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, November 23, 2017

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

November 23, 2017 Edition.
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Well the Don has come back from Asia proclaiming a brilliant success but with rather less conviction being expressed by most others!
The main news this week and for the next week or so will be the attempt to pass some “Tax Reform”. Currently it is hard to know how that will play out but you can be sure the poor are unlikely to be better off after it is done – if it ever is.
The main other issue has been a Senate Candidate who seems to be a child molester (9 women so far have complained) but he still thinks he can elected! He is hoping to outTrump Trump!
In the rest of the world things are in the usual mess with Syria and Myanmar hosting catastrophes and Brexit and Catalonia still unresolved.
Last, of course we have seen Mugabe deposed in Zimbabwe – oh joy and about 30 years too late!
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In Australia the results of the postal survey are on their way to becoming law – speed to resolution still unclear and we await the next polly to be caught out by Section 44 of the Constitution. We are already up to 9 having been knocked off!
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Here are a few other things I have noticed.
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Major Issues.

Why record low interest rates can't last

Jessica Irvine
Published: November 13 2017 - 12:00AM
If you're not confused about what's happening with the economy right now, you haven't been paying close enough attention.
Genuine head scratching at the highest echelons of economic policy making abounds.
Conventional economic wisdoms are being thrown out the window.
Of most concern to global central bankers and macroeconomy watchers is that the traditional relationship between falling joblessness and rising wages – otherwise known as the Phillips Curve – appears to many to be broken.
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Expect tax cuts, soon, says Deloitte Access Budget Monitor

Peter Martin
Published: November 12 2017 - 11:45PM
The federal budget is built on the back of impossibly large tax increases that won't survive the coming election, a new report has warned.
The Deloitte Access budget monitor, released four weeks ahead of the official budget update, finds that on the government's own forecasts by 2021 the typical Australian income will have climbed $6100, but the typical tax take will have climbed $2500.
The tax take of 41 per cent of each extra dollar is way in excess of the typical average rate of 14.9 per cent and the typical marginal rate of 32.5 per cent.
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Face the facts Australia - NZ is lapping us

Peter FitzSimons
Published: November 13 2017 - 12:18PM
Strange days indeed, most peculiar, Mama. Back in the day, on Wallaby and Waratah tours to New Zealand in the '80s and early '90s, we used to sneer a little unpleasantly about how . . . you know . . . provincial the Kiwis were. I mean, nice people and all, so long as they're not dressed all in black, wearing football boots and coming at you like herd of maddened bulls, but we had no doubt that, even as footballers for Gawd's sake, we were the sophisticates in the piece.
We were from Australia, you see, and were just so far ahead of them all in every field we could think of, bar the rugby field! But, bit by bit, things changed and it was the Kiwis who took in the lead on so many matters of progress.
At the 1999 World Cup, when the All Blacks sang their national anthem, they sang the first verse in Maori, and the practice took off soon afterwards, embraced by the whole population. Their racial politics is one where inclusion and integration are the shared goals of all races. Not long afterwards, Maori Television Service was established, a TV network devoted to the promotion of the Maori language and culture, after legal action was successfully taken forcing the government's hand, on the grounds that under the Treaty of Waitangi 1840, the British colonists had promised to preserve Maori culture. They have a treaty. It is taken seriously, and guides them.
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Australia: a nation of cash-poor millionaires

Elizabeth Knight
Published: November 14 2017 - 7:00AM
Who wants to be a millionaire? Forget the game show and the song titles – the average Australian household now has more than a million dollars in net wealth. The trouble is we are becoming increasingly cash poor.
While the value of our homes has risen to the point where the average household can boast millionaire status – on paper at least – Deloitte Access Economists has found 37 per cent of households are concerned about their ability to pay their bills and household costs. It expects this number to increase to 40 per cent within two years.
The major culprit has been the combination of slow wages growth and increases in the cost of living, including utilities, health costs and even groceries if taken on a 10-year view.
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Global credit market flashes early warning alert

Ambrose Evans-Pritchard
Published: November 13 2017 - 1:12PM
The credit markets have sharp antennae. They issued early warning alerts four to eight weeks before each episode of stress over the last 20 years, although with several false alarms along the way.
The shake-out in the US junk bond market last week had an ominous feel for traders and may finally mark the top of the post-Lehman boom in corporate credit. The exuberant reach for yield is nearing its limits.
"It is a sober moment. People are suddenly aware that central banks are turning serious and are not going to keep creating stimulus ad infinitum," said Marc Ostwald from ADM.
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RBA's Guy Debelle says non-mining investment is picking up

Eryk Bagshaw
Published: November 13 2017 - 12:03PM
There are signs of life returning to investment outside the mining industry, says the Reserve Bank of Australia, which is hoping business "animal spirits" will sustain spending in the services sector as the resources boom comes to an end.
"It now appears that there has been a solid upward trajectory in non-mining business investment over the past couple of years," the central bank's deputy governor Guy Debelle said in Sydney on Monday.
Dr Debelle said non-mining investment was around 17 per cent higher than in the first three months of 2008. 
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Why regulators are worrying about housing debt

Clancy Yeates
Published: November 14 2017 - 11:00AM
Barely a week goes by without some mention of Australians' record-breaking household debt.
You've probably seen the headlines: we have more housing debt relative to income than just about any country in the world, which would leave us vulnerable if there were another global financial crisis or a property bust.
Yet despite all these concerns, and tougher credit policies from banks, the debt pile is still growing faster than income. It recently hit a new record high as a proportion of household disposable income, at 190 per cent.
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Enough of the stuff: New tax break could help cure Australians of affluenza

Ross Gittins
Published: November 15 2017 - 1:05AM
If our grandparents could see us now, what would they think? They'd be amazed by our affluence, but shocked by our wastefulness.
You'd never know it to hear us grousing about the cost of living, but most of us are living more prosperous, comfortable, even opulent lives than Australians have ever lived.
We live in a consumer society, surrounded by our possessions. We're always buying more stuff, more gadgets, an extra car, more TVs for other rooms, more laptops, iPads and smartphones.
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Same-sex marriage postal survey: 'Love has had a landslide victory' as 'Yes' wins

Michael Koziol
Published: November 15 2017 - 11:44AM
Australians have emphatically voted in favour of legalising same-sex marriage, saying "yes" to the historic social change by a substantial margin of 61.6 per cent to 38.4 per cent.
After years of political stagnation, the public has now tasked the Turnbull government with changing the law before Christmas to allow same-sex couples to marry.
Almost 80 per cent of eligible voters participated in the unprecedented voluntary postal survey, giving the verdict an authority unmatched by most elections globally.
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SA dumps bank tax

The South Australian government has dropped its controversial bank tax and says it won't try and reintroduce it, even Labor wins the next state election.
Tim Dornin
Australian Associated Press November 15, 201712:34pm
The South Australian government has abandoned its controversial bank tax.
Premier Jay Weatherill says the levy, designed to raise $360 million from the big banks over the next four years, has no prospect of being passed in state parliament.
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Why interest rates will be lower for longer

Daryl Dixon
Published: November 16 2017 - 8:30AM
Despite the increasing concern of indebted borrowers about possible interest rate rises, continuing low inflation and a softening property market will ensure that even with likely rate increases overseas, Australian rates will remain low for longer.
At a macro-economic level, the Reserve Bank has recognised the mortgage stress that increases in interest rates to more normal levels would create. More importantly, the Bank considers that the Australian Prudential Regulation Authority's rule tightening has reduced the need for rate rises to slow down a buoyant property market.
Restrictions on overseas buyer purchases and an oversupply of apartments in Brisbane and parts of other major capitals has dramatically altered the situation of off-the-plan purchasers. Previously, the purchasers could be confident of obtaining loans at valuations close to their contract prices and have the option of selling their property for a profit before settlement date. 
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If you want to live even longer, you might not like what you have to do

Peter Martin
Published: November 16 2017 - 11:29AM
So you'd like to live forever.
I'm going to deliver some bad news, straight from this week's conference on the future of Australian lifespans. You probably won't even make 100.
Worse still, your children probably won't make 100, and maybe not even their children.
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How can we do democracy better?

Peter Hartcher
Published: November 18 2017 - 12:05AM
 Australia has just conducted "probably our boldest electoral experiment since the military conscription plebiscites of 1916 and 1917", in the words of Liberal Senator Dean Smith, the author of the private member's bill that will now carry the result of the marriage plebiscite into law.
"At a time when public faith in political institutions is being sorely tested, even opponents of the postal survey or plebiscites more generally" - and they included Smith himself - "must concede the Australian people have reminded us that they are the true custodians of our civic character."
Politicians on all sides tell us that now that the people have spoken, the Parliament will debate and legislate and show us "Parliament at its finest" or "Parliament at its best".
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Royal commission into child detention hands down 'disturbing' findings

Fergus Hunter
Published: November 17 2017 - 2:04PM
Posts
1:32pm on 17 Nov 2017   Fergus Hunter
Wrapping up
Thanks for joining us as we've gone through the royal commission's findings and recommendations and the reactions from political leaders and community groups.
To recap:
The commission has recommended wholesale change of the NT's youth detention and child protection systems to address "shocking and systemic failures". It says the problems have been ignored at the highest levels and called for the rapid closure of the Don Dale youth detention facility. 
The federal and NT governments have pledged serious action in response to the report. Community groups have made clear they will fight to make sure the recommendations are not forgotten and neglected.
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Why universities should never get to set their own fees

Ross Gittins
Published: November 18 2017 - 12:15AM
The Productivity Commission has changed its ideological tune, shifting away from the slavish adherence to an idealised version of the "neoclassical" model of the economy for which it and its predecessors became notorious.
It's moved to a more nuanced approach, recognising the many respects in which real-world markets differ from those described in elementary textbooks.
This shift has been underway since the present chairman of the commission, Peter Harris, succeeded Gary Banks in 2012.
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Coalition's crisis has a simple cause: it keeps supporting deeply unpopular policies

Richard Denniss
Published: November 18 2017 - 12:15AM
The times are a' changing. Australians voted overwhelmingly for equal marriage; the NSW and Victorian parliaments are achingly close to legalising voluntary euthanasia; and the Queensland Premier recently performed a spectacular backflip and committed her government to vetoing any federal government loan for the enormous Adani coal mine. A recent poll by the Australia Institute found 63 per cent of Queenslanders thought the loan should go to other projects; just 21 per cent wanted the money to go to Adani.
Conservative politicians have a loud voice in the media but are failing as spectacularly in their efforts to win over voters as they are to prevent the march of progressive policies. Just as Tony Abbott and Joe Hockey dumped most of the spending cuts that they proposed in 2014, the Turnbull government abandoned its plans to increase the GST and is crab-walking away from its promise to cut the company tax rate for big business. Most of the opponents of equal marriage hastily abandoned their plans to drag out the parliamentary debate with a focus on "religious freedom" in the face of overwhelming public support for marriage freedom.
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National Budget Issues.

  • Updated Nov 12 2017 at 11:45 PM

Cut imputation to fund company tax cut: academics

The Turnbull government could fund its company tax cuts by dumping dividend imputation in favour of a dividend discount or a Trump-style broadening of the base by denying interest deductions by companies.
Citing concerns about how Australia will afford to lower its corporate rate to 25 per cent, leading academics have modelled a series of reform options.
They include abolishing dividend imputation entirely, which would generate $11.1 billion a year at the 30 per cent rate.
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Scene set for tax cuts next year: Deloitte

Deloitte Access Economics' Chris Richardson doubts an improved budget bottom line will last, predicting the government will only just make a surplus in 2020/21.
Source: AAP 13 November, 2017 
An avid federal budget watcher believes personal income tax cuts will be on the agenda next year, a welcome relief with wage growth at a record low.
In coming to that position, economist Chris Richardson argues the budget is in better shape - at least in the short term - the government is behind in the polls and the tax take will rise relatively fast in the next few years, mostly from middle-income earners.
"That combination says tax cuts," Mr Richardson says.
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Report shows govt far from low taxing: ALP

Colin Brinsden, AAP Economics Correspondent
Monday, 13 November 2017 3:42PM
A new analysis discredits the Turnbull government's claim about being low taxing and further highlights the optimistic forecasts that underpin predictions of a surplus in 2020/21, Labor claims.
A Deloitte Access Economics report states that for every dollar saved on spending as part of budget repair, five dollars will come from higher taxes.
Shadow treasurer Chris Bowen says it wasn't long ago reducing income tax was the "great challenge of our time", but that's been replaced with income tax hikes for low and middle-income Australians.
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Health Budget Issues.

Health insurance reform: the good, the bad and the ugly

Authored by Hugo Wilcken
  • a requirement that insurers categorise their products as gold, silver, bronze or basic, depending on how much cover they provide;
  • discounts on premiums for adults aged under 30 years;
  • allowing customers higher excess limits for lower premiums;
  • allowing customers to upgrade policies to include full mental health cover with no waiting period;
  • providing travel and accommodation expenses to and from hospitals for rural and remote customers;
  • scrapping of rebates for a raft of complementary health therapies; and
  • slashing the cost of medical devices, such as pacemakers or joint replacements, for insurers.
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  • Updated Nov 13 2017 at 4:28 PM

Affordability challenge to Medibank's healthy prognosis

Craig Drummond has made some headway addressing the alarming increase in customer complaints and sliding market share he inherited when he took on the chief executive role at Medibank Private. There is still a lot more work to do though and his biggest challenge is the same one facing the industry as a whole – affordability.
As Drummond notes in his address to Medibank's annual meeting on Monday, the package of measures Health Minister Greg Hunt launched earlier this month will help chip away at the high costs of healthcare.
The more obvious savings will come from cheaper prosthetics and better access to mental health services. However, they are just the tip of the iceberg and analysts believe health insurers still face an uphill battle stopping Australians from ditching their policies because they are too expensive.
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Rate of private hospital cover continues to fall, new figures show

  • The Australian
  • 11:04AM November 15, 2017

Sean Parnell

The rate of private hospital cover in Australia continues to fall ahead of a series of reforms that Health Minister Greg Hunt hopes will make insurance more affordable and policies more transparent.
The latest figures from the Australian Prudential Regulation Authority, released yesterday, put hospital cover at 45.8 per cent of the population in the September quarter, down from 46.1 per cent in June. That is the lowest rate of coverage since early 2012, a downward trend blamed largely on the cost of premiums and erosion of the government rebate.
In response, the government is making a second round of cuts to prostheses prices and in March plans to introduce legislation to support discounts for young people, larger excess payments, regional and rural travel and accommodation benefits.
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Health insurance premium hike could be lowest in 13 years: Bupa executive

  • The Australian
  • 4:04PM November 14, 2017

Sarah-Jane Tasker

A top executive at Australia’s largest health insurer, Bupa, has hinted next year’s premium increase could be the lowest in almost 13 years as the government leans on the sector to address affordability concerns.
Dwayne Crombie, who heads up the Australian health insurance arm of UK giant Bupa, said given the focus on affordability concerns, it seemed obvious next year’s premium increase would be lower than this year.
“There is blunt pressure from the (Health) minister (Greg Hunt) and we are going through a process, so we can’t comment on the detail,” he said.
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Out-of-pocket health costs review needed more than ever

MEDIA RELEASE, FRIDAY 17 NOVEMBER 2017
Latest figures showing consumers are paying out more than ever to health funds and doctors, make it more important than ever for the Government’s proposed out-of-pocket costs project to result in a better deal for patients, the Consumers Health Forum says.
The Australian Prudential Regulation Authority figures show that in the 12 months to September, health fund revenue from members’ premiums rose at a faster rate than the amount they paid in benefits to their members.  Premium revenue totalled $23.3 billion, an increase of 4.3 per cent on the previous year while benefits totalled $19.7 billion, a rise of 3.7 per cent. The funds’ net profit after tax rose to $1.43 billion, up by 4.8 per cent.
“These figures might be healthy for health funds’ bottom line but they are not great medicine for private patients who not only face higher premiums but also a 5 per cent jump in out of pocket costs,” the CEO of the Consumers Health Forum, Leanne Wells, said.
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  • Nov 17 2017 at 11:44 AM

The great knees up: the operation that is bad for Australia

Knee arthroscopies are so popular in Perth that one of the city's top orthopedic surgeons advertises them on Facebook. In Sydney, health officials are trying to stamp them out. In Canberra, they are seen as an enemy of good public policy practiced by an entrenched medical profession.
The $5000 in-and-out procedure - which can help people improve their walking and running - has become an unexpected frontline in the national productivity debate.
Even though peer-reviewed research has found little or no benefit for many patients, especially those over 55, almost 30,000 arthroscopies were carried out in Australia in 2014-15, the latest period of public data.
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International Issues.

The truth Donald Trump's Asia trip confirms: Asia is sidestepping his clown act

Peter Hartcher
Published: November 14 2017 - 12:05AM
Is a clown on tour any less a clown? No. That's a truth that Donald Trump's Asia trip affirms. The region's nations are moving on, shaping a world where the US is still present but not leading. And that includes Australia.
If you'd ever wanted to see a case study in the soft bigotry of low expectations, it was the first part of Trump's trip. Because he didn't start a fistfight or insult his hosts, quite a few commentators gushed about the new serious Trump, the measured Trump, the strategist Trump.
Of course it was only a matter of time until the clown resumed his regular performances. He was soon in his element, exchanging schoolyard insults with the criminally despotic leader of a rogue regime. North Korea called him a "dotard".
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  • Updated Nov 14 2017 at 9:31 AM

The UK is at Europe’s mercy when it comes to a Brexit deal

by Gideon Rachman
Britain is drifting towards disaster on Brexit — without a viable diplomatic, economic or political strategy to make a success of the venture.
The central problem is that the British government is stuck between an implacable EU and an unrealistic Conservative party. The EU will not offer anything like the deal that Britain's Brexiters still dream of. But Theresa May's Conservative colleagues are still unprepared to accept this unpleasant reality.
In this paralysing situation, it seems increasingly likely the UK government will simply be politically and technically incapable of delivering a negotiated Brexit. As a result, the likeliest outcome is that, late in the day — perhaps in January 2019 — the EU will present Britain with a "take it or leave it" deal.
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Soldiers take over Zimbabwe broadcaster, explosions heard

MacDonald Dzirutwe
Published: November 15 2017 - 11:19AM
Harare:  Several loud explosions echoed across central Harare in the early hours of Wednesday after troops deployed on the streets of the capital and seized the state broadcaster, prompting speculation of a coup against 93-year-old President Robert Mugabe.
Some ZBC members of staff were manhandled when soldiers occupied the premises of Zimbabwe's ZBC, two members of staff and a human rights worker said. However, staff were told they "should not worry" as the soldiers were merely there to protect the site, one source added.
Earlier, the country's ruling party accused the head of the armed forces of treason as troops took up positions around the capital in a dramatic escalation of a dispute with Mugabe over political succession.
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Zimbabwe: Is it a coup? Sure feels like one

Adam Taylor
Published: November 16 2017 - 11:46AM
Military vehicles were stationed across Zimbabwe's capital early on Wednesday, with the country's long-time leader under house arrest. But is it a military coup? Not at all, according to the military.
"We wish to make it abundantly clear that this is not a military takeover," said a televised statement read by Major General Sibusiso Moyo, adding that the military was targeting "criminals" around President Robert Mugabe "who are committing crimes that are causing social and economic suffering in the country".
There are certainly those in Zimbabwe who seem to agree. On Twitter, journalist Maynard Manyowa described scenes of calm in Harare. "No coup here," Manyowa wrote.
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'This is a genuine crisis': The 'cliff edge' moment coming for Britain

Nick Miller
Published: November 17 2017 - 8:04PM
The British government has just lurched out of a horror fortnight, losing two senior ministers over serious misbehaviour.
Small beer, says the most excitingly named man in British politics, Lord Adonis (aka Baron Adonis, aka Andrew Adonis, Tony Blair's former head of policy). "All governments lose cabinet ministers because they behave badly," he says. "There are always more where they came from."
The real crisis is, and always has been, Brexit.
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Zimbabwe's ruling party set to sack Robert Mugabe on Sunday, sources say

Published: November 19 2017 - 3:51AM
Harare: Zimbabwe's ruling ZANU-PF party will meet on Sunday to dismiss President Robert Mugabe and reinstate the vice-president he dismissed, Emmerson Mnangagwa, two party sources told Reuters on Saturday.
The sources said a party central committee meeting scheduled for 10:30am local time would also dismiss 93-year-old Mugabe's preferred successor, his wife Grace, from her role as head of the ZANU-PF Women's League.
Mugabe's 37-year rule has been effectively at an end since the army seized control on Wednesday, confining him to his residence, saying it wanted to target the "criminals" around him.

Australia welcomes reported collapse of Islamic State 'caliphate' after three years of bloodshed

David Wroe
Published: November 18 2017 - 5:59PM
The Turnbull government has welcomed reports the Islamic State's so-called caliphate has fallen after the liberation of the last militant-held town in Iraq but signalled the group still needs to be fought globally as a terrorist outfit.
Late on Friday, Australian time, the Iraqi military announced it had retaken the town of Rawa on the Syrian border, the final hold-out for the militant group that swept across large areas of Syria and Iraq in mid-2014, sending shockwaves around the world.
About 1000 Australian military personnel have been involved in the fight against the group for the past three years, mostly in Iraq. These have included a large RAAF contingent, about 300 army trainers and several dozen special forces "advising and assisting" the Iraqis. There is no immediate news of their withdrawal.
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I look forward to comments on all this!
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David.

The Push To Try And Ramp Up Use Of The myHR Seems To Be Gathering Pace! I Wish They Would Spend Our Money More Wisely!

Two examples this week.
First we had:

Men Take Control of Their Health with My Health Record

Australian men need to take greater control of their health, announced the Australian Men’s Shed Association who is encouraging men to register for a My Health Record during Movember.
Gary Green, Community Engagement Manager at the Australian Men’s Shed Association, said they are partnering with the Australian Digital Health Agency to distribute My Health Record toolkits to members around Australia.
“This is an important step and opportunity for men to take more control over their health. The Men’s Shed movement aims to advance the wellbeing of Australian men and My Health Record is another step towards achieving this goal,” Mr Green said.
“We are pleased to be able to collaborate with the Agency to support the distribution of My Health Record to around 1000 Men’s Sheds and their members across Australia.”
Agency CEO Tim Kelsey believes that My Health Record provides many valuable benefits for men.
“Encouraging men to discuss their healthcare concerns with their doctor, pharmacist or other healthcare specialist can be difficult,” said Mr Kelsey.
“My Health Record supports and assists men to have these conversations; enabling better connected care and, ultimately, better health outcomes.”
My Health Record gives men (and the broader community) the capacity to upload important health information including allergies and current medications; and they don’t need to remember the dates of tests, medicine names or dosages.
More here:
and second we had:

Significant progress made in integration of My Health Record with pharmacies in Australia

By: Priyankar Bhunia
17 Nov 2017
My Health Record has been integrated with three pharmacy software solutions. In addition, a partnership has been reached with the peak national body representing pharmacists.
Pharmacists can now upload dispense records and view hospital discharge summaries, shared health summaries, and allergy information to My Health Record using enhanced Minfos, POS Works, and RxOne software. All three provide software solutions for pharmacies.
This is a result of close cooperation between the Australian Digital Health Agency (the Agency) and the Medical Software Industry Association (MSIA). It follows the launch of the Community Pharmacy Software Industry Partnership earlier this year. (In July, a partnership was initiated with the Pharmacy Guild of Australia.)
Connection to My Health Record is an important step to enabling pharmacists to play a more integrated role in medications management and coordinated care. Pharmacists can have timely information on a person’s current medications, whether dispensed at hospital discharge, or through any community pharmacy in the country.
My Health Record also provides pharmacists access to clinically relevant information from other healthcare providers including hospital discharge summaries, GP shared health summaries, and consumer-entered information about over-the-counter medications and other supplements.
Agency CEO Tim Kelsey said the announcement represents an important milestone to promote the safer use of medicine – and reduce the estimated 230,000 hospital admissions each year due to medication errors. (Click here for OpenGov’s recent interview with Mr. Kelsey where he talks about how the Agency is working to create a seamlessly-connected digital healthcare system for Australia.)
“I congratulate Minfos, POS Works, and RxOne for introducing this important capability. Pharmacists using these clinical systems will enjoy greater access to medical information about their customers and will seamlessly contribute important information on dispensed medicines in their customers’ My Health Records,” Mr. Kelsey said.
Other software providers are well advanced in their development work and are expected to integrate with My Health Record system in the coming weeks. Mr. Kelsey said that an enormous amount of work has gone into co-designing a solution with consumers, healthcare providers and the software industry, leading to this milestone for software organisations who took up the Agency’s industry offer.
MSIA President Emma Hossack said programs involving private enterprise and the government depend upon goodwill and trust.
“This project is proof of the new working relationship between the Agency and industry. It demonstrates what can be achieved in a relatively short time and augurs well for other jointly owned digital health improvements,” Ms. Hossack said.
Pharmaceutical Society of Australia National (PSA) President Shane Jackson said that conformant software is an important first step in connecting more community pharmacy software providers to My Health Record.
Co-sponsor of the Agency’s Medications Safety Programme Dr Steve Hambleton said that the addition of Minfos, POS Works, and RxOne to the suite of pharmacy software that can interact with My Health Record is another milestone in the rollout of better, safer care.
Lots more here:
I have to say I do have some worries with the security of data in the myHR with all those point of care pharmacy systems – which are often in reasonably open spaces – having access to the myHR, but it does seem the ADHA is pushing on regardless to flog this dead system to as many as possible.
If only they would pause, rethink and move on in better ways that might actually really work. Right now almost no-one seems to really want to use the myHR.
David.

Wednesday, November 22, 2017

There Are Lots Of Exciting Visions For Digital Health Out There! I Often Wonder How Real They Are?

Three forward looking articles  appeared last week:
First we had:

How data is ushering in the era of personalised healthcare

AI, augmented reality and vast amounts of data will help drive a new revolution in healthcare, Murray Brozinsky says.
Rohan Pearce (Computerworld) 15 November, 2017 06:00
Roughly every half century, there’s an innovation that drives a revolution in healthcare, according to Murray Brozinsky.
In the 1840s it was the use of anaesthesia in surgery; in the 1870s, germ theory. Then in the 1920s penicillin was discovered, and in the 1970s evidence-based medicine emerged on the back of the use of randomised clinical trials.
“We are at the dawn of the next revolution,” Brozinsky — the chief strategy officer of health technology firm Conversa — yesterday told Commonwealth Bank’s Future of Health conference. More than 100 of the bank’s corporate clients attended the conference, held at Telstra’s Customer Insight Centre in Sydney.
That revolution is the emergence of digital healthcare: Personalised healthcare driven by the availability of an enormous amounts data and the technology to leverage it. In 2020, there will be 25,000 petabytes of health-related data, Brozinsky said — “that’s roughly 500 billion four-drawer filing cabinets that would contain 500 times all of the written words since the dawn of human history”.
“We’re starting to get a glimpse of what that revolution is,” he told the conference. Evidence-based medicine draws on data but treats the “average” patient, Brozinsky said.
“We’re driven by clinical trials, which uses a set of patients to provide a standard of care or a guideline for the rest of the population — many of whom don’t look like those patients. And now we’re moving to a world where instead of treating the average patient, we’ll treat the individual person.”
That shift will be enabled by drawing on a vast array of data — including clinical data, genomic and other omics data, demographic data, data collected from sensors and patient-reported outcome data.
“In oncology we have treatments today that we know don’t work in 70 per cent of cancer patients,” Brozinsky said. “We need to move to a world where we know that the treatment will work 100 per cent of the time in the right 30 per cent of cancer patients. That’s personalised health.”
Artificial intelligence, blockchain, telehealth, virtual and augmented reality, sensors, 3D printing and, further down the track, CRISPR and SENS, are all set to change the face of healthcare, Brozinsky told the conference.
Lots more here:
And then we had this:
17 November 2017

Whatever happened to our digital health utopia?

Posted by Felicity Nelson
The digital health revolution has been a long time coming.
Once it arrives, we are told, everything will run at peak efficiency, for less money, with higher quality care, greater transparency and immaculate interoperability.
The digital data trinity – electronic medical records, artificial intelligence and big data – will, futurists claim, metamorphose healthcare.
But this sparkling vision grates uncomfortably against the reality; the dull dialling of fax machines can still be heard in most waiting rooms around the country. Frustrated, sick patients still cannot access their most basic medical records remotely online.
Experts came together this month at the Medical Technology Association of Australia annual conference in Sydney to discuss what is being done to close the expectation gap between what technology can do, and what it is actually doing right now.
Australia has fallen behind much of the Western world in terms of hospital digitisation; while the US has around 2000 “digital” hospitals, Australia currently only has three.
But significant work was under way to push many more hospitals into the digital age, Richard Royle, the national digital health leader at PricewaterhouseCoopers Australia, said
Australia’s first fully integrated digital hospital, St Stephen’s Hospital in Hervey Bay, Queensland, went live in 2014.
Since then, two additional hospitals have reached the highest levels of digitisation (called HIMSS Level 6): the Princess Alexandra Hospital in Brisbane and The Royal Children’s Hospital in Melbourne.
Mr Royle was the man behind the pioneering project at Hervey Bay.
As the former executive director of Uniting Care Health, Mr Royle transformed the Queensland facility using $47 million in funding from the former Gillard government.
Gone were the laborious, time-sapping and inaccurate paper records at this “hospital of the future”. Instead of clinicians at St Stephen’s having to write down the heart rate, blood pressure and temperature on the patient chart, data was automatically fed from monitoring systems into the electronic medical record.
The system nudged clinicians towards best practice by displaying standardised clinical decision-making pathways, Mr Royle said.
Medications used at St Stephen’s were packaged in individual, barcoded dosages and fully tracked to reduce waste and medical errors.
Doctors could also receive alerts about their patients in real-time, including information on allergies, medications, abnormal vitals and test results.
“The ability for the clinician to look on his or her laptop at home for the live vital signs, to be able to review and change the medications, to be able to talk directly with the staff who are treating the patients, that’s gold for the doctors,” Mr Royle said.
While Australian hospitals weren’t exactly embracing a digital future yet, there was significant traction occurring, particularly in NSW. But getting digital projects off the ground required engagement at all levels – from patients, to clinicians, up through management and inside parliament, he said.
A major obstacle was the cost. At around $50,000 to $70,000 per hospital bed, the price of digitisation remained steep. Mustering the political will to fund these projects was difficult, as the investment would only start produce efficiencies well into the following election cycle.
The government was also nervous about disasters in digital health because these could be very high profile and they hurt people, Mr Royle said.
Vastly more here:
and third we had this:

Transform GP care and trash fax machines, new digital healthcare report says

Lynne Minion | 17 Nov 2017
Abandon the idea of continuous GP care and throw away your fax machine - a new Microsoft report has told Australian healthcare it needs to undergo a dramatic change in mindset and get with the digital revolution.
Embracing the Change Mandate: The 2020 Digital Transformation Agenda for Australia’s Health Care Sector gathered input from a number of Australian experts, with GP and president of the Australasian College of Health Informatics Dr Chris Pearce claiming we are on the verge of the most significant shift in how healthcare is delivered since the scientific method arrived.
The ‘GP for 30 years’ care delivery model will disappear, according to Pearce, with patients already seeking primary care from five different clinics and 11 doctors in their lifetime.
“One of the cornerstones for general practice has always been this concept of continuity of care. But the reality for a large percentage of the population is that they are usually young, relatively fit people and there is no need for continuity of care – a vaccination here, a sore knee there – and that’s fine,” Pearce told Healthcare IT News Australia.
More here:
You can download the report here (with the usual seeking of details to permit pestering you with marketing):
Sadly I have been reading enthusiastic stuff like this for at least the last 15 years and so far very little of it seems to have come true – will the riskiest saying in finance and elsewhere actually come true in saying ‘this time it is different!” and actually mean it!
We will see! Comments welcome if you are a believer or not!
David.

Tuesday, November 21, 2017

The ADHA Issues Its First Annual Report - Not Much That Is New I Have To Say.

This appeared last week:

Annual Report 2016-17: New momentum for digital health in Australia

Tuesday 14 November, 2017
The first Annual Report of the Australian Digital Health Agency has been tabled in Parliament – it highlights a new partnership between governments, clinical and consumer leaders, industry and the research community to put real momentum behind bringing the benefits of digital health services to all Australians.
Significant progress has been made in the last year, the report says: Australia has a new National Digital Health Strategy endorsed by all health ministers; My Health Record is on track for national expansion in 2018; and new initiatives to enable secure paperless communications between clinicians have been launched.
Agency Chair Jim Birch AM said that the Agency is tasked with improving health outcomes for all Australians through the use of digital health technologies.
“Technology is already transforming our ability to predict, diagnose, and treat disease. But there is much more we can do to realise its full potential for the health of every Australian: giving consumers more control of their health and care, connecting and empowering healthcare providers and promoting Australia’s global leadership in digital health and innovation,” Mr Birch said.
In its first year the Agency has built a new organisation, connected hospitals and health services to My Health Record, improved the user experience for the 5.3 million registered Australians, and grown the volume of clinical document sharing with 14 million prescription and dispense records now uploaded.
Agency CEO Tim Kelsey said: “The Agency is here to serve the patients and citizens of this country – and would like to thank all our partners in the community – leaders in patient and consumer services, in clinical practice, industry and research, as well as the governments of Australia - for their continuing commitment and collaboration to ensure that everybody has access to the benefits of digitally empowered health services.
“Digital information is the bedrock of high quality healthcare and our shared goal is to ensure that all Australians benefit from the increasing number of digital health services,” Mr Kelsey said.
ENDS
Media contact
David Cooper, Senior Media Manager
Mobile: 0428 772 421 Email: media@digitalhealth.gov.au
About the Australian Digital Health Agency
The Agency is tasked with improving health outcomes for all Australians through the delivery of digital healthcare systems and the national digital health strategy for Australia. The Agency was established on 1 July 2016 by the Australian Government as a statutory authority in the form of a corporate Commonwealth entity, and reports to all Australian governments through the COAG Health Council.
www.digitalhealth.gov.au
Here is the link:
In the best NEHTA tradition there are a zillion happy smiling Digital Health Users and a lot of positive reporting.
Fun Facts:
1. As of 30 June, 2017 there were 247 employees (Temp and Permanent).
2. Agency Funding 2016-17. The Agency is jointly funded by the Commonwealth ($120.892 million) and the states and territories ($32.25 million) reflecting the commitment at all levels of government to the delivery of digital health reform. Note is seems the States are paying a lot less than they were under NEHTA! with the Commonwealth paying more.
3. Registrations:
 In 2016-17 the Agency, as System Operator, registered 1,120,817 people for a My Health Record. There were a total of 20,151 cancelled registrations during the year.
In 2016-17 the System Operator registered an additional 1,320 healthcare provider organisations. 89 registrations were cancelled or suspended.
4.Usage:
A total of 664,278 people accessed their My Health Record via the consumer portal in 2016-17.
A total of 2,217 unique healthcare provider organisations, via their clinical information systems, viewed records in the My Health Record system during 2016-17.
A total of 4,538 unique healthcare provider organisations uploaded records to the My Health Record system during 2016-17.
A total of 218,776,890 documents were uploaded to the My Health Record system in 2016-17.
5. Breaches:
35 data breach notifications were reported to the Office of the Australian Information Commissioner as required under Section 75 of the My Health Records Act 2012 (concerning potential data security or integrity breaches). Twenty-nine of these were reported by the Chief Executive Medicare as a registered repository operator under Section 38 of the Act.
6. Complaints:
In 2016-17 a total of 64 complaints were made in relation to the My Health Record system and, as of as of 24 July 2017, one remained open.
7. I could not find a single issue that was seen as a problem and all seems to be going fine.
A small reward is offered for anyone who can find a self-critical comment in the report. Maybe next year?
David.