delayed again: Labor

The Australian government's cancer-screening register will not be operational until March 2018, Labor has said, with Telstra again delaying the service to be delivered under its AU$220 million government contract.
By Corinne Reichert for Mobile Platforms | October 27, 2017 -- 01:42 GMT (12:42 AEDT) | Topic: Mobility
Australia's Shadow Minister for Health and Medicare Catherine King has accused Telstra of delaying the National Cancer Screening Register again, claiming the register will not be fully operational until March next year.
"The government said that this register and test would prevent around 140 cases of cervical cancer every year -- now it has been delayed by almost 12 months, they need to come clean about the deadly toll of this delay," King said.
"The national register will not be able to send cervical screening histories to pathology laboratories until March 2018 at the earliest, with laboratory staff concerned about the 'serious implications for patient safety'."
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Vale pharmacy as we know it: technology will “inevitably” change pharmacists’ role and lead to job losses

Lynne Minion | 27 Oct 201
Game changing technology will force dramatic shifts in pharmacy practice at a pace faster than lobby groups prefer or policy can keep up with, according to a new Productivity Commission report, ending the current retail model.
The ‘Shifting the Dial: 5 year productivity review’ studied factors likely to affect Australia's medium term economic performance, and predicted that technology will lead to increased mechanisation and job losses for pharmacists.
“Disruption and automation appears likely to produce job losses for some health occupations, notwithstanding growth in the healthcare sector,” the review found.
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Guild “strongly commends” real-time monitoring system

The Victorian Branch of the Pharmacy Guild has praised the state government for passing bill in Parliament last week

The Drugs, Poisons and Controlled Substances Amendment (Real-time Prescription Monitoring) Bill 2017 enables the rollout of SafeScript, which will monitor all Schedule 8 medicines such as morphine and oxycodone – which carry the highest risk of misuse – and other high-risk medicines, including all benzodiazepines such as diazepam.
Once fully implemented, it will be mandatory for prescribers and pharmacists to check the system before writing or dispensing a prescription for a high risk medicine.
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New medication app for staff working with people with dementia

Dementia Training Australia has released a new mobile app to assist staff involved in medication management to provide quality use of medicines for people living with dementia.
The Medication Management app is based on popular hard copy quick reference cards that were also developed by DTA.
DTA is funded by the Australian Government to provide dementia education and training across Australia.
The Medication Management app has two sections. The first provides information on the optimal use of antipsychotic medications for responsive behaviours; this includes medication management plans, monitoring, and side effects.
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Cochlear launches ‘world first’ Made for iPhone implant in Australia

Inventor of the bionic ear and hearing solutions company Cochlear has developed a “world first” Made for iPhone implant sound processor which it claims will significantly improve hearing for users in Australia.
Dubbed the “smallest and lightest” behind-the-ear cochlear implant sound processor available on the market, Cochlear says for the first time people living in Australia with severe to profound hearing loss can now reach the highest level of hearing performance with the Nucleus 7 Sound Processor, streaming sound directly from a compatible iPhone, iPad and iPod Touch to their sound processor.
The Nucleus 7 sound processor is 25% smaller and 24% lighter than the previous generation Nucleus 6 Sound Processor.
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Smartglasses help the hearing-impaired enjoy theatre

London's National Theatre is testing Epson Moverio BT-300 AR smartglasses to enable deaf and hearing-impaired people to read subtitles in their field of vision when they are watching any performance.
The National Theatre is one of the three most prominent publicly funded performing arts venues in the UK.
The BT-300 smartglasses feature Epson's silicon-based OLED digital display technology, enabling mobile augmented reality experiences. They are also the lightest binocular see-though smartglasses to date.
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Apple and Cochlear launch product that streams calls straight to implant in ear

Esther Han
Published: October 25 2017 - 12:15AM
When Julia Sattout had a Cochlear device implanted in her head five years ago, it didn't just restore her ability to hear again, it saved her career as a lawyer.
But there was one anxiety-inducing problem. Despite using the latest accessories, the simple task of picking up a call on her mobile phone often proved difficult.
"At one point I had a double adaptor, so I had a coil hooked over my right ear and an audio cable I had to plug into my sound processor," said Ms Sattout, 45 of Concord West.
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23 Oct 2017

HICAPS Go set to improve cost transparency for patients

Patients can now locate a practitioner, get a quote, pay for their consultation and claim their private health insurance benefit using a new one-stop healthcare app.
HICAPS Go, which has launched in Melbourne, provides patients with a simple and transparent experience which gives them more visibility on their out of pocket expenses before they see their healthcare practitioner and facilitates a completely digital process to pay their bill.
The app also and makes it easy for patients to locate, book and manage a health practitioner appointment.
-----

New healthcare app helps claim private insurance benefit online

The National Australia Bank and tech start-up Medipass have launched a health app that enables consumers to locate a practitioner, obtain a quote, pay for consultation and claim private health insurance benefits.
Known as HICAPS Go, the app has launched in Melbourne. It leverages the current NAB-owned HICAPS payment/claiming terminal system.
“We have re-imagined the user experience for a digital age and built an Uber equivalent for Australia’s healthcare ecosystem,” NAB chief operating officer Antony Cahill said.
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My Health Record security recommendations

23/10/2017
The Australian Digital Health Agency recommends:
We all understand the importance of health prevention activities – it is much better to avoid illness than have to cure it. It’s just the same with information technology (IT) – it is much better to secure your IT rather than deal with the consequences of not having done so. 
There are a number of things we can do to help secure the health information we handle, and at the same time help to protect against reputational and financial loss associated with cyber security threats.
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Simple steps to protect small healthcare businesses

23 October, 2017
The Information Security Guide for Small Healthcare Businesses (the Guide) is a simple tool produced by the Australian Digital Health Agency for every business to take simple steps to better protect their information.
The Guide, which was developed in partnership with the Australian Government's Stay Smart Online program, provides simple guidance for non-technical health professionals regarding issues such as privacy, passwords, software updates, back-ups and staff security awareness.
Healthcare providers are, rightly, focussed on providing quality care and patient outcomes, and sometimes information security can seem like an overly complicated and technical task.
- ----

#FHIR and R (Stats / graphing language)

Posted on October 27, 2017 by Grahame Grieve
I’ve spent the last 2 days at the 2017 Australian R Unconference working on an R client for FHIR.
For my FHIR readers, R is a language and environment for statistical computing and graphics. (Having spent the last couple of days explaining what FHIR is to R people).  My goal for the 2 days was to implement a FHIR client in R so that anyone wishing to perform statistical analysis of information available in R could quickly and easily do so. I was invited to the R Unconference by Prof Rob Hyndman (a family friend) as it would be the best environment to work on that.
My work was a made a lot easier when Sander Laverman from Furore released an R package to do just what I intended to do earlier this week. We started by learning the package, and testing it.
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HISA joins digital health showcase HealthHorizon

MTPConnect – the Medical Technologies and Pharmaceuticals Industry Growth Centre – today announced it will provide a proposed $100,000 provisional funding to a National MedTech, Pharmaceutical and Digital Health Showcase over one year, with proposed matched funding of $100,000 coming from the sector. The funding will allow the project to catalogue and track the progress of health innovations under development in Australia and make the information accessible to all on a public online platform.
The project consortium is led by Canberra-based start-up Health Horizon, and includes national organisations like Medical Technology Association of Australia (MTAA), Health Informatics Society of Australia (HISA) and Medical Software Industry Association (MSIA). Industry members of the consortium include ANDHealth (Australia’s only national mid-stage digital health integrator and accelerator), hospital and health services intellectual property management company Hospital and Health Services IP Ltd and Novartis Pharmaceuticals Australia. The academic consortium members include the Melbourne Academic Centre for Health and influential health innovation groups from QUT and the University of Newcastle.
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openEHR Task Planning – heading for implementation

Posted on by wolandscat
We’ve made a lot of progress since my last post on this topic. We have published a 1.0.0 version of the openEHR Task Planning specification, which will go into implementation immediately in the City of Moscow e-health project. The current version will certainly be changed by that experience, but we believe is good enough for use in implementation, having been reviewed and worked on by our development team, including people from Marand (provider of the Moscow EHR platform implementation), DIPS (largest EMR vendor in Norway) and others from Tieto (Finland) and Moscow.
We are currently looking at creating a visual language for it, of which the above diagram contains initial ideas for the TP conditional structures on the left, with BPMN equivalents on the right.
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Ipsos Global Advisor survey finds Australia ranks lowest for broadband satisfaction

Matt Wade
Published: October 25 2017 - 10:00AM
Australia has been ranked last out of 28 countries when it comes to broadband satisfaction, a new international poll shows.
Just 32 per cent rated the quality of Australia's broadband fairly or very good which was down 6 percentage points compared with a year ago and much lower than the international average of 56 per cent.
There were only two other nations in the international survey where fewer than four in ten respondents rated broadband as good - Italy (35 per cent) and Brazil (37 per cent).
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Problems plague transition to NBN for Aussie households: survey

Over one million (45%) Australian households who have connected to the national broadband network experienced issues when transitioning across to the service, according to a newly published research report.
Online comparison website iSelect says a new Galaxy Research study it commissioned to assess the attitudes of Australian households towards broadband services, reveals that 1.3 million Australian households who have connected to the NBN had issues with their transition.
And, according to iSelect, Australians now voice concerns about the speed of their broadband service, not so much about price and data allowance as previously raised.
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  • Oct 23 2017 at 11:16 AM

Time for government to act on NBN mess

Interviews with National Broadband Network chief executive Bill Morrow published on Monday show that the controversial project to bring Australia's telecommunications infrastructure into the modern age is a mess.
Pure and simple … from whichever way you look at it, it is a disaster both politically and for the hapless Australian population being told to accept second (or third or fourth) best internet speeds simply because we happen to live in a large, sparsely populated land mass … the unlucky country eh?
The way the NBN has been set up it has two main criteria by which it should be judged – is it providing Australians with world class broadband? And is it a successful business?
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Malcolm Turnbull says the NBN was a mistake and may never make money

James Massola
Published: October 23 2017 - 11:11AM
Prime Minister Malcolm Turnbull says that, in hindsight, the National Broadband Network project was a mistake and blamed the former Labor government for setting up a new government company to deliver the mammoth infrastructure project.
And Mr Turnbull, who was previously the Communications Minister in the Abbott government, admitted the giant project might never make back the money invested by taxpayers.
Despite this, the Prime Minister said his government had no plans to impose a levy or penalty on people who connect to the internet using mobile data connections, rather than the fixed line network.
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NBN CEO casts doubt on ability to turn profit

By Ry Crozier on Oct 23, 2017 6:55AM

Analysis: Your move, government.

NBN Co CEO Bill Morrow has confirmed what the industry has been saying for years: that the network builder’s economic model is broken and that - under current conditions - it may never turn a profit.
In a sensational interview with Fairfax Media pre-empting a damaging 4Corners investigation to be aired on Monday night, Morrow effectively laid out an ultimatum to the government: ditch the idea of making a return on taxpayers’ investment, or face more politically unpalatable options.
The NBN model has always been predicated on it generating an internal rate of return (IRR) on the $29.5 billion taxpayer investment in the project.
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Like it or not, you’re getting the NBN, so what are your rights when buying internet services?

October 23, 2017 6.03am AEDT
When buying internet services it pays to read the fine print. Dave Hunt/AAP

Author Jeannie Marie Paterson

Associate Professor, University of Melbourne
Most Australians will be forced to move onto the NBN within 18 months of it being switched on in their area, and that means navigating what can be confusing new contracts.
So, what are your rights regarding landline and internet connections?

Landlines

Many consumers can and do manage without a landline. But particularly for those without a reliable mobile service, a landline can be essential. It is included in many phone and internet “bundles” offered by internet service providers.
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  • Oct 23 2017 at 12:00 PM

If Wi-Fi is KRACK-ed what can you do to keep safe(ish)?

by Peter Moon
The news that most of the planet's Wi-Fi networks are at risk of being hacked has shocked the business world. Just search "WPA2" for a litany of reports that researchers have uncovered a gaping hole in the current standard for wireless security.
In brief, everything passing over most Wi-Fi networks is probably open to interception.
At times like this, grey hairs come into their own. We looked up a couple of tech veterans for their take on the nightmare news. They don't disagree for a moment that the threat is real.
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Enjoy!
David.

Sunday, October 29, 2017

Somehow Even The August Productivity Commission Has Been Drinking The Kool-Aide!

Early last week – before the High Court upended things a bit – we had a new major report released by the Productivity Commission.

Shifting the Dial: 5 year productivity review

Inquiry report

This report was sent to Government on 3 August 2017, then tabled in Parliament and publicly released on 24 October 2017.
This is the first document of its kind for the Productivity Commission — a look out across the landscape of factors and influences that may affect Australia's economic performance over the medium term, in order to offer advice on where our priorities should lie if we are to enhance national welfare.

Download the report

Here is the link to the Report page.
Health was a major focus in the report:

Healthcare fault lines ‘risk patients, funds’

  • The Australian
  • 12:00AM October 25, 2017

Sean Parnell

Australian doctors may be less inclined than their overseas counterparts to put patients at the centre of decision-making, and the primary care, public and private hospital sectors do not collaborate enough to improve healthcare, a review has found.
In an inaugural review to be repeated five-yearly, the Produc­tivity Commission has questioned the lack of integration and informed decision-making in health. Not only do these “fault lines” lead to substandard care and inequality, they waste hundreds of millions of dollars each year.
The findings yesterday prompted Treasurer Scott Morrison, who commissioned the review, to link the economic benefits of future health reform to better outcomes for patients.
“The pathway of patient care in Australia is all too often fragmented and plagued by poor or non-existent communication between different parts of the health system,” he said. “This veil of ignorance, where a doctor may not even be aware of significant health issues affecting their patient, can slow down the process of care, put the patient at risk, and lead to unnecessary procedures.”
The commission recommended funds be diverted to funding pools for primary health networks and local hospital networks to target problems at a local level. It also wants the Australian Commission on Safety and Quality in Health Care to drive better performance monitoring, data collection and reporting to aid transparency.
…..
While Mr Morrison has talked up the Coalition’s healthcare homes trial and a move to electronic health records, the commission had reservations. It suggested the homes trial was underfunded and should be better connected to local hospital networks to support people with chronic illness.
It said low public awareness of My Health Records pointed to a deeper problem: “Quite apart from the structural and attitudinal changes needed to the health system ... there is a glaring gap in peoples’ capabilities for exercising more control — a lack of health literacy. The majority of Australians have inadequate health literacy, and the share is greatest for those with chronic conditions. Even 40 per cent of people with a qualification related to health have inadequate health literacy.”
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More here:
I thought it was important to see what the PC actually said about the myHR.
Here it a summary… (Page 68 of the main report)

The role of My Health Record

An effective My Health Record is an important foundation for an integrated health system. The introduction of an opt-out system (compared with the initial opt-in approach) will lead to nearly universal coverage of Australians, as very few people in the trial opt-out sites chose to opt out. Given high take-up by providers, there is some promise that My Health Record can provide a central, lifelong depository for each patient’s medical records, regardless of provider, in an electronic format accessible by providers and patients.
There are compelling grounds to use My Health Record as a platform for providing clinically-proven advice to patients, rather than just as a method for collecting data for clinicians. For example, a person might be reminded of the potential need to have a vaccination or a screening test, such as a check for osteoporosis for post-menopausal women. The Australian College of Nursing supported a role of My Health Record as a source of information for self-care. The form of the advice that has the highest degree of compliance could readily be tested — the right words and the right technology (smart phone app, SMS, email, letter) — geared to the traits of the person. The clinician would ultimately be the decision maker (and their decision could be undertaken remotely in many cases). General practice could also receive online reminders. Currently, 56 per cent of Australian GPs say they routinely receive computerised reminders for guideline-based intervention or screening tests — though how often they act on these is not known.
There is some evidence of a lack of awareness by people of the potential uses of the Record. For example, only 971 people (0.002 per cent of registered users) had used My Health Record to lodge an Advance Care Planning Document, despite the relevance of such a document to all Australians. Clearly, communication of opportunity in data systems for patients is currently failing. This and other barriers will need to be overcome (section 3.2 of SP 5).
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So they are pretty keen – especially for patient use of the record – which we all know has been pretty abysmal to date.
But then you find this under the heading (Page 109 of Section 5)  “Things that Work”.
Integrated ICT: shared electronic health record, linked clinical and financial measures
“What it means for Australia”.
1. Invest in information technology and software for information flows throughout the system (Great idea)
2. Use My Health Record as the key patient record (WTF!)
That is all you need to read  – use of the myHR as the key patient record is just rubbish. It is not and was never intended to be the ‘key patient record’.  Sorry guys back to the drawing board – the Kool-Aide has got you!
Again we see bureaucratic lust for data and control overwhelm common sense. Pity about that because there is a lot in the rest of the report on pharmacy, integrated care and the like that is pretty good.
Again so called experts have gone ‘off the reservation’ on expectations for Digital Health!
David.

AusHealthIT Poll Number 394 – Results – 29th October, 2017.

Here are the results of the poll.

Do You Agree With Grahame Grieve (And Your Humble Pollster) That The myHR Is Architecturally Fundamentally Badly Flawed And That This Needs Correction If The myHR Is To Succeed?

Yes 99% (146)

No 0% (0)

I Have No Idea 1% (1)

Total votes: 147

I think this is the clearest vote ever! The myHR needs architectural change to succeed. Tinkering around the edge is an expensive waste of time and money!

Any insights welcome as a comment, as usual, especially regarding what might be done to fix things?

I begin to wonder who the single clueless person is who just likes to vote for the sake of voting?

A really great turnout of votes!

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

David.