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."

Monday, December 02, 2019

Weekly Australian Health IT Links – 2nd December, 2019.

Here are a few I have come across the last week or so. Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

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The big news item of last week was the release of the ANAO Audit of the #myHealthRecord implementation where the ADHA claimed perfection largely and most commentators who had a clue suggested there were at least a few areas that needed a serious look. You pay your money and take you chance!
Qld and a few other items also featured in an otherwise calm week as the silly season approaches!
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How two British shark victims posed a challenge for Queensland patient confidentiality

By Lucy Stone
November 24, 2019 — 9.33pm
Confidentiality "flags" were placed on the private medical records of two British shark attack victims treated at Mackay Hospital, warning curious staff they should only access the records for valid medical reasons.
The incident was one of several case studies presented to the Crime and Corruption Commission’s public hearings for Operation Impala, investigating the misuse of private data in public organisations.
Mackay Hospital and Health Service’s executive director of people, Rod Francisco, gave evidence to the hearings last week, detailing his concerns about the broad level of access to patient medical data in the integrated electronic medical record (ieMR).
The ieMR enables clinicians to view a patient's medical record from any of the 14 Queensland public hospitals in which the software has been installed.
Questioned by counsel assisting the CCC Julie Fotheringham, Mr Francisco said the broad access of data was a risk that Mackay HHS had not fully understood in the lead-up to the software’s rollout there about two years ago.
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'Flawed' privacy in Queensland Health's electronic medical record, expert says

By Lucy Stone
February 1, 2019 — 11.08am
A "very strange model" allows all Queensland Health clinicians to edit the medical data of all patients in public hospitals that have the integrated electronic medical record installed, a leading health law expert says.
Queensland University of Technology innovation law professor Matthew Rimmer said it appeared the $600 million electronic medical record project had a “whole host of issues”.
QUT law professor Matthew Rimmer: “There’s a real failure there to understand what adverse impacts could take place.”
Dr Rimmer, who specialises in intellectual property and public health, questioned why clinicians working in any of the state's digital hospitals could view any patient's record and edit all aspects, including medication prescriptions.
“That seems a terrible approach, surely one would want to engage in data minimisation,” he said.
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Qld Health risks patient admin system failure after halting overhaul

By Justin Hendry on Nov 28, 2019 6:55AM

Auditor says favoritism allegations delayed new system by several years.

Queensland Health’s decision to pause the replacement of its legacy patient administration system earlier this year due to nepotism allegations has increased the chance of potential system failure, according to the state’s auditor.
An annual audit of the department’s finances released on Tuesday found the almost 30-year-old hospital-based corporate information system (HBCIS) was now at greater risk after the “planned go-live was pushed out several years”.
Queensland Health has been trying to replace the mission critical system, which is currently used in all of the state’s public hospitals to keep track of patients and their treatment, for at least the last six years.
“This [delay] increases the risk of the current system not being appropriately supported and failing,” the auditor said [pdf], adding that the department was in process of “procuring resources to mitigate this risk”.
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'TripAdvisor for hospitals' legislated in Queensland Parliament

By Lydia Lynch
November 28, 2019 — 11.15pm
Queenslanders will now be able to choose hospitals based on surgical wait times and patient outcomes.
Under legislation passed by State Parliament on Thursday, patients and their families will be able to compare information about both public and private health facilities, published online.
Facilities including hospitals, day surgeries and aged care homes will be required to upload information such as staffing levels, average time spent in hospital and infection management and hygiene practices.
Private aged-care facilities will be able to opt out of providing information for the website, but they will be named and shamed if they do
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Agencies fail My Health privacy audit

By Finbar O'Mallon
November 25, 2019 — 3.07pm
Most of the emergency access requests made by third parties to Australians' digital health records were unjustified, the national auditor has found.
The Australian National Audit Office (ANAO) said government agencies overseeing Australians' digital health records didn't properly manage or consider the cyber security and privacy risks.
The auditor made a number of recommendations to improve privacy and cyber security in its report released on Monday.
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Third party minimum cyber compliance for My Health Record skipped: Audit Office

Instead of testing against the Australian government's Information Security Manual, vendors sign a form saying they are compliant.
By Chris Duckett | November 25, 2019 -- 05:07 GMT (16:07 AEDT) | Topic: Security
The Australian National Audit Office (ANAO) has pointed out a number of security issues concerning the Australian Digital Health Agency's (ADHA) My Health Record implementation, among a report that widely gave ADHA the tick as "largely effective".
In its report released on Monday, ANAO pointed out that in a 2016 end-to-end security review, ADHA decided against accrediting those that provide services to healthcare providers.
"ADHA rejected this recommendation on the basis that it 'presents several challenges' including the additional burden to vendors and potential for reputational damage," ANAO said.
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My Health Record failed to manage cybersecurity and privacy risks, audit finds

Government agency in charge of $1.5bn system did not provide appropriate protections, national audit office says
Implementation of the $1.5bn My Health Record system failed to appropriately manage cybersecurity risks, a review by the national audit office has found.
The review found implementation was “largely effective”, but revealed the government agency could not guarantee that all “emergency access” requests to view an individual’s record were legitimate, and that four privacy reviews funded since it became an “opt-out” system were never finished.
The Australian National Audit Office review said the cybersecurity and privacy risks were not properly managed or considered by the Australian Digital Health Agency, which oversees the national electronic heath records.
The database, which relies on doctors and medical practices to upload clinical information about patients, seeks to ensure continuity of care for patients with all medical information centralised. It was opt-in from 2012, but converted to opt-out this year.
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My Health Record exposed to shared cyber security risks

By Justin Hendry on Nov 26, 2019 12:10AM

Otherwise positive audit concerned by lacklustre third-party controls.

Australia’s national auditor has given the country's My Health Record system a mostly clean bill of health, despite persistent issues with the management of shared cyber security risks.
In an audit [pdf] into the implementation of the electronic health record released on Monday, the Australian National Audit Office (ANAO) said the planning and delivery of the system had been “largely effective”.
This includes preparations for the switch to an opt-out model, which took place this year after an extended opt-out period saw in excess of 2.5 million Australians elected not to have a record.
“The My Health Record expansion to an opt-out model was implemented in accordance with an approved business case and implementation plan,” the audit states.
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My Health Record ‘largely effective’ despite security risks, audit finds

Tuesday November 26, 2019
The federal government’s controversial My Health Record has been given the tick of approval by the national auditor-general, despite it being exposed to shared cybersecurity risks.
The online medical database sparked national privacy and security concerns from tech experts to family violence groups to teenage health advocates in the lead up to the “opt-out” deadline in January this year. 
In its latest report, the Australian National Audit Office has described the widespread criticism as simply, “parliamentary and public interest in relation to privacy and cybersecurity risks”.
But apparently there was nothing to fear. The implementation of the My Health Record system was “largely effective”, auditor-general Grant Hehir concluded. 
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My Health Record on track to save $15 billion, audit finds

But a security concern could lead to a crackdown on GP clinics
26th November 2019
My Health Record is on track to save $14.6 billion in healthcare waste by 2027, the Australian National Office of Audit claims.
The office’s 10-month review of whether the maligned system has been value for money has concluded the rollout of My Health Record has been “largely effective”.
It is meeting goals for participation and awareness, including having more than 80% of GP clinics registered by 2019, said the audit report, which was published on Monday.
The audit — which itself cost taxpayers $613,000 — said the Federal Government was expected to have spent $3.3 billion on My Health Record by 2028.
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My Health Record gets clean bill of health

National auditor finds implementation was ‘largely effective’.

By Casey Tonkin on Nov 27 2019 02:49 PM
Controversial digital health scheme My Health Record has been given a relatively clean bill of health by the Australian National Audit Office (ANAO).
This week, the ANAO released its findings into the implementation of the My Health Record system.
For the most part, the ANAO concluded that the system was built in a “largely effective” manner with appropriate planning, execution, and communication throughout the implementation.
The national auditor said My Health Record’s cybersecurity posture – a major cause for concern during its rollout – was good, but expressed disappointment with how shared cyber risk is currently handled.
“Risks relating to privacy and the IT system core infrastructure were largely well managed, and were informed by several privacy risk assessments and the implementation of key cyber security measures,” the ANAO report said.
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My Health Record expansion "largely effective": ANAO

By Dylan Bushell-Embling
Thursday, 28 November, 2019
The Australian National Audit Office (ANAO) has given the government a qualified nod for the expanded implementation of the My Health Record system, despite identifying several security risk management shortcomings.
A recently released performance audit into the implementation of the system by the Australian Digital Health Agency (ADHA) and Department of Health has found that the expanded implementation incorporating the opt-out system was “largely effective”.
Implementation planning for and delivery of My Health Record under the opt-out model was likewise found to be appropriate and effective in achieving its objectives, the audit found.
But risk management for the expansion program was found to be only “partially appropriate”. While privacy and IT system core infrastructure related risks were largely well managed, management of shared cybersecurity risks was not appropriate and still needs improvement.
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Audit reveals potential security risks in My Health Record

It also found monitoring and evaluation arrangements for the system are ‘largely appropriate’.
28 Nov 2019
The Australian National Audit Office (ANAO) concluded that the implementation of the My Health Record system has been ‘largely effective’, despite determining risk management for the expansion program to be only ‘partially appropriate’.

It also found monitoring and evaluation arrangements for My Health Record are ‘largely appropriate’, and the planning for and delivery of the opt-out model was ‘effective in promoting achievement of its purposes’.

Dr Rob Hosking, Chair of the RACGP Expert Committee – Practice Technology and Management (REC–PTM), told newsGP the report shows infrastructure is secure, with concerns raised related to peripheral connections to My Health Record – including hospitals, pharmacies and all other health practitioners who are connected.

‘For the most part, this is currently GPs. It also includes patient connection via computer or mobile apps,’ Dr Hosking said.
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My Health Record: Australian healthcare scheme grades poorly on cybersecurity

Emma Woollacott 28 November 2019 at 14:13 UTC
Audit finds centralized database puts patient privacy at risk
A review of Australia’s controversial My Health Record scheme has concluded that it does, as experts have warned, present security risks to the public.
My Health Record is an electronic healthcare system designed to provide Australians with seamless healthcare across different medical services.
Earlier this year, it was changed from an opt-in to an opt-out scheme, despite concerns about privacy and security.
In its review of the system, published on Monday (November 25), the Australian National Audit Office (ANAO) concluded that the A$1.5 billion ($1 billion) project is “largely effective”, although poor management of shared cybersecurity risks, including inadequate controls over access to patients’ records, remains a pressing issue.
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On the safety of EHRs

Posted on November 29, 2019 by Grahame Grieve
The subject of EHR safety is back in the news – probably driven by the AMIA meeting last week:
“I remember internal conversations where we talked about ‘What is the equivalent of a plane crash that is going to get the attention of people?’” said Reider, who now practices family medicine in upstate New York. “‘Is it going to be a congressperson’s relative is harmed by health IT that causes the attention to shift?’ I would offer that still hasn’t happened yet, but someday it will. And gosh, wouldn’t it be a horrible thing that we have to wait for that to happen?”
What the article doesn’t discuss – which is actually a remarkable omission – is that the issue at heart is not technology, and not even the software under question.
That’s actually evident in the two solid instances of harm offered in the article:
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Dreaded chore or fresh start? This GP faces the fallout of a new e-health records system

Dr Duvefelt, aka 'A Country Doctor', is a family doctor in the US.
27th November 2019
At the end of the year my patients and I will start over.
That is what changing e-medical records (EMR) does to us.
I have mixed feelings about data migration, if it even happens.
I will move into a new virtual environment and my patients will take on slightly different appearances, maybe even alter their medical histories.
Some will perhaps be asking me to edit diagnoses that have haunted them since we went from paper to computer records almost a decade ago.
With our first EMR, we scanned in a few things from patients’ paper records – sometimes only a few pages from years or decades of first handwritten and later typed notes.
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Monash Uni widens blockchain research scope with new centre

The new centre will see the university's IT faculty work with other faculties and international partners in the Asia-Pacific region.
By Aimee Chanthadavong | November 25, 2019 -- 13:01 GMT (00:01 AEDT) | Topic: Innovation
Monash University has launched a research centre dedicated to blockchain that will see different faculties within the university and its international partners in the Asia-Pacific region develop and demonstrate the usability of blockchain technology.
The Monash Blockchain Technology Centre (MBTC) will be headed up by Monash University associate professor Joseph Liu as director, who explained to ZDNet that the creation of the MBTC comes off the back of a blockchain research lab that already exists within the university's faculty of IT.
"We have a blockchain research lab that was established two years ago. But the research lab is just an internal research lab within the IT faculty, and we found that blockchain is not just restricted to IT," he said.
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PHO reveals story of cyberattack

Wednesday, 27 November 2019  
Hayley McLarin
It takes a long time to recover services after a cyberattack – but it takes even longer to recover trust, says the chief executive of primary healthcare organisation TÅ« Ora Compass Health.
Martin Hefford spoke to a packed session at Digital Health Week NZ in Hamilton on 21 November, three months after the agency was targeted in a cyberattack.
He told attendees the organisation was already scoping its digital vulnerability and investigating buying cyber insurance when the breach occurred in August.
TÅ« Ora immediately informed the Ministry and an investigation has since revealed evidence of four attacks by cyber criminals dating back to 2016.
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'Serious misjudgment': policeman fined for giving friend intelligence

By Georgina Mitchell
November 25, 2019 — 6.16pm
A NSW highway patrol officer has been convicted and fined $3080 after he met a long-term friend at a cafe this year and gave him restricted information from the police computer system, in an interaction witnessed by an undercover operative.
Phillip Edward Parker, 53, told his friend of 30 years that Strike Force Raptor – a police taskforce targeting bikies and criminal activity – had written two intelligence reports about him in police database COPS.
Parker told his friend the dates the reports were put into the system and said they concerned his friend's presence at an incident, as well as information about a stolen tow truck from 2008.
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Canberra concedes parts of robo-debt are unlawful

Federal government concedes robo-debt averaging, 10% penalty fee, and tax return seizing were unlawful.
By Chris Duckett | November 27, 2019 -- 05:30 GMT (16:30 AEDT) | Topic: Innovation
Major elements of the automated debt recovery process known as robo-debt are unlawful, the federal government has conceded in a test case brought by Victoria Legal Aid and Deanna Amato in Federal Court.
On Monday, the government sent a letter to the Court stating its averaging process, 10% penalty fee, and seizing of tax returns were unlawful, Victoria Legal Aid said.
Issuing orders [PDF] by consent on Wednesday before a full hearing, the Federal Court ordered the government to pay costs and to pay Amato back AU$92 in interest, after Canberra previously returned the AU$1,710 it had seized from her entire tax return.
"My robo-debt should never have occurred in the first place. I feel pleased to have won my case but it's bittersweet to know so many people have paid money under this system," Amato said.
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After robo-debt smackdown, Robert claims Canberra's digital transformation pushes on

The Minister for Government Services said the Australian government is making progress in achieving its 2025 digital transformation goal.
By Aimee Chanthadavong | November 29, 2019 -- 02:01 GMT (13:01 AEDT) | Topic: Digital Transformation
Minister for Government Services Stuart Robert has announced the federal government has started to undertake work to build a single, whole-of-government technology architecture as part of its digital transformation strategy to make all its services digital by 2025.
In his address at an Australian Information Industry Association (AIIA) event in Canberra on Friday afternoon, Robert detailed how the Digital Transformation Agency (DTA) has created a taskforce with the largest "technology shops" in government -- Defence, Home Affairs, ATO, and Government Services -- to explore what the technology architecture could potentially look like.
"It will start by identifying critical technology capabilities that support broad business outcomes and progressively develop a more nuanced view of strategic capabilities across government," he explained.
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Data61, UNSW create tool that uses AI to predict disease outbreaks from Twitter

Australian researchers have created a tool that monitors Tweets to predict outbreaks of diseases. Researchers from Data61, the data research arm of Australia’s national science organisation CSIRO, say the tool uses artificial intelligence to analyse Twitter posts to establish a pattern of a disease outbreak.
The agency has been working on the project with the University of NSW Sydney’s Kirby Institute
Data61 says it tested the tool on a breakout of a thunderstorm asthma epidemic that hit Melbourne exactly three years ago.
Thunderstorm asthma is the triggering of an asthma attack by environmental conditions directly caused by a local thunderstorm.
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Transition to e-prescribing vital for national health

By Amy Sarcevic
Wednesday, 27 November, 2019
The healthcare sector should phase out paper prescriptions sooner rather than later, but be prepared for patient reactions in the transition to e-prescribing, said the Chair of the SHPA’s Electronic Medications Management Leadership Committee, James Grant.
Grant’s comments come after the federal government’s $15.3 million pledge to build e-prescribing technology into doctors’ existing clinical software and the recent passing of Commonwealth legislation, setting states and territories up to enable e-scripts as a legal alternative to their paper counterparts.
“At present e-scripts aren’t mandatory, but as long as the sector remains beholden to archaic practices, it will be constrained and won’t realise its full economic or health benefit potential,” he told Hospital + Healthcare.
“At an individual level, the benefits of e-prescribing may seem trivial. But at an organisational or national level, they are staggering. We are talking multimillion-dollar savings, significantly improved clinical workflows and better patient outcomes.
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How a near-death predictor will improve aged care

Antony is a medical reporter with a special interest in technology and pharmacy.
26th November 2019
Aged care has been the topic of the year, with the royal commission’s public hearings culminating in the interim report, Neglect, published last month.
It comes as Telstra Health says it will revamp its aged care clinical software to include a computer-based clinical decision support tool to predict when residents are near death.
The tool will compare the patient’s history and other health data to historical cases and alert doctors and nurses if the patient is likely to die soon.
It’s not a new approach; it’s used in ICUs, either in the form of pen-and-paper mortality risk scores or more cutting-edge machine learning technology.
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How a face scan in the GP waiting room may just save your life

Australian researchers have developed new camera technology that can detect heart rhythm defects by scanning patients’ faces in a GP waiting room.
The heart rhythm abnormality known as atrial fibrillation, which triggers catastrophic strokes, is a common condition that often remains undiagnosed.
Doctors usually detect atrial fibrillation in patients by performing an electrocardiogram.
The new technology uses a ­single camera to record facial features on groups of people at once, said Heart Research Institute cardiologist Ben Freedman, who researched and developed the technology in conjunction with Hong Kong-based academics.
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Garvan Institute debuts VR genomics experience

By Staff Writers on Nov 28, 2019 1:30PM

Capturing processes textbooks miss.

One of the biggest barriers in communicating the work done at Sydney’s Garvan Institute of Medical Research is that cells and their components don’t really look like the 2D figures in textbooks.
The institute has turned to virtual reality (VR) to better engage stakeholders, helping them visualise the constant 3D movement of cellular activity, with elements of gamification added to increase users’ understanding of how cells function.
The VR experience was developed in-house by biomedical animator Dr Kate Patterson and Mark Arrebola, who also works at the 3D Visualisation and Aesthetic Laboratory at UNSW Sydney.
Dubbed 'Cell Explorer', the game first shrinks the user down to the size of a cell before taking them inside to observe and interact with the molecules and structures that keep the cell functioning.
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HICAPS and HealthShare announce new partnership          blank

25 November, 2019
HICAPS, Australia’s leading claims and payments solution for healthcare providers, has partnered with digital health company HealthShare to help private health fund members find a healthcare provider who offers HICAPS in their practice more quickly and easily.
HealthShare’s market-leading Find a Provider directory allows both consumers and GPs to research and find the right health provider for their individual needs. It is available at www.healthshare.com.au and receives more than 500,000 unique visitors a month.
NAB Health Customer Executive, Kate Galvin, said NAB continually looks for ways to improve the customer experience.
“This partnership will better connect healthcare providers with users looking for their services,” Ms Galvin said.
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Tuesday, 26 November 2019 10:57

Govt still dawdling on encryption bill amendments, says Dreyfus

Shadow attorney-general Mark Dreyfus has slammed the Morrison Government over its tardiness in implementing amendments to the encryption law which was passed last year, saying Finance Minister Senator Mathias Cormann had agreed to do so, and has yet to keep his word nearly a year on.
Dreyfus told the House of Representatives on Monday that Labor had agreed to pass the bill if it and the amendments suggested by the government be immediately referred to the Parliamentary Joint Committee on Intelligence and Security and that the new laws conformed to the recommendations of the committee by early 2019.
The encryption law, known as the Telecommunications and Other Legislation Amendment (Assistance and Access) Bill 2018, was passed on 6 December 2018.
A review was instituted by the PJCIS as soon as bill was passed, with a reporting date of 3 April. It was expected to provide some solace to the technology industry.
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November 27 2019 - 4:30AM

Sick days soared amid My Health Record flap

·         Adrian Rollins
The troubled introduction of the opt-out deadline for the $1.5 billion My Health Record may have taken a heavy toll on those tasked with its implementation.
There was a large spike in sick days with the roll out of opt-out apparently!
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Broadband tax now planned to kick in July 2020

By Justin Hendry on Nov 28, 2019 12:41PM
The federal government has reintroduced long-delayed legislation for a broadband tax on non-NBN operated fixed line services, which it hopes will be in place from 1 July 2020.
Communications Minister Paul Fletcher reintroduced the Telecommunications (Regional Broadband Scheme) Charge Bill 2019 “without notice” in parliament this morning after the government’s former bill automatically lapsed at the close of the last parliament in April.
The bill, which was introduced alongside another complementary bill to establish NBN Co as the new default fixed-line operator in Australia, will see residential and business users of "NBN-equivalent" fixed line services hit with a monthly fee of $7.10.
The proceeds of the tax would be used by NBN Co to fund future costs of commercially unviable portions of its network - the satellite and fixed wireless footprints - and prevent future calls on the budget or public funds.
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Tuesday, 26 November 2019 14:42

NBN Co spells out plans in wholesale pricing review paper

Lifting take-up of the National Broadband Network in under serviced consumer segments, promoting much higher speeds and improving support for Retail Service Providers in the face of increasing demand for broadband, are some of the key areas targeted by NBN Co in its newly released Wholesale Pricing Review 2019 Close-out Paper.
And creating a “regular cadence for future pricing consultations and “making it simpler and easier for RSPs to do business with NBN Co” are also included in the key areas to be targeted by NBNCo.
Announcing release of the paper on Tuesday, Chief Customer Officer Residential at NBN Co, Brad Whitcomb said, “Retailers strongly advocated for greater certainty on future wholesale prices, more included data capacity and better value for money. We’ve listened and this is exactly what we’re announcing today”.
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Tuesday, 26 November 2019 13:22

Lower prices, more data with new NBN wholesale discount plans

NBN Co, the operator of the National Broadband Network, has announced a range of new wholesale bundles offering lower prices and more data inclusions, following an extensive industry consultation process.
The announcement was welcomed by the Minister for Communications, Cyber Safety and the Arts, Paul Fletcher, who said “with this announcement, the effective wholesale price of data capacity across most bundles is now less than half its 2016 level.”
“It is pleasing to see NBN Co delivering greater value and more certainty for retailers, which is expected to result in better outcomes for consumers,” Minister Fletcher noted.
“NBN Co’s new wholesale products will provide more choice of cheaper, faster plans, with more data. This will deliver significant benefits for around 10.3 million Australian homes and businesses able to connect to the NBN.”
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NBN Co doles out data discounts

NBN Co is trimming its wholesale prices and giving retail telcos a chance to better manage their data capacity, in a bid to quell industry discontent over high charges imposed by the company rolling out the National Broadband Network.
The new measures, announced by NBN Co on Monday, will see the cost of the 25 megabits per second (Mbps) plan cut from $45 to $37. Meanwhile, the connectivity virtual circuit (CVC) inclusion on the 50Mbps bundle is being bumped up from 2Mbps per customer to 2.25Mbps per customers from May 2020, with the effective wholesale charge unchanged at $45. This CVC inclusion will increase again to 2.5Mbps from May 2021.
CVC is the price telcos pay to move data from the NBN to their networks. The amount of CVC a telco buys affects the internet speed, particularly at peak usage times from 7pm to 11pm.
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NBN Co to allow internet providers to pool CVC nationally

By Ry Crozier on Nov 26, 2019 12:00PM

Also approves over-dimensioning on most fixed-line services.

NBN Co will allow retail service providers to pool all their connectivity virtual circuit (CVC) bandwidth nationally from May 2020, a move that could ease pressure on rising costs.
The move forms part of NBN Co’s response to its five month long wholesale pricing review and is likely to be welcomed by retail service providers (RSPs).
Traffic exchanged between the RSP and NBN Co runs over a single CVC interconnect at each of the 121 points of interconnect (PoIs). 
CVC is pooled for all customers serviced at each PoI. RSPs manage this pool of CVC capacity dynamically and, if certain usage thresholds are reached, will generally top up the amount of CVC available in the pool. 
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NBN Co to temporarily cut 100Mbps prices starting 2020

By Ry Crozier on Nov 26, 2019 12:00PM

But not for existing users.

NBN Co is hoping to drum up interest in its forthcoming 100/20Mbps product by temporarily lowering the price of 100Mbps services in the New Year.
The company is planning to officially launch its new 100/20Mbps tier in May 2020, which will ultimately live alongside its existing 100/40Mbps product.
There is still no firm word on how retail service providers (RSPs) will treat the two 100Mbps products.
NBN Co earlier suggested that 100/20Mbps might naturally become a residential offering and 100/40Mbps a business offering, though it later said that positioning would be left up to RSPs.
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NBN to be given freer rein on greenfield sites

Nov 25, 2019 — 2.12pm
NBN Co would be freed up to use its Commonwealth-backed clout to compete for fibre broadband contracts in new residential developments, under rule changes flagged by the federal government.
The changes were flagged in a paper, released on Monday, calling for submissions on changes to its 2015 Telecommunications in New Developments (TIND) policy.
Unlike existing residential premises, where NBN Co is the monopoly fixed line broadband wholesale provider, new residential developments in greenfield sites remain open to competition.
Developers are obliged to build the pipes and ducts to carry fibre themselves, and then commission a fibre specialist to connect the premises. NBN Co and private player OptiComm are the main fibre specialists competing in this space.
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NBN Co has "difficulty competing" for new housing estate jobs

By Ry Crozier on Nov 25, 2019 10:52AM

Commercial operators' success prompts government review.

NBN Co’s ability to compete with commercial operators that build telecommunications networks in new housing estates is being tested, with the government plotting to intervene.
The Department of Communications today called a review of its Telecommunications in New Developments or TIND policy.
The department notes several reasons for the timing of the review, including to update it ahead of the completion of the NBN in mid-2020.
NBN Co’s role in building to new premises - known as greenfields - will continue into the future as one of its mandated obligations.
But housing developers do not have to select NBN Co to provide infrastructure into their estates.
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Enjoy!
David.

Sunday, December 01, 2019

The ADHA Is Pulling A Large And Costly Confidence Trick On The Australian Medical Profession.

An Efficiency Audit of the #myHealthRecord was published by the Australian National Audit Office (ANAO) on Monday 25 November.
Here is the direct link:
The broad conclusion regarding the Program was as follows:

Conclusion

6. Implementation of the My Health Record system was largely effective.
However, with that said, the Auditor-General then went on to express significant and important concerns with respect to major aspects of the cyber-security of the system, a lack of a Privacy Impact Assessment of the system following the move to opt-out and aspects of the plans for assessment and realisation of actual benefits from the system.
It is the third area I wish to focus on – not in any way to diminish the importance of the other two – they are key and critical.
Here are the key claimed benefits for the My Health Record:
“Potential health sector economic benefits were estimated from 2017 to 2027, totalling $14.59 billion. The benefit categories identified were:

  • ‘Improved health outcomes: if clinicians have greater access to medication information, it will result in avoided hospital admissions and saved lives’ requiring evidence of reduced hospital admissions, lengths of stay, emergency presentations, and general  practice visits;
  • ‘A much more efficient health system’ — requiring evidence of reduced healthcare provider time gathering information and communicating with other providers;
  • ‘Avoided duplication of diagnostic tests’ requiring evidence of reduced expenditure   duplicate tests due to better access to pathology and diagnostic imaging information;
  • ‘Putting the person at the centre of their healthcare’ requiring evidence of improved patient self-management through increased use of care plans, mobile apps and advance care plans linked to My Health Record; and
  • ‘Enabling innovation and developments in healthcare’ — requiring evidence of system improvements arising from secondary use of data and innovation in care delivery.”

Ignoring the obvious issue of trying to value such totally woolly ill-defined benefits for two decimal places any consideration must be balanced against the total expected investment with is slated to be of the order of $3.3 billion ($1.15B to 2016 and an additional $2.13B to 2027) for hardware, software services and the like.
So what we have is a very rubbery and unsubstantiated claim for benefits based on theory (as the A-G said – “The plan estimated the potential health sector economic benefits from implementing My Health Record as an opt-out model. Estimates were derived from academic studies rather than being extrapolated from actual My Health Record usage, due to a lack of sufficient historical data. Estimates were reviewed by a clinical reference group and clinicians from ADHA and Health. The plan stated that ‘estimates were calculated conservatively’.” With figures of this quality, which are essentially guesses I believe, one wonders how they would know.
The costs are equally unknowable over a decade (what new technology may emerge etc.) but for one important input which is not accounted for at all.
This is the cost / value of the time devoted by clinical users of the system to use of the system over a decade of usage.
If we assume each GP spends one session in total a day (15-20mins) on data entry and review, which would usually be billed at about $80, we can see a very interesting outcome.
The RACGP says the are about 36,000 active GPs.
Assuming 260 working days for $80 each = $20,800 in forgone income for each GP.
Assume 36,000 GPs all are involved at this level and we arrive at $748m p.a. And this assumes no donation to Government coffers from all the specialists (No wonder the ADHA is keen to involve them) which may easily double the total forgone payment while typing and searching for data.
Excluding the PIP payments of $50,000 per practice of which there are about 6300 - $315M in total if they all claim the payment - there is, at least, a net $400M or more of myHealthRecord subsidy to the system operation provided in kind by just GPs if they use it as hoped.
So, in summary, overall, we have a system with very ill-defined benefits, which are a long way out time-wise, being heavily subsidised in kind by the profession, when it does not offer them much value they can recognise for either them or their patients.
No wonder the level of keenness expressed as recently as a few days ago by the RACGP President is very low. Even modest use of the system, for little clinical value, costs the GP real income! Things, and subsidies, will really have to change a great deal to get any significant GP use of the system and any real quantum of the imagined benefit to be realised.
My bet – it just won’t happen!
David.

AusHealthIT Poll Number 503 – Results – 1st December, 2019.

Here are the results of the poll.

Is It Time For A Formal Review Of The ADHA And Its Management, Strategic Direction(s), Delivery, Finances, Competencies, Capabilities, Value for Money And Workplace Environment?

Yes 89% (96)

No 10% (11)

I Have No Idea 1% (1)

Total votes: 108

Well that was pretty clear. A huge majority thinks that the time has come for a close look at how the ADHA is working after 3 or so years.

Any insights on the poll welcome as a comment, as usual.

A very reasonable turn out of votes.

It must have been a very easy question as only 1/108 readers were not sure how to respond.

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

David.