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."

Sunday, April 29, 2018

AusHealthIT Poll Number 420 – Results – 29th April, 2018.

Here are the results of the poll.

Do You Expect General Data Protection Regulation (GDPR) Like Regulations In Australia Over The Next Few Years?

Yes 12% (16)

No 80% (105)

The General Data Protection Regulation (GDPR) Is A Total Mystery To Me 7% (9)

I Have No Idea 1% (1)

Total votes: 131

Looks like 80% see no revamp of personal data protection in the next few years.

I believe the majority are wrong – but there you go!

Any insights welcome as a comment, as usual.

A really, really great turnout of votes!

It must have been a really easy question as just 1 reader was not sure what the appropriate answer was.

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

David.

Saturday, April 28, 2018

Weekly Overseas Health IT Links – 28th April, 2018

Here are a few I came across last week.
Note: Each link is followed by a title and 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.
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How a single source of truth database is helping one health system drive analytics success

Health Quest concluded it needed one database to help inform its approach to various clinical, financial and operational initiatives.
April 19, 2018 02:22 PM

Health Quest, a Hudson Valley-based health system comprising four hospitals and provider organizations, decided it needed a single source of truth database where it could send its staff for projects focused on achieving the Triple Aim.
With some work, it was able to combine its homegrown enterprise data warehouse with another developed by vendor Health Catalyst.
With that goal achieved, Health Quest is now seeing results.
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April 19, 2018 / 9:05 AM / 2 days ago

AI pharma firm BenevolentAI raises $115 million in funding

LONDON (Reuters) - BenevolentAI, a British pharmaceutical company that uses artificial intelligence to identify new drug candidates, said it had raised $115 million in a funding round that valued it at $2 billion. 
The company, which has more than 20 drugs in development, said it would use the funds to scale its activities, broaden the disease areas on which it focuses, and extend its AI platform capabilities.
Founder and chairman Ken Mulvany said the company had grown rapidly since it was founded in 2013.
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Is Your Health Data About to Get Hacked?

In March, Under Armour announced that the accounts of more than 150 million MyFitnessPal users had been compromised. What does that mean for the rest of the workout app industry?

Apr 19, 2018
Data breaches are now literally more than a daily occurrence—2,216 happened in the past year alone, according to Verizon’s annual Data Breach Investigations Report, released on April 10.
Health-related organizations accounted for a quarter of those incidents. Three weeks ago, that group claimed a troubling new member: Under Armour’s MyFitnessPal, which announced a data breach had exposed information (usernames, email addresses, and passwords) of up to 150 million users.
This is the first known data breach of a major consumer fitness app. (In 2016, Fitbit suffered a small breach, but the issue involved just a few dozen accounts where hackers stole user passwords independently, and used the accounts to seek fraudulent refunds.) But it likely won’t be the last. And what’s at stake is data far more intimate than passwords and usernames. Fitness trackers know our heart rates and step counts. They know we didn’t sleep well last night, maybe because they also know we ate barbecue and had a couple beers. And they track detailed patterns on when and where we like to work out, with whom, and where we live.
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FDA's 2019 budget request cites digital health; agency rolls out medical device initiative

April 18, 2018
Digital health appears to be making its way onto the national stage. Yesterday, FDA Commissioner Scott Gottlieb gave the field a shout-out in his remarks to the US House Subcommittee on Agriculture, Rural Development concerning the Fiscal Year 2019 budget request for the FDA. 
“The Budget requests new resources for the FDA to make significant investments in advancing critical areas of science, domestic technology and public health,” Gottlieb said to the subcommittee.  “Among these efforts, we're seeking to advance a new paradigm in the regulation of digital health technology that I believe will allow us to grow this promising field more quickly.”
The President’s Fiscal Year 2019 budget request asks for a total of $5.8 billion for the FDA, which means an increase of $663 million or 13 percent more than the FY 2018 Annualized Continuing Resolution, according to Gottlieb. 
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NHS Digital’s sharing of non-clinical patient data branded “inappropriate”

17 April 2018
NHS Digital’s sharing of non-clinical patient information with the Home Office has been branded “entirely inappropriate” by MPs, who say they are concerned about the body’s ability to act as a reliable steward of the data.
The Health and Social Care Committee launched an inquiry into the memorandum of understanding (MoU) on data sharing between NHS Digital, the Department of Health and Social Care and Home Office.
The memoradum, which came into effect in January 2017, allows the Home Office to gain access to patient data – including non-clinical information – for the purpose of tracing immigration offenders and vulnerable people.
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HIT Think How automation is thwarted when humans get involved

Published April 20 2018, 3:41pm EDT
Automation holds incredible power to streamline our work and personal lives and is a significant contributor to the progress being experienced in healthcare. Automation has a huge impact on lowering cost, but too often “automated” processes require far too many manual touches.
It’s hard to think of another industry where data plays such a dynamic role, with millions of transactions occurring daily between healthcare providers and suppliers. Automation has helped to speed those orders and payment transactions, but too often, price discrepancies, bad data or other data errors require manual intervention that disrupts the entire process, creates more opportunity for error, and raises overall costs. It’s the cascading effect of humans.
What’s needed is a heightened priority for validating the accuracy of data before sending it through to the next function in the order-to-pay process. The best way to get speed into the process is accuracy. Errors will always stop automation cold.
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AMIA letter casts broadband as a social determinant of health

Published April 19 2018, 7:21am EDT
The American Medical Informatics Association is calling on Congress to provide some kind of exemption for healthcare uses of the Internet from recently finalized federal rules on net neutrality.
The professional organization this week wrote letters to Reps. Marsha Blackburn (R-Tenn.) and Michael Doyle (D-Pa.), leaders of the House Energy and Commerce committee, which recently held a hearing on the issue of Internet prioritization.
“We’re trying to say that when Congress thinks of policies impacting availability of and cost of broadband, they have to know that care has become digitized,” says Jeff Smith, AMIA’s vice president of public policy. “How we give care has become digital.”
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Telemedicine can accurately diagnose rare cause of preemie blindness

Published April 19 2018, 7:23am EDT
Telemedicine has been shown to accurately diagnosis a rare cause of blindness in premature babies as effectively overall as in-person eye exams.
Researchers from Oregon Health & Science University teamed with seven medical institutions to examine the eyes of 281 infants who were at risk for retinopathy of prematurity (ROP), a rare but devastating cause of blindness in preemies.
They compared the accuracy of in-person exams with digital eye images that were remotely evaluated using telemedicine and found that there was no difference in the overall accuracy between the two evaluation methods. Results of the study were published in the journal JAMA Ophthalmology.
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Interoperability at top of CMS, White House agenda

Published April 19 2018, 7:24am EDT
Interoperability is a top priority for the Centers for Medicare and Medicaid Services and the White House as well, according to Kate Goodrich, MD, chief medical officer and director of the CMS Center for Clinical Standards and Quality.
There’s “lots of ongoing work around interoperability,” including coordination with the Office of the National Coordinator for Health IT and the Department of Veterans Affairs, said Goodrich during Wednesday’s HIT Advisory Committee Meeting.
“We are looking very broadly at all of the levers we have within CMS around how we can promote interoperability,” she added. “There were a number of roundtables held at the White House around this topic, which actually gave us a lot of terrific ideas that we are actively exploring. You will see some provisions intended to enhance the ability for folks to have access to their data from a patient-centric point of view.”
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Special Report: Diagnostic digital pathology

While experts welcome the current interest in diagnostic digital pathology, they believe that implementation of digital workflows, which includes integration between systems and software, is key to achieving widespread adoption and driving improvements. Claire Read reports.
As a key voice in digital pathology, Darren Treanor admits with a chuckle that people probably expect him to have foreseen the “absolute explosion” of interest in the field over the past 12 months.
But after over a decade as one of the few UK pathologists using the technology – in which slides are scanned into a computer for review, rather than being viewed on a glass slide down a microscope – he and others had become used to waiting for a moment which seemed determined not to arrive.
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KLAS report explores health IT buying decisions, customer satisfaction

The new study takes a broad view of dozens of healthcare market segments, from acute EHRs to virtual care platforms, and assesses the how providers choose vendor partnerships.
April 18, 2018 04:32 PM
When choosing a vendor, customers focus on integration, consolidation and functionality, according to a new study from KLAS that looks at how IT decision-makers choose their technologies in different market segments.
Satisfaction level of existing customers and retention rate (the percent of buyers planning to continue with a given vendor) were also included as reasons.
The Decision Insights 2018 report draws on the insights of buyers of EHRs, population health platforms, analytics tools, imaging systems and more to track the rationale for the initial acquisition and assess customer satisfaction afterward.
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Lean Methodology Boosts EHR Documentation Quality, Efficiency

Lean methodologies helped improve EHR documentation quality and efficiency, extended patient care time, and increased patient and provider satisfaction.

April 18, 2018 - Applying Lean methodologies to an inefficient, first-generation electronic health record (EHR) system could enhance EHR documentation quality and efficiency, increase patient care time, and improve both provider and patient satisfaction, according to a study published in AHIMA’s Perspectives in Health Information Management.
Led by Maryane M. Dinkins, MS, PT, the research noted that many healthcare professionals are concerned that EHR use is obstructing quality care although one of the primary goals of an EHR is to provide clinicians with timely, accurate, and complete patient data,.
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FDA Announces Plan to Advance Medical Device Safety and Cybersecurity

April 18, 2018
by Heather Landi
While medical devices play an increasing role in patient care and provide life-saving benefits to patients, these devices can be vulnerable to security breaches and therefore pose significant risks to healthcare cybersecurity. To address medical device safety, the Food and Drug Administration (FDA) has announced plans to advance new frameworks for identifying risks and protecting consumers, including proposals aimed at advancing medical device cybersecurity.
This week, the FDA released the Medical Device Safety Action Plan: Protecting Patients, Promoting Public Health. This new Action Plan outlines the FDA’s vision for how the agency can continue to enhance programs and processes to assure the safety of medical devices. “Our aim is to make sure that the new advances in technology that are enabling better capabilities and benefits are also harnessed to bring added assurances of safety, so that more patients can benefit from new devices and address unmet needs,” FDA Commissioner Scott Gottlieb, M.D., said in a statement.
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What are the challenges to getting precision medicine into the mainstream?

Experts point to the need to demonstrate value, as well as challenges integrating genomic data into EHRs and handling massive amounts of data.
April 17, 2018 02:59 PM
Research and innovation in personalized medicine are surging. However, adoption of personalized medicine technologies into clinical practice is comparatively slow.
There are a number of significant challenges to the integration of personalized medicine into healthcare practice. The Personalized Medicine Coalition is one organization that has been working to help identify and categorize challenges as well as identify strategies for providers to overcome these challenges.
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US, UK accuse Russia of actively targeting internet routers, devices

The rare joint alert says Russia, behind the global NotPetya attack, has been laying the groundwork for future cyberattacks and targeting critical infrastructure.
April 17, 2018 12:59 PM
Russian hackers are actively targeting devices that control the flow of internet traffic to gain access and spy on Western governments and businesses, according to a rare joint alert from the U.S. and U.K. released Monday.
Delivered by the Department of Homeland Security, FBI and U.K. National Cybersecurity Centre, the warning outlines Russian state-sponsored cyberattacks penetrating software programs and devices, including firewalls and internet routers, on a global scale.
The goal, according to officials, is to steal company secrets and spy on these countries. The hackers also are attempting to lay the foundation for future cyberattacks, the agencies said.
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How Apple's Health Records could reshape patient engagement

Dignity Health's chief digital officer explains why he thinks Apple can succeed for population health and precision medicine efforts where other PHR launches have not.
April 18, 2018 09:46 AM
As a longtime collaborator with Apple – since before it even beta-tested its Health Records project, live now at 39 hospitals – San Francisco-based Dignity Health is in sync with the iPhone developer's vision, said Shez Partovi, MD.
"We had been working with Apple prior to their initial announcement for some time," said Partovi, chief digital officer and senior vice president of digital transformation at Dignity Health. "We'd been working with them for a while because we're aligned in our philosophies of empowering patients by giving them their data."
As part of the Health Records launch, Dignity will leverage HL7's FHIR standard to securely move patients' health data from own electronic health record system to the iPhones of patients using iOS 11.3 – enabling them manage meds, labs, allergies, conditions and more, and notifying them when the health system makes changes to their health information.
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DEA to share prescription drug data with 50 attorneys general, crack down on drugmakers

Apr 18, 2018 11:32am
The Drug Enforcement Agency has reached an agreement with 50 attorneys general to share prescription drug data with one another to support ongoing investigations.
As part of the agreement, the DEA will provide attorneys general in 48 states, the District of Columbia and Puerto Rico with data from its Automation of Reports and Consolidated Orders System (ARCOS), which collects 80 million prescription drug transactions from manufacturers and distributors each year.
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Obstetrician will no longer be able to deliver babies after refusing electronic records training

Apr 18, 2018 8:50pm
Computers have spelled the end of delivering babies for an Illinois obstetrician.
Jeffrey B. Johnson, M.D., 75, has declined to participate in mandatory training to learn how to use the new electronic medical record system at St. Alexius Medical Center located in Hoffman Estates, Illinois, a Northwest suburb of Chicago. 
That means he won’t be able to continue to deliver babies at the medical center after a more than 50-year career, according to a column in the Daily Herald.
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Smaller practices struggle to use advanced EHR features, Black Book finds

Author Tony Abraham

Published April 17, 2018

Dive Brief:

  • Nearly 90% of practices with six or fewer practitioners aren't using advanced EHR features such as electronic messaging, clinical decision support, interoperability, data sharing and patient engagement, according to a recent Black Book survey of about 19,000 EHR users.
  • The majority of larger practices use advanced features frequently, and 30% of practices with 11 or more clinicians said they expect to replace their current EHR system by 2021. 
  • Although larger practices are better positioned to implement new IT tools, 93% of all practices with functioning EHR systems are using basic features that are directly tied to customer satisfaction. 
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NIST Unveils Latest Version of Its Popular Cybersecurity Framework

The National Institute of Standards and Technology has released version 1.1 of its popular Cybersecurity Framework.

April 17, 2018 - The National Institute of Standards and Technology (NIST) recently released version 1.1 of its popular Cybersecurity Framework, which incorporates feedback received from public comments and workshops during 2016 and 2017.
Version 1.1 of the Framework for Improving Critical Infrastructure Cybersecurity (The Framework) includes updates on authentication and identity, self-assessing cybersecurity risk, managing cybersecurity within the supply chain, and vulnerability disclosure.
The new version adds a section explaining how the Framework can be used by organizations to understand and assess their cyber risk and sections on risks associated with the supply chain and purchasing commercial off-the-shelf products and services.
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Physician practices disillusioned as they don’t maximize EHR benefits

Published April 18 2018, 5:26pm EDT
Nearly 90 percent of physician practices with six or fewer practitioners are not using optimization tools included in their electronic health record systems, according to findings in a new report from Black Book Research.
Those capabilities give practices the ability to take advantage of patient engagement services, secure messaging, decision support and health information exchange. Black Book surveyed about 19,000 EHR users across practices of all sizes and types to assess the industry environment for EHR replacement activity.
“Traditionally, it’s been the smaller and solo practices with the highest dissatisfaction ratings for electronic health record applications,” says Doug Brown, managing director at Black Book. “We confirmed also that the smaller the practice, the less likely they are to use advanced IT tools, and that’s where EHR frustration among small practices is generally focused.”
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HIT Think Why the new EU privacy rule will be challenging for providers

Published April 18 2018, 5:53pm EDT
While Facebook is in the hot seat for failing to safeguard data privacy, the European Union is about to take a giant step forward to protect personal data. The EU’s General Data Protection Regulation (GDPR), adopted two years ago, will go into effect on May 25, and the implications are large for companies that handle data belonging to Europeans.
This includes SaaS providers looking to develop and deploy apps that work with data across international boundaries. It also impacts healthcare organizations collaborating with countries in Europe to speed research and development of healthcare solutions.
Key provisions
The GDPR takes a broad view of what constitutes personal identification information. Organizations that must comply with GDPR will need the same level of protection for an individual’s IP address and cookie data as for their name, address and medical ID number. Companies can hold and process only the minimum amount of data needed to achieve their objectives, only for as long as necessary.
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Facebook knows a ton about your health. Now they want to make money off it.

April 18 at 6:00 AM
Kirsten Ostherr is a media scholar and digital health technology researcher at Rice University.
Let’s say you have had discussions on Facebook about your breast cancer diagnosis. It has been a useful forum for comparing treatment options with others who have dealt with similar health issues. There’s only one problem: Facebook has now categorized you as a patient, and you constantly receive precisely targeted ads about cancer services available near you. They are showing up on your computer screen at work, for all your co-workers to see, right when you’re up for a big promotion.
Many users experience a version of this scenario when they receive creepily personalized ads while browsing on Facebook. When those ads follow users onto sites outside Facebook, it feels like an invasion of privacy. But how do you regulate data privacy in an age of big-data black boxes?
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CIO reflections from HIMSS18: What to do with all that EHR data

Penn Medicine chief information officer Mike Restuccia shares four tactics for ensuring success with big data projects.
April 17, 2018 08:53 AM
The HIMSS18 Global Conference held in Las Vegas, Nevada was once again a delight to attend and exchange thought leadership among fellow colleagues. It seemed that thousands of vendors promoted services and solutions, all with the intent of facilitating better patient care, advancements in research, safer work environments and more efficient organizations.  
At the core of many of these offerings is data, and in some cases vast amounts of Big Data. Patient monitoring systems, wearables, patient reported outcomes, and new research algorithms are just a few of those offerings which transmit large streams of data.  Almost as befuddling to the Information Services executive as attempting to navigate the HIMSS18 vendor floor is what to do with all of this data.  The challenge is multi-faceted and despite the claims of many in the vendor community; not easily addressed.  
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Follow the money: Where Gartner, IDC and HIMSS Analytics say hospitals will invest the most in 2018

With bold projections that we are on the cusp of the biggest IT spending growth in a decade, new predictions from industry analysts show how much, and on which technologies, hospitals will acquire, modernize or optimize IT.
April 17, 2018 09:24 AM
IT spending is on the rise. Everyone working in healthcare leadership positions, information and technology, or even remotely paying attention to the sector already knows that.
And for executives trying to balance a budget to stay competitive amid a tech talent shortage and ever-evolving regulatory landscape, having a strong sense of where rivals and even partners are planning to spend on IT could prove to be make-or-break insightful.
Let’s take a look at what Gartner, IDC and HIMSS Analytics have to say about IT investment plans in 2018 and beyond.  
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Alexa Is a Revelation for the Blind

Legally blind since age 18, my father missed out on the first digital revolution.
“Is it ‘Electra?’” my father asks, leaning in close to the Amazon Echo my mother has just installed. Leaning in close is his trademark maneuver: Dad has been legally blind since age 18, the result of a horrible car crash in 1954. He has lived, mostly successfully, with limited vision for the 64 years since.
“Call it the right name!” my mom shouts as Dad tries to get the device’s attention. In response, he adopts an awkward familiarity, nicknaming the Echo “Lexi.” Hearing this, I groan. There goes Dad again, trying to be clever, getting it wrong, and relishing the ensuing chaos.
Then I stop myself. Isn’t it possible that he expects Alexa to recognize a prompt that’s close enough? A person certainly would. Perhaps Dad isn’t being obstreperous. Maybe he doesn’t know how to interact with a machine pretending to be human—especially after he missed the evolution of personal computing because of his disability. Watching him try to use the Echo made me realize just how much technology forms the basis of contemporary life—and how thoroughly Dad had been sidelined from it.
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How many hospitals are on each stage of HIMSS Analytics' EMR Adoption Model?

Written by Jessica Kim Cohen | April 16, 2018 
Most hospitals sit on the second-highest level of the EMR Adoption Model, an eight-stage roadmap developed by Healthcare Information and Management Systems Society subsidiary HIMSS Analytics.
The EMR Adoption Model, which runs from Stage 0 to Stage 7, measures the degree to which a hospital utilizes its EMR functions. Hospitals are scored on standards related to digital imaging, interoperability and data security, among other capabilities.
Here's how all 5,487 registered U.S. hospitals stacked up in the fourth quarter of 2017.
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Report: VA, DoD EHR Contracts to Spur Federal Health IT Spending

April 16, 2018
by Rajiv Leventhal
The federal government has estimated that federal healthcare spending will increase 80 percent, from $918 billion in 2015 to $1.7 trillion in 2025, with one of the key IT-related factors being the Department of Veterans Affairs’ (VA) and Department of Defense’s (DoD) implementations of new EHR (electronic health record) systems.
The estimation, coming from Deltek’s Federal Health Information Technology Market report, noted that “Federal health IT spending over the forecasted period is greatly influenced by these new EHR platforms as well as potential solutions by the Coast Guard and Department of State. Efforts to increase medical innovation, mobile health, healthcare cost control and combat public health issues such as the current opioid epidemic will also solidify investments in health IT products and services.”
The report’s authors also stated that requirements for improved quality, interoperability, data sharing and privacy will drive federal agencies taking on the role of promoter, provider or payer to invest in more IT solutions for enhanced health effects and to thwart waste, fraud and abuse.
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Every hospital tested for cybersecurity has failed

Chris Smyth, Health Editor
April 18 2018, 12:01am, The Times
All 200 hospitals and other NHS organisations tested so far have failed cybersecurity checks, according to a report by MPs that finds not enough has been done to protect patients from hackers.
Some hospitals have not fixed the original vulnerability that led to last year’s cyberattack and NHS chiefs are not working fast enough to protect the health service, even though a repeat is a matter of “when, not if”, the public accounts committee (PAC) says.
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Netsmart introduces EHR focused on post-acute care

Written by Anuja Vaidya (Twitter | Google+)  | April 13, 2018 
Netsmart, an EHR solutions and services provider, launched a cloud-based EHR geared toward home health and senior living communities.
The myUnity platform features analytics, interoperability as well as consumer and family engagement capabilities. It aims to consider the unique needs of various types of post-acute organizations.
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How health apps factor into a $950B ecosystem

Apr 16, 2018 2:34pm
Healthcare apps played a prominent role in a new report that estimates the mobile app industry has evolved into a $950 billion ecosystem.
Highlighting the ubiquity and importance of smartphones across multiple industries, a new report by ACT | The App Association indicated that two out of three businesses utilize enterprise apps. And many of those opportunities are rising up throughout the healthcare industry.
“Innovations in the app economy are providing new avenues for users to interact with their doctors, make financial transactions, manage employee contracts, and even secure parking permits,” the report stated. “With these new opportunities, patients will need secure channels to share health data with their doctors and insurance companies.”
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Impact of the implementation of electronic health records on the quality of discharge summaries and on the coding of hospitalization episodes

International Journal for Quality in Health Care, mzy075, https://doi.org/10.1093/intqhc/mzy075
Published: 13 April 2018

Abstract

Objective:To determine whether the implementation and use of the electronic health records (EHR) modifies the quality, readability and/or the length of the discharge summaries (DS) and the average number of coded diagnosis and procedures per hospitalization episode.
Design: A pre–post-intervention descriptive study conducted between 2010 and 2014.
Setting:The ‘Hospital Universitario 12 de Octubre’ (H12O) of Madrid (Spain). A tertiary University Hospital of up to 1200 beds.
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6 health data privacy takeaways from Zuckerberg testimony

Published April 13 2018, 8:46pm EDT
Facebook CEO Mark Zuckerberg spent two days on the hot seat getting grilled by members of Congress regarding the social media company’s use of consumer data. In separate Senate and House hearings earlier this week, Zuckerberg was both apologetic and defiant in response to questions and allegations from lawmakers about Facebook’s abuse of personal information collected by the online platform.
Zuckerberg was specifically called to Washington to respond to the Cambridge Analytics scandal and Russia’s interference in the 2016 U.S. election. However, he was more broadly questioned about Facebook’s sharing of sensitive consumer data—including health information—with third parties.
Apps that collect information from consumers—and not on behalf a provider, health plan or healthcare clearinghouse—are not subject to the Health Insurance Portability and Accountability Act as either a covered entity or business associate. As a result, developers are not required under HIPAA to protect the privacy and security of consumers’ data, which is not considered protected health information (PHI). It’s a loophole that has gotten the attention of lawmakers in the Zuckerberg hearings.
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Opioid Crisis: How 4 health providers are using tech to fight the epidemic

Published April 13 2018, 11:57pm EDT
America’s opioid epidemic shows no sign of letting up. Addiction to legal painkillers and illegal drugs like heroin has resulted in more than 42,000 overdose deaths in 2016, according to Centers for Disease Control and Prevention figures released at the end of March.
Health Data Management, over the past few months, has profiled a number of healthcare organizations that are turning to health information technology to combat the crisis. What follows is a look at four of those initiatives.
Geisinger: Pairing EHR and e-prescribing data
Geisinger, an integrated health system, is curbing patient use of opioids by leveraging health information technology and electronic prescribing, according to CIO John Kravitz, who contends that other healthcare organizations can generate similar results through effectively using their EHRs or clinical order entry systems.
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Enjoy!
David.

Friday, April 27, 2018

A Comment For The Ages I Believe. Just Too True To Ignore!

This popped up last week:
Anonymous said...
...the Australia Digital Health Agency does not guarantee, and accepts no legal liability whatsoever arising from or connected to, the accuracy, reliability, currency or completeness of any material contained on this website or on any linked site.

The Australian Digital Health Agency recommends that users exercise their own skill and care with respect to their use of this website and that users carefully evaluate the accuracy, currency, completeness and relevance of the material on the website for their purposes.

Well that's OK then. The website is about as reliable as the My Health Record itself.

How "users carefully evaluate the accuracy, currency, completeness and relevance of the material on the website for their purposes" isn't explained.

Trust us, but don't rely on us.
----- End Comment:
I guess that must include the myHR since surely it is a linked site!
Here is the shiny new front page:

What is My Health Record?

My Health Record is an online summary of your health information. You control what goes into your record, and who is allowed to access it. Share your health information with doctors, hospitals and other healthcare providers from anywhere, any time.

Learn more about My Health Record

Here is the link:
For the first time we are fully told what to do to opt out of having a myHR. (Item 5)
However, if your record is created for you it will hang around for a very long time:

Cancel my record

If you have a My Health Record, you may cancel your record at any time.
You can also cancel the record of someone else if you are their authorised representative.

How to cancel your My Health Record

To cancel your My Health Record, or the record of someone in which you are their authorised representative:
  1. Log in to your My Health Record through myGov.
  2. Select the 'Profile & Settings' tab.
  3. Select profile and navigate to the bottom of the page.
  4. Read the information and click on ‘Cancel My Health Record’.

What happens when you cancel a My Health Record?

When you cancel your record, it means that:
  • Healthcare providers will not be able to upload documents to the record, or access the record - even in an emergency.
  • You, or your representative can only access the record by making a request to us.
  • Once your record is cancelled, it will be retained for a period of 30 years after your death or, if the date of death is unknown, for a period of 130 years after the date of your birth.
  • Your My Health Record may be accessed by us for the purposes of maintenance, audit and other purposes required or authorised by law.

Records contained in local clinical information systems

Even if you cancel your My Health Record, healthcare providers will continue to hold copies of any records they have uploaded to My Health Record stored on their own clinical information system.

Re-register a cancelled My Health Record

If you have cancelled your My Health Record, you can re-register at any time by:
If you re-register online, your record will include information which was in your record before it was cancelled. If you re-register via the call centre you can ask for the record to be cleared of all previous documents. These documents will remain in the archive but will not be able to be viewed by you, your representatives or your healthcare providers.
----- End Extract.
Usual rules therefore apply – stay away unless you have some compelling reason to use it!
Just why is it you can’t delete your record – technical reasons they say, but with the GPDR making Facebook and Google be able to delete records how long is it going to be the case with the myHR. The ADHA’s attitude to whose data it is must change and fast!
David.

Thursday, April 26, 2018

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

April 26, 2018 Edition.
Australia has to come first this week as the Royal Commission into Financial Services shocks and appalls us all with an astonishing array of dishonest and unethical spivs who were pretending to provide us with Financial Services. The Government looks like they got this badly wrong in resisting the RC. This week the Royal Commission has claimed even more amazing scalps and it would be fair to say the Financial Advice Industry has some real issues!
Just awful. We also have some (slight) progress on the National Energy Guarantee and the usual array of nonsense around energy policy - and it is not clear when it all will get resolved.
Trump, after the Syrian attack, has gone back to the trade wars and North Korea while wondering who is going to drag him into court first! I fear things in the Middle East may seriously unravel - especially between Iran and Israel. Watch this space!
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Here are a few other things I have noticed.
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Major Issues.

Bank boss bonuses in the spotlight as Royal Commission rolls on

By Jessica Irvine
15 April 2018 — 8:18pm
Forget supply and demand. Forget the benefits of free trade.
The most profound lesson economics has to teach us is this: people respond to incentives.
It starts early in life.
Try convincing a child to do something they don’t want to do by appealing to their best interests, or their sense of social niceties.
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How could the Syrian strikes affect Australia?

By Clive Williams
15 April 2018 — 4:37pm
There are several implications for Australia from the US-led strikes on Syria.
First, is in relation to adherence to the “rules-based global order” that Australia promotes. The US-led military action against Syria short-circuited the “official” process whereby the Organization for the Prohibition of Chemical Weapons conducts its own investigation of a suspected breach of the Chemical Weapons Convention , before reporting to the UN for any UN-sanctioned action.
In this case, OPCW confirmation of chemical use at Douma would probably have gone nowhere because of Russia opposing any military action against Syria.
The question of course is whether this justifies the US’s breaking of international rules and taking upon itself the punishment of a “wayward” member of the UN.
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Molan issues warning over Australia’s fuel reserves

  • The Australian
  • 10:14AM April 16, 2018

Primrose Riordan

Liberal Senator Jim Molan has said there needs to be “action” on Australia’s low fuel reserves in the wake of the joint Syrian airstrikes.
After the US, the UK and France carried out airstrikes in Syria on the weekend, Donald Trump warned that America remains “locked and loaded’’ to launch another missile strike pushing oil prices to their highest since late 2014.
Last week Retired air vice-marshal John Blackburn, a former deputy chief of the air force told The Australian that there was a risk the conflict could undermine Australia’s energy security, which he said was dependent on regional refineries and oil flows from the Middle East.
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Solving power problems is a piece of yellowcake

  • The Australian
  • 12:00AM April 16, 2018

Adam Creighton

The Monash Forum, the ginger group of Coalition MPs pushing for a new coal-fired power plant, would have been more constructive and credible if it had come out in favour of nuclear power. Championing the diversification of Australia’s energy supply to include nuclear energy makes a great deal of environmental, economic and strategic sense, yet curiously few politicians say so.
This is strange because less than half the public is “against” nuclear energy according to a survey of households conducted last year by the Australian ­National University. It showed more than 41 per cent of voters were in favour of nuclear power plants to generate electricity, only a quarter were “strongly opposed”.
Having at least one nuclear power station, capable of providing to the grid emissions-free, reliable power, wouldn’t be a repudiation of solar, wind or even coal power. It would be a sensible outcome for a country with 30 per cent of the world’s uranium with vast tracts of uninhabited land that wants to lower its carbon emissions.

Nine out of 10 SMSF advisers failing to consider best interests of clients: ASIC

  • The Australian
  • 12:16PM April 16, 2018

Ben Butler

Financial advisers giving advice about self-managed super funds failed to consider the best interests of their clients in an astounding nine out of 10 cases, according to new Australian Securities and Investments Commission data revealed at the Financial Services Royal Commission this morning.
ASIC deputy chairman Peter Kell said the failure to comply with a key requirement of the law, revealed in a survey of 137 financial services licensees, was “obviously very disappointing, to say the least”.
He said a smaller percentage of cases, which he did not provide, resulted in financial detriment to the consumer.
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  • Apr 16 2018 at 12:16 PM

Banking royal commission exposes financial planning's most egregious rip-off

The big five of financial planing – Commonwealth Bank, NAB, ANZ, Westpac and AMP – are going to get the book thrown at them in round two of the Hayne royal commission at them for ripping off their customers.
And after just one morning of the hearings, it's hard to say anything other than: good.
Round two of the hearings will focus on financial planning, fertile ground for disagreements between client and adviser.
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  • Updated Apr 16 2018 at 6:13 PM

AMP faces music in commission dock

'Significant financial detriment': Royal Commission to hear from victims
In court 4A of the Commonwealth Law Buildings in Melbourne, Kenneth Hayne's long, thin face lends itself to a naturally lugubrious air – despite his occasional flashes of dark humour. But as he listens intently, pen in hand to take notes as needed, the royal commissioner is taking a very sharp-edged interest in what's unfolding.
And that turns out to be an awful lot of embarrassing material – with worse to come  – for the banks and AMP .
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Joint Treasury-Home Affairs analysis highlights economic benefits of Australia's immigration intake

By Eryk Bagshaw & Matt Wade
16 April 2018 — 7:20pm
A briefing paper delivered to the Turnbull government amid a politically fraught debate on immigration warns cutting the current intake risks costing the federal budget billions of dollars, lowering economic growth and damaging the living standards of Australians.
The migrant intake from 2014-15 alone will provide a $10 billion boost to the budget over the next five decades, the newly released Treasury and Home Affairs analysis found. It warned of "far reaching effects" of significantly lower economic growth if the current rate of migration is not maintained.
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Turnbull government blames Russia after hack targets Australian organisations

By Fergus Hunter
17 April 2018 — 8:27am
The Turnbull government says hundreds of Australian organisations have been affected in a global campaign of cyber attacks carried out by Russian state-sponsored hackers.
Australia has joined the United States and Britain in condemning the attacks, which have targeted government agencies, businesses and critical infrastructure by exploiting vulnerabilities in internet routers and network equipment around the world since 2015.
 “This attempt by Russia is a sharp reminder that Australian businesses and individuals are constantly targeted by malicious state and non-state actors, and we must maintain rigorous cyber security practices," said Law Enforcement and Cyber Security Minister Angus Taylor.
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  • Apr 17 2018 at 3:30 PM

Spike in bank bill swap rate threatens bank profits

The big banks will have to play higher funding costs with a dead bat, experts say.
The three-month bank bill swap rate has continued to climb in April, defying predictions this year's spike in bank wholesale funding costs would prove short-lived.
Over the past two months, the BBSW has surged 0.32 percentage points, or 32 basis points, to 2.08 per cent. The rate looked to have stabilised late March, only to restart its steep upward trajectory this month.
The short-term money market rate directly affects the cost of bank wholesale funding costs. The BBSW is also used to set interest rates on most variable-rate business loans, and can flow through to mortgages as banks seek to pass on those higher funding costs to consumers.
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IMF’s glowing report card for Australian economy

  • The Australian
  • 11:00PM April 17, 2018

David Uren

Australia’s economic growth will be among the best in the advanced world over the next two years, with the International Monetary Fund predicting further support from strong commodity markets.
The fund’s review of the global economy, released overnight, said a recovery in business investment in advanced countries and in household spending in emerging countries was lifting economic growth across the world.
“Growth this broad-based and strong has not been seen since the world’s initial sharp 2010 bounce back from the financial crisis of 2008-09,” the fund’s chief economist, Maurice Obstfeld, said.
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Are there hidden costs to high immigration?

By John Daley
18 April 2018 — 12:00am
Australia is more defined by migration than almost any other country. One in four Australians wasn’t born here; one in two has a parent born overseas.
But public concern about this migration is growing. More people are asking whether you can have too much of a good thing.
The big issue is not Australia’s permanent migrant intake. It’s the number of temporary migrants that’s growing fast. But this label is somewhat misleading: many “temporary” migrants live in Australia for more than a decade – and often ultimately become permanent migrants and citizens.
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There are more jobs, but 730,000 people are still out of work

By Matt Wade
18 April 2018 — 12:00am
You’d have to be hiding under a rock not to know that jobs growth has been strong lately.
As Malcolm Turnbull keeps reminding us employment has increased by more than 400,000 in the past year “the largest number on record”.
That's very good news but it hasn’t made much difference to the unemployment rate. The latest figures put the rate at 5.6 per cent, exactly what it was six months ago.
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Stinking AMP reveals our soft line on corporate dishonesty

By Adele Ferguson
17 April 2018 — 6:33pm
The fish rots from the head and AMP is stinking. As the royal commission into banking spent the day unpicking the conduct of AMP, some outrageous behaviour was exposed.
It doesn’t get much worse – or serious - than blatantly lying to the corporate regulator on at least 20 occasions, but AMP did just that.
The commission's investigations have also caught the board and senior executives meddling with and changing an independent expert's report before it was finalised and passed off as an “independent” investigation to the Australian Securities and Investments Commission.
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The $211 trillion problem: IMF sends warning about record global debt

By Andrew Mayeda
19 April 2018 — 5:42am
The world's debt load has ballooned to a record $US164 trillion ($211 trillion), a trend that could make it harder for countries to respond to the next recession and pay off debts if financing conditions tighten, the International Monetary Fund said.
Global public and private debt swelled to 225 per cent of global gross domestic product in 2016, the last year for which the IMF provided figures, the fund said Wednesday in its semi-annual Fiscal Monitor report. The previous peak was in 2009, according to the Washington-based fund.
"One hundred and sixty-four trillion is a huge number," Vitor Gaspar, head of the IMF's fiscal affairs department, said in an interview. "
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We need to stop spending billions on things we don't really need

By Peter Martin
18 April 2018 — 7:37pm
I am going to say it. We are spending too much on infrastructure – on roads, railways, bridges and the like. We don’t try the cheap things first. And we have with the NBN.
You probably disagree, especially if you are waiting for a train, or in a car with a driver who is stuck in traffic. If you go to the footy you would prefer a better stadium, if you use the internet, you would like it faster.
Late last month, the NSW premier was defending her government's transport infrastructure program in the face of growing discontent, as thousands of protesters marched in Sydney over the state's road and rail problems.
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Australian debt surges as world pares back: IMF

  • The Australian
  • 12:00AM April 19, 2018

David Uren

Australia’s government debt has risen faster since the global financial crisis than the debt of almost any other country, International Monetary Fund figures show.
The IMF is concerned that government debts around the world have improved little since the ­financial crisis and says it is urgent that countries make use of better economic conditions to cut budget deficits and pay down debt.
Although Australia’s total ­government debts are low compared with many other advanced countries, they have grown more rapidly over the past decade, jumping from 16.7 per cent of GDP to an expected 41.7 per cent this year, a rise of 25 percentage points.
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International Monetary Fund warns Australian Government against Budget spending spree

Shane Wright  |  The West Australian
Thursday, 19 April 2018 4:00AM
The Federal Government has been warned against going on a Budget spending spree by the International Monetary Fund, saying now is the time to fix the nation’s finances before an “eventual” worldwide economic downturn hits.
As Treasurer Scott Morrison said the Government was committed to “living within its means”, the IMF revealed growing concerns many nations were failing to “save for a rainy day” with overall debt continuing to climb.
Globally, countries now owe a record $US164 trillion.
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  • Apr 19 2018 at 11:39 AM

Banking royal commission could be extended: Finance Minister Mathias Cormann

'Significant financial detriment': Royal Commission to hear from victims
The Turnbull government is open to extending the life of the banking royal commission after it uncovered a series of damaging revelations about misconduct in the financial sector, as Coalition MPs led by Barnaby Joyce admit they were wrong to oppose the probe.
The royal commission was given just 12 months to examine the industry with a February 2019 deadline but Finance Minister Mathias Cormann said the government was willing to give Commissioner Kenneth Hayne more time if required.
"We will not protect anyone. Justice Hayne... is doing an outstanding job and we will take our advice from him," Senator Cormann told 2GB.
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Turnbull asserts Australia's 'perfect right' to sail South China Sea

By David Crowe
20 April 2018 — 6:20am
London: Prime Minister Malcolm Turnbull is insisting on Australia’s “perfect right” to sail its fleet through the South China Sea after a robust exchange in the disputed waters between Australian frigates and the Chinese navy.
Mr Turnbull said Australia asserted its right to freedom of navigation throughout the world’s oceans, including the South China Sea.
The remark came after the ABC reported that three Royal Australian Navy vessels were “challenged” by Chinese forces when sailing through the region earlier this month.
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Syrian tragedy reveals embarrassing triviality of Australian politics

By David Crowe
19 April 2018 — 11:58am
Moaed Dumane was in a Damascus suburb two weeks ago when a helicopter flew overhead. He took shelter with his family from what he knew was an attack from the Syrian regime of Bashar al-Assad.
“Several barrel bombs fell from a helicopter, and then there was a strong, strange smell,” he told The New Yorker. “After the bombardment subsided, we went to check out where the barrel bombs fell, then we saw a lot of families in their homes who couldn’t escape.
 “Their pupils were narrow. Most victims were women and children. It was a horrific scene. The smell was extremely strong. The dead were moved to makeshift medical clinics. Most were dead from suffocation.”
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How Trump's hair-raising level of debt could bring us all crashing down

By Ambrose Evans-Pritchard
Updated20 April 2018 — 7:24amfirst published at 7:14am
If there is such a thing as a capital crime in economics, it is Donald Trump's exorbitant fiscal stimulus at the top of the cycle. The effects are entirely pernicious.
Such deficit spending at this juncture can only provoke a ferocious monetary response, threatening to bring the global expansion to a shuddering and climactic end sooner rather than later, and with particular violence.
Twin reports by the International Monetary Fund sketch a chain reaction of dangerous consequences for world finance. The policy - if you can call it that - puts the US on an untenable debt trajectory. It smacks of Latin American caudillo populism, a Peronist contagion that threatens to destroy the moral foundations of the Great Republic.
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Lesson from an ancient town: Dark ages pass, but knowledge is forever

By Tony Wright
19 April 2018 — 5:51pm
The damnedest things come to mind when you’re travelling.
As I wandered the tangled alleys of the ancient city of Cordoba in southern Spain a few weeks ago, an intriguing puzzle presented itself.
We are drowning in knowledge these days; all of it no more than a Google click away.
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China challenges three Australian warships in South China Sea

  • The Australian
  • 7:55AM April 20, 2018

Rhian Deutrom

Prime Minister Malcolm Turnbull has issued a strong warning to the Chinese government that Australia will not be prevented from asserting its “right of freedom of navigation throughout the world’s oceans” after a group of Australian warships were challenged by China’s military earlier this month.
Three naval ships, HMAS Anzac, HMAS Toowoomba and HMAS Success were travelling from separate ports to the Vietnamese capital, Ho Chi Minh, when they were confronted by the People’s Liberation Army.
The warships are participating in a series of exercises with nations in the region when they were stopped by Chinese military in the South China Sea.
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  • Apr 19 2018 at 11:00 PM

Has global growth reached the beginning of the end?

It's hard to escape the conclusion that markets are suddenly less confident about the growth outlook. 
There's an emerging consensus that the final quarter of 2017 "was the peak in global growth", Westpac head of macro strategy David Goodman says. "We all came into work after Christmas very optimistic," Goodman adds. Alas, that pace of growth could not be sustained.
It's not all bad. As the International Monetary Fund flagged this week, global growth still looks robust. The fund's economists (as reliable as they are) forecast the world will enjoy the fastest pace of economic growth since 2011, at 3.9 per cent this year and the next. More timely indicators of economic activity than official GDP stats, such as purchasing managers' indices, still show manufacturing and services sectors in expansion mode.
But markets are trying to factor future growth into current prices, so it is momentum that matters. Investors care about the trend, and that trend is heading lower. Citi's global economic surprise index has plunged firmly into negative territory, indicating that more data points are coming in under expectations than above. Leading indicators, such as those put together by the OECD, have rolled over.
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Rein in tech titans: IMF

  • Philip Aldrick
  • The Times
  • 12:50PM April 20, 2018
An urgent crackdown on big technology is needed to break its stranglehold on the economy and drive greater competition, the managing director of the International Monetary Fund says.
In an unusually strong attack, Christine Lagarde warned that countries would suffer if power remained concentrated in the hands of such a small group of “technology titans”, but stopped short of calling for them to be broken up.
In little more than a decade, Amazon, Google, Facebook and Apple have turned into digital monopolies wielding enormous influence over people’s lives, prompting widespread concern matched only by anger about their tax avoidance.
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5 Months After Marriage Equality, The Homophobes Are Back At It Again

by Rob Stott 20 April 2018
Just in case anyone thought we could relax after last year’s marriage equality victory, this week gave us the proof we needed that a large section of the Coalition would wind back queer rights the second they got a chance.
It all started with some members of the party’s Victorian branch putting forward a number of anti-queer motions to be debated at the upcoming state council. Along with banning Safe Schools and broadening “religious freedom” (which is simply a code for entrenching discrimination), was a motion debating the merits of gay “conversion therapy”.
Put forward by a branch linked to federal MP Kevin Andrews — who thinks same-sex couples are the same as his cycling buddies — called for the law to allow law to be changed to ensure doctors “can offer counselling out of same-sex attraction or gender transitioning”, according to Fairfax.
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  • Updated Apr 20 2018 at 5:32 PM

Energy: NEG proceeds to final design stage as consensus reigns at COAG

COAG leaders meet to discuss energy policy
Federal, state and territory energy ministers have agreed to send the National Energy Guarantee to the next stage – final design and drafting of legislation and rules.
The final design will be voted on at the next COAG Energy Council meeting in August, with the goal of finalising the new policy by the end of the year for implementation over the next two years.
The National Energy Guarantee (NEG) is the Turnbull government's signature policy aimed at combining emissions reduction and energy reliability goals after more than a decade of national dysfunction in the area that has led to instability in the grid and rising power prices.
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Does royal commission turncoat Scott Morrison really think the public is so dim?

By Tony Wright
Updated20 April 2018 — 3:01pm first published at 2:59pm
As a clearly panicked Scott Morrison announced on Friday a stream of eye-watering new penalties for serious misconduct by banks and financial services firms, it’s instructive to look back at his zealous efforts over two years to protect the banks from a royal commission currently uncovering just that sort of misbehaviour.
The Treasurer and his colleague, Revenue and Financial Services Minister Kelly O’Dwyer, are falling over themselves to claim the new jail-time threats and bank-busting fines are just business as usual by responsible stewards of the national interest.
Why, they insisted, they’ve been working on the new regime of penalties since examining the findings of an ASIC enforcement task force inquiry established way back in November 2016.
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The right to free speech doesn't make really bad ideas any better

By Jacqueline Maley
21 April 2018 — 12:00am
It’s reached the point where any mention of free speech in the public debate has become what left-wing tender-hearts might call “triggering”.
The minute a conservative politician (and it tends to only be conservative politicians) drops the “free speech” bomb, you know it’s going to be in the service of something pretty dreadful.
George Brandis defending the right to be a bigot. Tony Abbott leading the charge to abolish or change section 18C of the Racial Discrimination Act, so we can all be free to offend, insult or intimidate on the basis of race.
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How New Zealand helped Australia achieve its 25-year economic dream

By Jessica Irvine
21 April 2018 — 12:05am
Twenty five years ago, the Australian economy was still emerging from the ravishes of recession. The jobless rate stood at an unacceptably high 11 per cent.
But the Reserve Bank governor of the day, Bernie Fraser, saw an opportunity; a chance to vanquish the beast of inflation once and for all.
On March 31, 1993, Fraser gave a landmark speech to the Australian Business Economists in Sydney in which he laid down a new objective for monetary policy.
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Breach of trust: how Australian banks went bad

By Jessica Irvine
20 April 2018 — 10:57pm
It did not take long for the first banker appearing in this week’s sensational royal commission hearings to crumple.
Under sustained questioning from senior counsel assisting Michael Hodge, QC, about what exactly he had apologised “unreservedly” for in a prior written witness statement, AMP’s head of advice, Anthony “Jack” Regan, pleaded for mercy.
“I will have to take that on notice,” an ashen-faced Regan told his inquisitor.
“That’s not really how it works,” reprimanded Hodge. “Is the answer you just don’t know?”
“Yes, I’m uncertain,” Regan replied.
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Liberals push for national rollout of data trump card

  • The Australian
  • 12:00AM April 21, 2018

Michael Owen

The Liberal Party is being urged by its South Australian and Victorian divisions to roll out nationally a sophisticated, data-mining ­approach to campaigning using a US-designed software system that was critical to delivering unlikely successes for Donald Trump in key swing states that won him the election.
The i360 program has been credited with playing a key role in the South Australian Liberals’ success in last month’s state election.
The Victorian Liberals are also using the program in the lead-up to November’s state’s election and their Queensland counterparts are about to sign up.
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Ban percentage fees to fix the advice industry

  • The Australian
  • 12:00AM April 21, 2018

Alan Kohler

It’s perfectly understandable that AMP’s and CBA’s financial planning arms kept charging fees when no services were being provided — even, in the case of CBA, to the long deceased — because there is very little difference between providing financial advice and not providing it.
Financial planning services, especially those provided by the banks and AMP, have always been a joke, and it is beginning to look like His Honour Kenneth Hayne, royal commissioner, is going to so find. It is almost as big a joke as the statement in the royal commission’s terms of reference that Australia boasts “the strongest and most stable banking and superannuation systems”, and “world’s best prudential regulation and oversight”.
The fact that financial advisory practices were continually referred to in the commission this week as “dealer groups”, which is what everyone in the industry has always called them and still does, rather gives the game away. They don’t see themselves advisers, but groups of dealers.
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Planning for retirement is no longer simple

By Daryl Dixon
22 April 2018 — 12:00am
Planning for retirement is no longer the simple process it once was. Choosing investments to prepare for retirement is now much more complicated.
Already the government has capped the maximum amount that can be invested in tax-free pension funds at $1.6 million and limited annual tax-deductible superannuation contributions to $25,000.
Higher income taxpayers will require other ways to accumulate sufficient wealth to maintain their living standard in retirement.
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National Budget Issues.

Labor tax switch a ‘$1bn-a-year blow to states’

New housing sales would slow under the Labor policy, modelling shows.
  • The Australian
  • 12:00AM April 16, 2018

Adam Creighton

Increasing tax on capital gains, including the sale of investment properties, a core Labor policy, would increase rents, reduce economic growth, and sap state government coffers by $1 billion a year — more than twice the extra tax raised at the federal level — an analysis has found.
The economic analysis of the effect of halving the capital gains tax discount to 25 per cent — a policy Labor plans to take to the election — found this would also increase house prices because the supply of new homes would be lower than otherwise.
Scott Morrison seized on the report last night to remind voters of Labor’s plans to increase taxes by more than $200bn over a decade, including winding back negative gearing and stopping cash refunds for franking credits.
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We will show budget restraint: Morrison

The IMF has urged governments to take steps to bolster growth and take action now to counter the next economic downturn.
Updated  19-Apr-2018
Treasurer Scott Morrison has flagged the May budget will show the Turnbull government continues to live within in its means while investing to produce a strong economy.
"Australians continue to ensure their belts are tightened and the government will continue to do the same thing," Mr Morrison told reporters in Sydney on Wednesday, responding to a warning on the global outlook from the International Monetary Fund.
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Health Budget Issues.

Private health insurance analysis shows double-digit rise in some premiums

Consumer group Choice says in one case a private provider increased costs by 45%
Thousands of private health insurance customers have seen the cost of their premiums soar well above the expected 3.95% average increase, with figures showing more than a dozen policies have jumped by double-digit figures.
A new analysis of the annual health insurance premium increases – which came in on 1 April – reveals that in one case a private provider increased costs by 45%.
The figures were revealed by consumer advocacy group Choice on Sunday. The group said in some cases the increases will mean families will need to pay an additional $800 a year, and will put more pressure on the growing number of Australians already struggling to pay their private health insurance.
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No cure close for ailing $2.3bn Royal Adelaide hospital

  • The Australian
  • 12:00AM April 16, 2018

Michael Owen

It was supposed to be the hospital of the new millennium, once rated the world’s third-most expensive building at an eye-watering $2.3 billion.
But seven months after it opened a year and a half late and $640 million over budget, the new Royal Adelaide Hospital is beset by chronic overcrowding, which has almost reached “disaster” levels, and inefficient patient flow — and that is before the winter flu season strikes.
Relatives have told of loved ones being sent home a day after major surgery, and being urged to wait outside to be picked up on hot days; of corridors buzzing with privately contracted catering and cleaning staff but an apparent shortfall of medical workers capable of dealing with an actual medical emergency.
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'Super gonorrhoea' resistant to all routine antibiotics found in Australia

By Jorge Branco
Two people in Australia have been diagnosed with the “super gonorrhoea” infection recently reported for the first time, which has highlighted growing concerns about antibiotic overuse.
A Queensland Health spokesperson on Tuesday confirmed two cases of gonorrhoea resistant to multiple antibiotics were detected in the past month; one in Queensland and one in Western Australia.
Both cases were diagnosed after pathology tests and it is understood one of the cases acquired the infection while in south-east Asia. Investigations were continuing into the second case.
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Spot check uncovers aged-care breaches

  • The Australian
  • 12:00AM April 18, 2018

Rick Morton

A sixth aged-care home operated by an arm of the Uniting Church in Queensland has failed an unannounced audit because it did not have enough qualified staff.
The failure of Blue Care Mareeba on the Atherton Tableland, west of Cairns, has emerged as the government announces today that an independent commissioner will oversee safety and standards in nursing homes and critical incident response units will be sent to troubled facilities.
The Herald Sun reports that, nursing homes will face unannounced inspections and the organisations that run them will be subject to tougher standards, from the food they serve to the medical treatment provided.
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Aged care a ‘national crisis’: Bill Shorten

  • The Australian
  • 3:49PM April 18, 2018

Greg Brown

Bill Shorten has labelled Australia’s aged-care industry as a “national crisis” and a “disgrace” as he savaged the Turnbull government for a “too little too late” announcement of a new safety watchdog for nursing home operators.
The Opposition Leader said the government’s overhaul of the aged-care system, announced today by Aged Care Minister Ken Wyatt, was an “overdue step” from a government that had not taken the issue seriously.
“For older Australians in aged care they are out of sight therefore they are out of the Turnbull government’s mind,” Mr Shorten said.
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'Set up to fail': PHNs are facing multimillion-dollar cuts

Stalled contract negotiations could see some hit with cuts of more than $3 million
19th April 2018
Primary health networks (PHNs) are facing multimillion-dollar funding cuts just as Health Care Homes and other major reforms pick up speed.
Contract negotiations between the Department of Health and several of the 31 PHNs have been at a stalemate for more than five months after a number of the networks baulked at plans to reduce their scope to commission GP support services.
The Federal Government plans to reduce annual spending on local primary care co-ordination and quality improvement programs from $423 million to $327 million by 2020/21.
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Health imaging workers tackle Coalition ‘promise’ on Medicare

  • The Australian
  • 12:00AM April 20, 2018

Sean Parnell

The political firestorm over the Medicare freeze has reignited three weeks out from the budget, with radiologists, sonographers and diagnostic imaging providers escalating their campaign for Medicare rebates to increase.
Tensions between the sector and the Turnbull government have emerged on several fronts, with radiologists also fighting restrictions proposed by a Medicare review taskforce and using a Senate committee to call for greater access to expensive MRI services.
It is reminiscent of the broader industry response to health cuts and reforms in the Coalition’s first term, which Malcolm Turnbull acknowledged had provided “fertile ground” for Labor’s so-called ­Mediscare campaign.
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Psychiatrists concerned subpoenas could compromise patient care

By Blake Foden
Psychiatrists fear patients will withhold information vital to their care because their full psychiatric histories can be subpoenaed and aired in tribunal hearings.
Canberra-based psychiatrist Dr Ingrid Butterfield said two of her patients' records had been subpoenaed by the Administrative Appeals Tribunal, at the request of the National Disability Insurance Agency, in the past month.
The cases before the tribunal relate to the patients' disputes with the agency, which assesses eligibility for care under the National Disability Insurance Scheme.
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International Issues.

Trump's strike against Assad futile, but will make him feel better

By Peter Hartcher
15 April 2018 — 8:10pm
After an unhappy century, the Western powers are leaving the Middle East in a state of dangerous disarray but sought to retrieve a little dignity on the way out.
The US, Britain and France on the weekend launched missiles at a handful of Syrian government sites to defend the global ban on the use of chemical weapons.
The Western strike was a small action with a specific stated aim - the strikes "were successful and necessary to deter" Assad from using chemical weapons in future, according to a background briefing for reporters at the Pentagon.
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Government calls on Britain to raise effort in the Pacific amid China push

By David Crowe
15 April 2018 — 4:15pm
The Turnbull government is urging Britain and other Commonwealth nations to step up their engagement in the Pacific amid concerns about the growing influence of China, calling for a shift in thinking on billions of dollars in aid funding.
The new message highlights Britain’s exit from the European Union to make the case for a stronger Commonwealth presence in the Pacific Islands based on “shared beliefs in freedom” and a commitment to the rule of law.
The call comes after the construction of a mammoth port in Vanuatu fuelled concerns about China’s ability to extend its naval power in the region, triggering a denial from the Vanuatu government that it would support any such military plans.
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Vladimir Putin predicts 'global chaos' if West strikes Syria again

By Jack Stubbs & Laila Bassam
16 April 2018 — 2:35am
Moscow: Russian President Vladimir Putin warned on Sunday that further Western attacks on Syria would bring chaos to world affairs, while signs emerged that Moscow and Washington want to pull back from the worst crisis in their relations for years.
Putin made his remarks in a telephone conversation with Iranian counterpart Hassan Rouhani after the United States, France and Britain launched missile strikes on Syria on Saturday over a suspected poison gas attack.
A Kremlin statement said Putin and Rouhani agreed that the Western strikes had damaged the chances of achieving a political resolution in the multi-sided, seven-year conflict that has killed at least half a million people.
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Russia launches cyberwar on UK as Macron offers to mediate Syria crisis

By Gordon Rayner
16 April 2018 — 8:42am
London: Russia has launched a "dirty tricks" campaign against Britain and the US in the wake of the Syria airstrikes, according to British government sources.
Whitehall confirmed a 20-fold increase in "disinformation" being spread by Kremlin-linked social media "bot" accounts since the missile attacks on Syria in the early hours of Saturday. There are fears that this could be a precursor to a full-scale campaign of cyber attacks by Moscow, with British Foreign Secretary Boris Johnson saying Britain would take "every possible precaution" to guard against it.
Russia, which backs the regime of Syrian President Bashar al-Assad, had repeatedly warned in the build-up to the cruise missile strikes that there would be consequences if they went ahead, and Johnson told the BBC's Andrew Marr that Russia "gives us every possible signal and evidence that we have to beware".
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Strike on Assad: the good, bad and ugly of a limited hit

  • The Australian
  • 12:00AM April 16, 2018

David Kilcullen

On Friday evening Bashar al-Assad and his sponsors were showing signs of nervousness. Russian ships stood out to sea in case of a strike, and the regime sent its most advanced aircraft to Russia’s airbase at Khmeimim, putting them under the Russian air-defence umbrella. Assad spent the night at an undisclosed location, concerned about a decapitation strike.
As the sun rose on Saturday, he no doubt woke up relieved. If last year’s US strike on al-Shayrat was a pinprick, then this was three pinpricks: sharply limited attacks on three facilities selected for symbolic effect. The bulk of Assad’s air force and regime structures were untouched, while his war-making power remains unimpaired.
Like any operation, the strike had its good, bad and ugly aspects.
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The three amigos of the West strike a blow for the good of humanity

  • The Australian
  • 12:00AM April 16, 2018

Greg Sheridan

The combined American, British and French strike on Syria is the most important geo-strategic development of the Trump era so far.
Donald Trump looks infinitely more formidable acting in the company of Theresa May and Emmanuel Macron.
This is a much more important development than Trump’s earlier missile strike on Syria. It flatly contradicts the idea that the Trump administration is isolationist.
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Syria strikes: history of chemical warfare has been foul indeed

  • Clive Williams
  • The Australian
  • 12:00AM April 16, 2018
The Syrian government’s attack on Jaysh al-Islam fighters in Douma, probably using chlorine gas and a nerve agent, highlighted the temptation to use chemical weapons when other means of military attack are likely less effective.
Jaysh al-Islam (Army of Islam) is a Saudi-backed coalition of Salafist anti-regime militant groups based in the Douma and Eastern Ghouta regions of the Syrian capital of Damascus. About 4500 to 5500 Jaysh al-Islam insurgents had remained in Douma “to fight to the death” after earlier safe-­conduct evacuations.
Talks between the insurgents, the Assad regime and the Russians (about the insurgents evacuating Douma) broke down the week ­before, leaving the regime with the prospect of having to fight through Douma against an enemy well-­entrenched in buildings and basements, and using civilians and Syrian army prisoners of war as protective shields.
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US to hit Russia with new sanctions for aiding Syria

  • The Australian
  • 10:21AM April 16, 2018

Cameron Stewart

President Donald Trump has defended his use of the phrase “Mission Accomplished” to describe a US-led missile attack on Syria’s chemical weapons program, even as his aides stressed continuing US troop involvement and plans for new economic sanctions against Russia for enabling the government of Bashar al-Assad.
Stepping up the pressure on Syria’s president, US Ambassador to the United Nations Nikki Haley indicated the sanctions to be announced today would be aimed at sending a message to Russia, which she said has blocked six attempts by the UN Security Council to make it easier to investigate the use of chemical weapons.
“Everyone is going to feel it at this point,” Ms Haley said, warning of consequences for Assad’s foreign allies.
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Russia's been at war with the US for years – they just didn't know it

By Peter Hartcher
Updated17 April 2018 — 8:33amfirst published 16 April 2018 — 6:28pm
It's taken a while, but it seems that the US is starting to grasp the nature of the campaign that Russia has been waging against it for years.
Even Donald Trump, who'd been blocking his ears to the evidence for years, is coming around to acknowledge the depth and forcefulness of the Russian challenge to the US and its allies.
Vladimir Putin has been operating an holistic political war, most broadly defined as a war using all means other than conventional military. He is at a disadvantage against the US in the conventional elements of hard power - money and weapons.
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Russia bombards Western allies with cyber attacks in Syria defence

By Nick Miller
16 April 2018 — 6:30pm
London: Russia has “reignited” its disinformation campaign against the UK and US, at a time when the British Prime Minister, Theresa May, is likely to face heavy political pressure over her decision to bomb Syria’s chemical weapons program.
On Monday pro-Russian sympathisers and bots were busy spreading a Russian claim that there was no chemical attack on Douma, or that it was a “false flag” operation by the White Helmets rescue volunteer group.
They even claim the attack was staged to distract the public from a supposed lack of clarity about who poisoned ex-spy Sergei Skripal in Salibsury in March.
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What is the OPCW? What can it do about chemical weapons in Syria?

By Palko Karasz
18 April 2018 — 6:33am
New York:  International chemical weapons inspectors on Tuesday entered Douma, the Syrian town that was the site of a suspected poison gas attack that led to Western airstrikes against the Syrian government, state media reported.
The team from the organisation for the Prohibition of Chemical Weapons arrived in the suburb east of the capital, 10 days after the alleged attack, raising concerns that any evidence the inspectors find could be useless.
Global chemical weapons experts finally reached the Syrian town of Douma, amid fears that evidence of an alleged chemical weapons attack there will now have been cleaned up.
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Launching missiles was the easy bit. Now what about Syria's future?

By Juliet Samuel
17 April 2018 — 2:19pm
There's a cartoon doing the rounds online in Idlib, one of Syria's last rebel strongholds. It depicts a huge mountain of skulls, all white except for one, which is glowing bright yellow from the effects of a chemical weapon attack. A spindly Uncle Sam is reaching into the pile to pluck out the yellow skull, outraged and shocked, while ignoring all the skulls around it.
A signature on the cartoon indicates it's from last year, but it could just as well have been drawn today. "Mission accomplished," boasted Donald Trump, after Saturday morning's air strikes. Britain, said Theresa May, had learnt "the lesson of history" and was taking a stand on "the global rules and standards that keep us safe". This will ring rather hollow in Syria, where at least 400,000 people have died and 13 million been displaced by its civil war so far. The truth is that, despite these air strikes, the war is getting worse, not better, and the ferocious debate we are having in this country is nothing but a sideshow.
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China's live fire drill a 'red line' in Taiwan Strait

By Kirsty Needham
18 April 2018 — 5:40pm
Beijing: China has held a live-fire drill in the Taiwan Strait, with Chinese media reporting the aim was to "deter separatists" and "draw a red line to the US and Taiwan".
However Taiwan's president, Tsai Ing-wen, who has drawn the ire of Beijing since taking office in May 2016, was not in the country as the naval drill started on Wednesday.
Taiwan accused Beijing of sabre rattling, and Taiwan's military chiefs downplayed China's People's Liberation Army's exercise, which is the first live fire drill in the Taiwan Strait since Tsai took office.
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Israel warns Iran: leave Syria

  • The Australian
  • 12:00AM April 20, 2018

Adam Creighton

One of Israel’s most senior diplomats has laid down the gauntlet, suggesting the Middle East could be months away from major conflict if Iran persists in maintaining military bases in Syria.
In a sit-down interview with The Australian to mark the country’s 70th anniversary, Israel’s new ambassador to Australia, Mark Sofer, doesn’t mince words, dwelling on Israel’s grave concerns about the insidious beachhead of Iranian military power pushing into Syria, which shares a border with Israel.
“Iran cannot stay in Syria, period. We’re not going to have them on the border. It has passed what we are going to be able to accept under any circumstances,” he says, adding Iran is “crossing a red line”.
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  • Apr 20 2018 at 11:00 PM

Rampant Chinese IP abuses at heart of President Donald Trump's trade war threat

Donald Trump and American business leaders are fed up with China pilfering the "secret sauce" of innovative US firms that underpins America as a global economic and security superpower.
At the heart of the US President's threat to ignite a trade war is China's rampant intellectual property (IP) abuses and forced technology transfers from American companies.
To help understand the ire of the Trump administration, corporate America, and Republicans and Democrats alike, US business groups are pointing to the case of American Superconductor (AMSC) as one pertinent case study among many examples.
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Nobel laureate economist declares war against 'know-nothing' Trump

American economist and Nobel laureate Joseph Stiglitz has been talking about the dangers of inequality since the 1960s. That a prime beneficiary of the growing chasm between rich and poor now occupies the White House is beyond galling to him. It’s war.

By Nick Bryant
Updated21 April 2018 — 1:23amfirst published at 12:09am
Growing up, Joseph Stiglitz bore witness to America's economic future. The decline of the once-mighty industrial heartland. The hollowing-out of Rust Belt communities. The decimation of the middle class. The chasm not just between rich and poor, but the rich and the rest.
The Nobel laureate in economics, who wore hand-me-downs from his elder brother that were clothes bought by his mother off the sale rack, came of age in Gary, Indiana. Even then, back in the supposed Golden Age of the 1950s, the struggling steel town was becoming part of a post-industrial landscape that provided a seedbed for Donald Trump. "I saw the case studies before people gathered the data," says Stiglitz, whose writings over the past 50 years about the growing income gap in the US economy now read like forewarnings of President Trump's rise.
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I look forward to comments on all this!
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David.