Thursday, 2 June 2016

The Macro View - Budget, Election  And Health News Relevant To E-Health And Health In General.

The Macro View - Budget, Election And Health News Relevant To E-Health And Health In General.

June 03  Edition
With the Budget on May 3 now almost forgotten we are now off and rolling in the election campaign. We are seeing a lot of promises with Health from Labor with Medicare well and truly in focus.
As we move further into the campaign I am sure it will become more interesting - with the polls as tight as they are at present - and seemingly getting tighter.
I also note concerns on economic growth,  the changes to superannuation as well as continuing cuts in other areas. It will be a while yet before it is clear just what the final outcomes of policy in both parties will be.

General Budget Issues.

Worries about budget in election of choice

- on May 22, 2016, 1:47 pm
Labor argues the budget can't afford the Turnbull government's $50 billion in business tax cuts, but that's not stopping the opposition redirecting the money for its own agenda.
It's all about choice.
But such choices come at a time when the heads of Treasury and the Department of Finance, as well as a major global rating agency, express concern about the budget outlook.
After the Pre-election Economic and Fiscal Outlook was released on Friday, Moody's Investors Service again described as "challenging" the government's plan to bring the budget back to surplus in 2021.
-----

Deflation looms: how to be alert amidst the gloom

By Tony Featherstone | 23.05.2016
The dreaded D-word, “deflation”, is getting more airplay in financial markets. Australia is following international trends with lower interest rates and expectations are rising that the Reserve Bank will cut interest rates at least once more this year.
Could Australia fall into a deflationary spiral where even zero interest cannot stop price fallings? And where consumers defer purchases because they expect lower future prices, and lower-than-expected inflation increases the real burden of debt?
An all-time low of 2.2 per cent on the 10-year Australian Government bond this week shows just how concerned the market has become about future economic growth. For context, the Government bond yield fell to 4 per cent after the 2008-09 Global Financial Crisis. Even a 2.2 per cent bond yield looks like a luxury compared with several advanced economies that have negative bond yields.
-----
  • May 22 2016 at 11:45 PM
  • Updated May 22 2016 at 11:45 PM

Election 2016: Shorten's $8b drag on budget

A Labor commitment to unwind another Coalition budget saving has taken the cost of major promises on schools and health over the next four years to at least $8 billion, raising the prospect that pledges to date could leave the budget worse off in the short term.
An initial look at Labor's major spending and saving promises appears to leave the opposition with significant room to move to spend more over the budget period and still claim an improvement in the budget bottom line of around $8 billion.
But a number of its tax increases and savings measures have subsequently been taken up by the government, meaning that the claimed budget improvement may not be anywhere near as great.
-----

Why you can’t believe the budget forecasts

  • The Australian
  • May 21, 2016 12:00AM

Terry McCrann

Treasury’s pre-election economic and fiscal update was never going to contradict the budget and the retiring government. Properly ‘‘managed’’, it never does.
But retiring — more accurately, sacked — Reserve Bank director John Edwards certainly does, and will continue to do so, whichever side wins the election. I can’t help feeling that any criticisms from him would be more frequent and more powerful if the government is re-elected.
We should long ago have been disabused of the belief that just once, every three years — like a fiscal version of the fantasy musical Brigadoon — the fiscal and economic truth would erupt from the mouths of the Treasury and finance secretaries in their pre-election exercise known as PEFO.
-----

Election 2016: The black hole in ScoMo's $67b black hole

Date May 24, 2016 - 6:18PM

James Massola

Chief Political Reporter

Treasurer Scott Morrison has denied there is a black hole of as much as $35 billion in the government's own claim that Labor has a $67-billion, four-year black hole in its budget costings.
As debate over policy costings erupted on Tuesday ahead of Friday's economic debate at the National Press Club, the Coalition's attempt to attack Labor's costings backfired and the Treasurer was forced to admit an $18 billion error - which may grow as high as $35 billion - in its $67 billion claim.
The under-pressure Treasurer, when confronted by errors in government calculations of Labor policies, back-tracked and conceded that the claimed Labor funding shortfall was "at least $32 billion and as much as $67 billion. They are well behind".
-----
  • May 25 2016 at 11:45 PM
  • Updated May 25 2016 at 11:45 PM

We are not living within our means

by The Australian Financial Review
In late 2014, Reserve Bank governor Glenn Stevens told The Australian Financial Review that Australians had voted for lots of new public services, but were yet to vote on how to pay for them. With spending still climbing and the revenues of the resources boom continuing to crumble, the budget deficit outlook has got worse. On Tuesday, Mr Stevens warned that whoever wins the July 2 election will face years of hard and unpopular decisions to fix the mess.
Last Friday, two other top econocrats, the Treasury and Finance departmental secretaries John Fraser and Jane Halton, in an unprecedented commentary in their independent pre-election economic and fiscal outlook (PEFO) spelled out what that means. To remain on any medium term track to a surplus, they said, either spending will have to be cut substantially, or taxes will have to rise above the average for the last 30 years. And expressing as much scepticism as public servants are able, they suggested that neither side of politics has much of a record at cutting spending. Their PEFO forecasts also assumed that we can keep up the same pace of policy reform to boost productivity, the economy and the tax base that we have for the last 30 years. That was the time we floated the dollar, dismantled import protection, privatised a bunch of government businesses and genuinely reformed the tax system. In today's political climate, a repeat performance seems like a fantasy.
-----

Federal election 2016: budget problem bigger than both sides think

  • The Australian
  • May 26, 2016 12:00AM

David Uren

One of the dividing lines between Labor and the Coalition is whether the budget has a revenue or a spending problem. Labor’s Chris Bowen says revenue is falling short and the answer is to raise more in taxes, through tax increases and closing loopholes.
The Coalition’s Scott Morrison says revenue will be at its long-term average level by 2017-18 but spending will remain at elevated levels far into the future and can be brought back into balance only with significant spending restraint.
The truth is that the budget is in trouble on both the revenue and spending side; however, cranking up taxes, as Labor proposes, is no solution. The problem with the Treasurer’s analysis is that it assumes revenue will grow at an average rate of 7 per cent a year into the future to reach the long-term average. That assumption is not unreasonable measured against long-term averages, but it misses the cause of the repeated blowouts in budget deficits across the past four years.
-----

Election 2016: Forget about searching for budget black holes, they're not there

Date May 25, 2016

Peter Martin

Economics Editor, The Age

This time last election the Rudd Labor government blew itself up with a document purporting to find a $70 billion black hole in the Coalition's costings.
The mistakes say much about the helplessness of government staffers when they are without the support of the bureaucracy. 
There wasn't. The error-ridden claim was rated "false" in the first Fairfax-Politifact fact check and set the tone for the rest of the campaign.
Rattled, Labor had jumped at shadows. Twenty billion of its total shouldn't have been there and much of the rest was guesswork based on figures the Coalition hadn't yet provided, or had provided but Labor chose not to believe.
-----

Another day, another billion dollars: we are deep in debt and deficits denial

Date May 26, 2016 - 6:30PM

Jessica Irvine

Senior Writer

It happened again on Wednesday, at precisely 11am.
A few days prior, an official sitting at a computer in the Treasury building in Canberra sent out an alert.
Across the Sydney trading rooms of the big four Aussie banks and the local arms of international banks – about 15 of them in total – an alarm sounded and a message flashed on screen to notify them of the upcoming event.
Hey buddy, can you spare a billion dollars? Australian government debt is on course to top the $500 billion limit next year.
Traders hit the phones, talking to bank clients to see: "Do we want in?"
At 10.45am on Wednesday, the traders logged in to a special computer application called "Yieldbroker" where they began to make bids.
-----

The alarm bells that our politicians are ignoring

Date May 28, 2016 - 12:00AM

Peter Hartcher

Sydney Morning Herald political and international editor

At a corporate handwringing session this week, business leaders piled one political worry on top of another and pretty soon you might have expected Chicken Little to rush in and scream that the sky was falling.
Instead, a respected businesswoman arrested the growing hysteria over global and local political dangers.
Neither side is ready to tell us yet exactly how much more debt they are going to get us into. 
-----

'Growth and jobs': the numbers that debunk a company tax cut

Date May 28, 2016 - 12:15AM

Ross Gittins

The Sydney Morning Herald's Economics Editor

OPINION
Malcolm Turnbull and the many economists supporting his plan for a 10-year phased cut in the rate of company tax have failed to make the case that this expensive measure would deliver a significant increase in "growth and jobs".
Economists are meant to be too hard-headed to believe in the existence of a magic bullet – the single measure that will work wonders in solving our problems.
After 20 or 25 or 30 years, the level of real after-tax wages will be 0.4 per cent higher than otherwise. 
-----

Health Budget Issues.

Labor promises to keep medication cheaper at cost of $3.6bn over 10 years

Bill Shorten pledges to axe 2014 budget cut to pharmaceutical benefits scheme, which has been booked as saving $1.3bn but is blocked by the Senate
Bill Shorten at Drummoyne medical centre in Sydney, where 15 month old Eleanor Luopis and her mum Katherine were getting a cough checked out. Photograph: Mike Bowers for the Guardian
Paul Karp with agencies
Patients will pay less for taxpayer-subsidised medication if federal Labor wins the election, but the move will cost $3.6bn over a decade.
-----
22 May 2016 - 4:20pm

False economy to cut health funding: Labor

Source:  AAP 22 May 2016 - 4:20 PM 
Federal Labor won't make any major funding cuts to health amid warnings about the state of the budget.
After the Pre-election Economic and Fiscal Outlook was released on Friday, Global credit rating agency Moody's Investors Service warned the rising government debt burden would constrain the ability to buffer "potential negative economic shocks".
Opposition health spokeswoman Catherine King insists Labor has been pretty cautious when it comes to saving money in the health budget.
"We are not proposing to make major cuts," she told Sky News on Sunday.
-----

Labor sticks to indexed medicines charge

- on May 22, 2016, 3:11 pm
Most Australians wouldn't know it, but each year they pay a little bit more for taxpayer-subsidised medicines.
Labor wants to keep it that way while the coalition wants a one-off increase to the amount we contribute towards the cost of every prescription.
Under a plan, first included in the Abbott government's infamous 2014 budget and retained in the latest edition, most Australians would pay an extra $5 for each prescription under the Pharmaceutical Benefits Scheme.
-----

Advocates call for end to aged care 'lottery': 'I want him to enjoy the time he's got left'

Date May 23, 2016 - 8:39AM

Jane Lee

Legal affairs, health and science reporter

Exclusive
Doctors told Dominica Vevile shortly before Christmas last year that after almost a year in hospital her father Giovanni may not live beyond the new year.
Giovanni has one kidney left, which works at 5 per cent capacity. He has been diagnosed with chronic renal failure and chronic heart disease.
Last year, he was found to be eligible for a "level four" federally funded aged care package to help care for him at home. This would pay for aged care workers to take him out twice a week, which would also provide respite for his wife.  
-----

2016 Federal Election: Live coverage of Day 14 of the campaign

May 23, 2016 9:30am
FEDERAL Health Minister Sussan Ley has broken ranks with Cabinet, revealing it is her preference to have the Medicare rebate freeze lifted as soon as possible.
Speaking on ABC radio this morning, the Health Minister said: “I said to doctors I want that freeze lifted as soon as possible, but I appreciate that Finance and Treasury aren’t allowing me to do it just yet.”
The admission is set to take the wind out of the Coalition’s sails as it sought to push home a message that Labor’s ‘spendometer’ was out of control.
-----

Election 2016: Health Minister Sussan Ley 'not allowed' to lift Medicare freeze

Date May 23, 2016 - 3:01PM

Jane Lee

Legal affairs, health and science reporter

Health Minister Sussan Ley says she wanted to lift the freeze on Medicare rebates but was prevented from doing so by "Finance and Treasury".
Labor has pledged to lift the freeze from next January if elected, which is expected to cost $2.4 billion over the first four years, the most expensive spending commitment of the election campaign yet.  
Doctors have said they had understood that the freeze would be lifted, rather than extended, at this year's budget. The Royal Australian College of General Practitioners and the Australian Medical Association have both launched public campaigns over the move, warning this would force more doctors to charge patients a co-payment, rather than bulk-billing them.
-----

Federal election 2016: Shorten warning over GP rebate freeze

  • The Australian
  • May 24, 2016 12:00AM

Joe Kelly

Bill Shorten has dismissed the ­Coalition’s superior record of ­delivering higher bulk billing rates since winning government, saying the extension of a contentious freeze on GP rebates means more doctors will cease the practice.
The Opposition Leader is relying heavily on doctors’ groups such as the Australian Medical ­Association to give credibility to his campaign against the freeze on the indexation of rebates paid to GPs under the Medical Benefits Schedule, a move Labor warns will increase patient fees by $20 a visit.
Mr Shorten campaigned on health yesterday in the West Australian seat of Hasluck, held by Liberal MP Ken Wyatt, and ­declared the election a referendum on the future cost of medicine and going to the doctor.
-----

Federal election 2016: PBS fee means we fund new drugs: Turnbull

  • The Australian
  • May 23, 2016 12:00AM

Sarah Martin

Labor’s pledge to scrap a ­proposed fee for subsidised medi­cines has been countered by government claims that patients could miss out on lifesaving new drugs without the measure, worth almost $1 billion.
Arguing that a new charge for prescription medicines would ­adversely affect millions of people, Bill Shorten promised yesterday to reverse the “co-­payment by stealth” announced in the 2014 budget but blocked by the Senate.
“Sick people should not be deterred from going to the doctor because of the price of seeing the GP or the cost of medicine,” the Opposition Leader said of the government’s plan to lift the cost of subsidised prescriptions by $5 for general patients and 80c for concessional patients.
-----

Guild, PSA welcome Labor PBS plan

Pharmacy stakeholders have welcomed Labor’s announcement that if elected, it will scrap the Turnbull Liberal Government’s cuts to the PBS.

Labor says this will ensure that there will be no increase to PBS copayments or safety net thresholds in addition to regular indexation.
“Labor’s announcement provides patients with certainty about what they would be expected to contribute to the cost of their medicines under a Shorten Government,” the Pharmacy Guild of Australia said in a statement.
“Health Minister Sussan Ley has previously indicated she does not intend to proceed with these co-payment and safety net threshold increases, but they have been kept in the forward estimates.
-----

Federal election 2016: Shorten warning over GP rebate freeze

  • The Australian
  • May 24, 2016 12:00AM

Joe Kelly

Bill Shorten has dismissed the ­Coalition’s superior record of ­delivering higher bulk billing rates since winning government, saying the extension of a contentious freeze on GP rebates means more doctors will cease the practice.
The Opposition Leader is relying heavily on doctors’ groups such as the Australian Medical ­Association to give credibility to his campaign against the freeze on the indexation of rebates paid to GPs under the Medical Benefits Schedule, a move Labor warns will increase patient fees by $20 a visit.
Mr Shorten campaigned on health yesterday in the West Australian seat of Hasluck, held by Liberal MP Ken Wyatt, and ­declared the election a referendum on the future cost of medicine and going to the doctor.
-----

Federal election 2016: doctors urged to help rein in costs

  • The Australian
  • May 24, 2016 12:00AM

Sean Parnell

One of the doctors seeking to ­replace Brian Owler as president of the Australian Medical Association believes the lobby group should be working with the federal government to find savings in the health budget.
Perth gynaecologist Michael Gannon, state AMA president, will run against federal vice-president Stephen Parnis on Sunday and believes the doctors’ lobby needs to be “in the game” or risk a repeat of the bad policies the Coalition adopted without its input.
“It would be really unfair to criticise Brian for the things that have gone wrong this term, but I would hope the AMA would have a more constructive relationship with the government in future,” Dr Gannon said yesterday.
-----

Federal election 2016: Greens’ Di Natale $6.6bn extra for health

  • The Australian
  • May 26, 2016 12:00AM

Sid Maher

Greens leader Richard Di Natale has pledged more than $6.6 billion in extra funds for a range of health measures that would see dramatic increases in spending on hospitals and higher government payments for doctors.
In Goulburn in southern NSW yesterday, Senator Di Natale pledged $4bn in additional funding to public hospitals to 2020. The funding would reverse the Coal­ition’s lower health spending traject­ory announced in the 2014 budget.
Senator Di Natale, a former GP, also pledged $2.4bn in extra funding for the Medicare Benefits Scheme, to end the freeze on payments to doctors.
-----

Doctors around the country bringing an end to bulk billing

May 26, 2016 12:00am
Sue Dunlevy National Health Reporter News Corp Australia Network
EXCLUSIVE.
Bulk billing is being killed off at GP practices around the country as doctors respond to the Government’s plan to freeze the Medicare rebate at $37 for six years.
A survey of over 500 doctors by the Royal Australian College of Medical Practitioners to be released today finds 14.5 million patients will face new charges to see a doctor.
Twenty nine per cent of doctors will end bulk billing for all patients as a result of the freeze.
Another 22 per cent will end bulk billing for all and introduce capped fees for low income earners, the survey shows.
-----

Federal election 2016: Labor pledges to set up reform commission

  • The Australian
  • 12:00AM May 27, 2016

Sean Parnell

Labor will set up a permanent health reform commission if ­elected on July 2, abandoning the various bureaucracies it established in government in favour of a new agency focused on making better use of limited budgets.
Amid mounting concern over costs to patients, governments and insurers, the new Australian Healthcare Reform Commission would seek to advise the commonwealth and the states on ways to improve outcomes and reduce disparities. Labor wants the agency to examine and evaluate structural changes to the system and also have a role in funding agreements and new payment models.
Within the new commission would be a centre for Medicare and healthcare system innovation charged with examining new payment and service delivery models to improve efficiency and efficacy.
-----

AMA's Brian Owler delivers scathing attack on Coalition government

Outgoing head of peak medical body calls past two years ‘a period of lost opportunity in health policy’, characterised by lack of consultation
Brian Owler also criticises government’s medical treatment of asylum seekers in detention, saying he is proud the AMA has taken a strong stance on the issue. Photograph: Lukas Coch/AAP
The outgoing president of the Australian Medical Association, Associate Professor Brian Owler, has delivered a scathing attack on the Coalition government, describing the past two years as “a period of lost opportunity in health policy”.
Speaking at the peak medical body’s national conference on Friday, Owler said his presidency, which began in 2014, coincided with “a turbulent time in Australian politics” including the government’s budget announcement of a patient co-payment for GP visits.
The government refused to consult with the AMA on the issue, Owler said.
-----

A third of GPs plan to cease all bulk-billing

27 May 2016
A THIRD of GPs will cease bulk-billing patients - including concession card holders - because of the continued freeze on Medicare rebates, an RACGP poll suggests.
Asked how the recently announced freeze extension would impact their billing policy, 163 out of 564 respondents - 29% - said they would cease all bulk-billing.
Some 122 - or 22% - said they would privately bill but cap yearly out-of-pocket fees for concession card holders.
About half said they had no plan to change their billing policy.
-----

Health Insurance Issues.

Public hospitals lure patients to pay for treatments with private insurance, costing funds $1 billion

May 23, 2016
Sue Dunlevy News Corp Australia Network
EXCLUSIVE
NEARLY half the patients in some public hospitals are using their private insurance to pay for care in a move that is costing health funds $1 billion a year and driving up health fund premiums.
The industry estimates premiums could be slashed by $250 a year if public hospitals stopped asking patients to get their health funds to pay for their care.
Every Australian is entitled to free care in public hospitals under Medicare, but cash strapped hospitals are now making a practice of asking patients to charge their health funds to get extra revenue.
-----

Applied Medical criticises government pricing

  • The Australian
  • May 26, 2016 12:00AM

Sarah-Jane Tasker

US-based medical devices major Applied Medical has warned that competition in Australia’s health system is suppressed, calling for the scrapping of the controversial list that designates the pricing of prostheses that qualify for insurance rebates.
Applied Medical founder Nabil Hilal, who failed in his ­attempt to sue the health minister last year over the inefficiency of the list, said no other public market in the world operated a system with a government-­sanctioned list that set the rebate for medical devices. He also said the government was dictating the price for devices used in private hospitals at many times above what public hospitals pay for the same device.
Mr Hilal said things were further complicated by large manufacturers ­offering private hos­pitals a ­rebate of that ­inflated price, to encourage them to buy their product.
-----

Superannuation Issues.

BT Investment chief blasts changes to superannuation

  • The Australian
  • May 23, 2016 12:00AM

Glenda Korporaal

The federal government had undermined community trust and confidence in its policy making with its wide-sweeping changes to superannuation in the budget, BT Investment Management chief executive Emilio Gonzalez said yesterday.
Speaking on the side of the Australian Leadership Retreat on Hayman Island, he said there was support in the community for tightening up the concessions on superannuation, including limiting post tax contributions to superannuation. But he said the government’s total package was trying to “claw back” money that people had put into super in a way that had been encouraged by government.
“The government had a very good opportunity to position the superannuation debate right with the support of the industry — around superannuation being a vehicle to fund your retirement as a supplement or a replacement for the pension.
-----

Unsettling the political heartland

23 May 2016Mike Taylor |
The Government appears to have upset some rusted-on Liberal voters with its Budget changes to superannuation but it remains to be seen whether it will actually matter on polling day, Mike Taylor writes.
It is highly unusual for a Federal Budget to be brought down only days before the Parliament is prorogued ahead of what amounts to a two-month Federal Election and it seems probable the Government will come to rue the timetable it has imposed upon itself.
Looked at objectively, the 2016 Federal Budget was not an election Budget. Rather, it was arguably a mid-term Budget; one which accommodated a number of policy decisions which, while mostly sensible, are already proving problematic with respect to political saleability.
-----

Federal election 2016: Liberals push Morrison for super retreat

  • The Australian
  • May 25, 2016 12:00AM

Dennis Shanahan

Scott Morrison is resisting pressure from within the Liberal Party to review his contentious superannuation proposals aimed at raising revenue from high-income earners.
The Treasurer said yesterday he was not planning to adopt a similar review for superannuation as he has agreed on the backpackers tax announced in the budget.
The government gave in to pressure from farmers, tourism operators and National Party MPs over a proposed tax on foreign workers which threatened to undermine the market for fruit-picking and seasonal work.
The decision was deferred for six months and would be reviewed before being legislated, with many National MPs believing it would be dumped.
-----

Federal election 2016: Labor slams ‘chaotic’ super change

  • The Australian
  • May 26, 2016 12:00AM

Dennis Shanahan

The Labor Party is directly challenging the government’s contentious $500,000 “retrospective” lifetime cap on concessional super­ contributions that is causing deep dissent in the Liberal Party.
Bill Shorten has accused Scott Morrison and Malcolm Turnbull of sending “a shock wave through superannuation” by retrospectively “changing the goalposts”.
Opposition superannuation spokesman Jim Chalmers will today warn that the Coalition’s “chaotic” super changes announced in the budget are undermining confidence in super­annuation far beyond those directly affected. “In the immediate post-budget world, you will be grappling with a set of proposed changes to superannuation which are among the most drastic since compulsory super was brought in,” Dr Chalmers says in a draft speech to be given at a superannuation conference in Sydney.
-----
27 May 2016 - 8:04am

Older women worst-affected in budget super changes: report

Changes to tax on super contributions in the May budget will affect older women the most, modelling from NATSEM suggests.

Source: SBS News 26 May 2016 - 1:57 PM  UPDATED 1 HOUR AGO
The May budget’s changes to superannuation will affect women over the age of 65 the most, new research from NATSEM suggests.
Changes in the 2016-17 Budget have lowered the threshold for paying tax on superannuation contributions.
Modelling from the National Centre for Social and Economic Modelling (NATSEM) says the changes will discourage some people from making voluntary contributions to their superannuation, particularly women aged 65 and older.
-----
I look forward to comments on all this!
-----
David.
Baca selengkapnya

Wednesday, 1 June 2016

The Northern Territory Aims To Make A Big Difference With A New E-Health Approach. I Hope They Are Sensible And Ignore NEHTA in The First Instance.

The Northern Territory Aims To Make A Big Difference With A New E-Health Approach. I Hope They Are Sensible And Ignore NEHTA in The First Instance.

This appeared last week:

NT Govt commits $186m to e-health record system

25/05/2016
news The Northern Territory has announced plans to spend $186 million on a jurisdiction-wide, integrated electronic health record system.
Implemented as part of the 2016 Budget, the investment will be spread over five years as part of the Core Clinical Systems Renewal Program (CCSRP).
Minister for Corporate and Information Services Peter Styles said the program to upgrade the existing core clinical information systems will be the “largest ICT reform ever undertaken” in the Territory.
“For the first time clinicians will be able to electronically access patient records from any public health care facility, anywhere in the Territory,” he said.
The e-health program will replace four existing clinical information systems with a single end-to-end clinical information system at the point of care for all public health facilities, including all NT public hospitals and more then 50 health clinics.
“It will improve efficiency, eliminate outdated, manual systems of patient support and ultimately improve health outcomes,” Styles said.
John Elferink, Minister for Health, said the NT Government has set out to revolutionise healthcare delivery in the Territory by modernising the “outdated” ICT system to ensure correct information on patients is available at the point of treatment.
“The program will transform our public health care network meaning clinicians will no longer need to re-assess a patient’s history each time they visit a Territory public health service,” Elferink said.
He added that immediate access to patient records will improve the delivery of healthcare in the Territory through reduced readmissions, reduced emergency department waiting times and improved patient safety.
The announcement extends the Country Liberal Government’s commitment to set the standard in core clinical health and follows the development and implementation of innovative health solutions such as Telehealth.
There is additional coverage here:

NT sinks $186m into ‘largest ever’ clinical systems replacement

Outdated hospital IT to get the boot.

By Paris Cowan
May 25 2016 12:12PM
The NT government has committed $186 million to the replacement of four of its critical clinical systems with a single, integrated patient information database that will be accessible in real-time from any one of the territory’s hospitals or medical centres.
The core clinical systems renewal program will take five years to complete and represents a comprehensive overhaul of the health system’s operational IT environment.
It will deliver the NT’s doctors and clinicians a single view of a patient, integrating data that is currently stored in four different systems - CareSys, the clinical workstation system, the primary care information system, and the community care information system.
Changes to a record made anywhere in the state will be updated and appear in the system in real-time.
The NT’s Minister for Corporate and Information Services described the CCSRP as the largest IT reform ever undertaken in the territory.
“It will improve efficiency, eliminate outdated, manual systems of patient support and ultimately improve health outcomes,” he said.
The establishment of a single, integrated source of truth on a patient’s medical history is expected to be particularly transformative for the NT’s 50 medical centres, many of which serve regional and remote communities.
Health Minister John Elfrenik said the program ”will transform our public healthcare network meaning clinicians will no longer need to re-assess a patient’s history each time they visit a territory public health service".
More here:
There is also some information (rather old) regarding what is intended:

Core Clinical Systems Renewal Programme (CCSRP)

Market Sounding Brief

The following documents are provided in support of the CCSRP Market Sounding Brief:
Here is the link:
When I first read all this I was encouraged that the plan was to create a system designed to optimally support clinicians in caring for a mobile and complex population in an integrated way. However reading the market Brief one notices all of the NEHTA specifications which seem to be what is being requested.
Were it me, I would just ignore all that work - develop a proper requirements specification and go to the market for a system that will efficiently meet the clinical needs. I seriously doubt there is anything out there that meets all these baseline requirements and without testing the market functionally the NT might wind up with a real lemon.
Bottom like the NT should decide what it needs functionally for its clinicians and move on from there - not move from the basis of what terminology and display standards are used (many of which are not proven in implementation).
This program has a very long way to go and watching progress will be fascinating!
David.
Baca selengkapnya

Tuesday, 31 May 2016

UK health IT 'glitch': Hundreds of thousands of patients have potentially been given an incorrect cardiovascular risk estimation after a major IT system error

This in the UK.

What is euphemistically referred to as an "IT system error" is, in reality, the mass delivery of a grossly defective medical device adversely affecting hundreds of thousands of patients.  I'm surprised not to see that other kindly euphemism, "glitch" (http://hcrenewal.blogspot.com/search/label/glitch):

http://www.pulsetoday.co.uk/your-practice/practice-topics/it/gps-told-to-review-patients-at-risk-as-it-error-miscalculates-cv-score-in-thousands/20031807.article

Hundreds of thousands of patients have potentially been given an incorrect cardiovascular risk estimation after a major IT system error, Pulse can reveal.

The MHRA has told GPs they will have to contact patients who have been affected by a bug in the SystmOne clinical IT software since 2009.

Of course, this refrain appeared, a corollary of "Patient care has not been compromised" (http://hcrenewal.blogspot.com/search/label/Patient%20care%20has%20not%20been%20compromised) when health IT crashes and outages occur:

The regulator says that means that ‘a limited number’ of patients may be affected, and the risk to patients is ‘low’.

At best, it's good that only a "limited number" of patients were "affected."  I guess they feel they can justify a "limited number" of patient harms for the glory of a medical Cybernetic Utopia.

At worst, how do "the regulators" know exactly who was affected?  Answer: they don't and this is boilerplate BS meant to CYA.

But Pulse has learnt that the 2,500 practices using SystmOne are having lists sent to them of around 20 patients per partner who may need to be taken off statins, or be put on them, after their risk is recalculated.

Statins are not an innocuous medication.  From WebMD at http://www.webmd.com/cholesterol-management/side-effects-of-statin-drugs?page=2#1:

The most common statin side effects include:
Statins also carry warnings that memory loss, mental confusion, high blood sugar, and type 2 diabetes are possible side effects. It's important to remember that statins may also interact with other medications you take.


Not to mention the risks of not being on a statin if you truly need one.

And this number could increase if a practice provides NHS Health Checks routinely. In addition, the lists being sent to practices only go back to October 2015, but practices will be sent further lists potentially dating back to 2009 over the next few weeks.

Wait!  The "regulators" said that ‘a limited number’ of patients may be affected.  They are clairvoyant, I would imagine.  Maybe one of them is Harry Potter?


The "regulators", who have the same powers as the man-wizard above, know through clairvoyance that only a limited number of people were affected, and risk to them low.

A statement from MHRA to Pulse said: 'An investigation has been launched into a digital calculator used by some GPs to assess the potential risk of cardiovascular disease (CVD) in patients.

'We are working closely with the company responsible for the software to establish the problem and address any issues identified.

The problem is incompetence and negligence.  One wonders what testing was performed before this was unleashed on the public in the UK.

TPP told Pulse they were working to address the ‘Clinical Safety Incident’ and that the QRISK calculator was provided as an advisory tool to support decision making. They added they were working to ensure the issues were addressed and GPs are informed of affected patients ‘as soon as possible’.

‘Clinical Safety Incident’ - what a wonderful euphemism for "healthcare IT debacle."


Deputy chair of the GPC’s IT subcommittee Dr Grant Ingrams told Pulse it would be ’loads of work’ to sort out.

He said: ‘It affects everyone who has had a QRISK, and SystmOne are sending out messages to say “look at these patients”. But then you have to see if the change is significant, and whether you would have made a different decision at the time, or put them on a different treatment’

It will probably be more work than if such a system had never been constructed.

Dr Ingrams said: ‘There’s potential harm both ways…What happens when a patient who had been of a high risk and this hadn’t been identified and they’ve now had a stroke or heart attack?  ‘Similarly if someone had a low risk and they’ve been put on a statin and had a side-effect who’s responsible? That’s the clinical risk.’

Answer: the company that produced this grossly defective software, and those "regulators" who allowed it on the market without independent and thorough testing, are responsible.

Dr William Beeby deputy chair of the GPC’s clinical and prescribing subcommittee, said the bug ‘certainly had the potential to impact on patient confidence’ and this could create even more work  ... ‘It’s the tool we’ve been told to use. So if the tool is inaccurate, then you start to lose confidence and the doctors will then lose confidence as well.’

Patient confidence (let alone physician confidence) in cybernetics already took a big hit in the UK several years back, as at my Sept. 2011 post "NPfIT Programme goes PfffT" at http://hcrenewal.blogspot.com/2011/09/npfit-programme-going-pffft.html.

However, it seems, hyper-enthusiast overconfidence in health IT, including that of the "regulators", would not be injured even if bad health IT caused more casualties than the bombings and V2 attacks suffered by the UK in WW2.


After the health IT debacles involving billions of wasted pounds in the UK, perhaps the UK's "regulators" need to look upon health IT as fondly as this piece of technological wizardry.

A TPP spokesperson told Pulse: 'TPP is dealing with the Clinical Safety Incident involving the QRISK2 Calculator in SystmOne. The tool is intended to support GPs in assessing patients at risk of developing cardiovascular disease and in developing treatment plans. The QRISK2 Calculator is presented within SystmOne as an advisory tool.

"Advisory tool"?  That the doctors can safely ignore?  Hogwash.

’We are actively working to ensure the issues identified are addressed and to ensure that clinicians are informed of any patients that may have been affected as soon as possible.’ 

Until the next health IT "bug" arises, that is.

-- SS


Baca selengkapnya

HIT Mayhem, Canadian Style: Nanaimo doctors say electronic health record system unsafe, should be shut down, non-medical PR hacks say it's perfectly safe

Some candid honesty:

To hell with doctors and nurses and their concerns about horrible health IT.  

That seems the international standard in 2016 regarding their concerns.  There's just too much money to be made in this business to worry about such piddling annoyances as maimed and dead patients.

Doctors, after all, don't know anything about computers, and cybernetic medical experiments on unconsenting human subjects are just good fun.

This new example from Canada:

http://www.theprovince.com/health/local-health/nanaimo+doctors+electronic+health+record+system/11947563/story.html

Nanaimo doctors say electronic health record system unsafe, should be shut down

By Cindy E. Harnett
Victoria Times Colonist
May 27, 2016

Implementation of a $174-million Vancouver Island-wide electronic health record system in Nanaimo Regional General Hospital — set to expand to Victoria by late 2017 — is a huge failure, say senior physicians.

Who cares what they say?  They're just doctors, so sayeth the imperial hospital executives.. 

After a year of testing, the new paperless iHealth system rolled out in Nanaimo on March 19. Island Health heralds the system as the first in the province to connect all acute-care and diagnostic services through one electronic patient medical record, the first fully integrated electronic chart in the province.

EHR pioneer Dr. Donald Lindberg, retired head of the U.S. National Library of Medicine, called such total command-and-control systems "grotesque", and that was in 1969 (See http://hcrenewal.blogspot.com/2014/06/masters-of-obvious-aat-athens-regional.html).  He observed back then:



But he's a doctor too, so what does he know, sayeth the hospital executives.

But nine weeks after startup, physicians in the Nanaimo hospital’s intensive-care and emergency departments reverted to pen and paper this week “out of concern for patient safety.”

Who cares what they say?  apparently not the executives, per Toni O'Keeffe, Vice President and Chief, Communications and Public Relations, http://www.viha.ca/about_viha/executive_team/toni_okeeffe.htm, as below.  The system's perfectly safe!


Doctors said the system is flawed — generating wrong dosages for the most dangerous of drugs, diminishing time for patient consultation, and losing critical information and orders.

“The whole thing is a mess,” said a senior physician. “What you type into the computer is not what comes out the other end.

“It’s unusable and it’s unsafe. I’m surprised they haven’t pulled it. I’ve never seen errors of the kind we are now seeing.”

Doctors are so concerned, they want Island Health to suspend the implementation.

“Take it away and fix it and test it before you bring it back — stop testing it on our people,” said one doctor. “Why wasn’t this introduced in Victoria first? If they went live in Victoria first, they would have a riot.”

(Is there anything unclear there, I ask?)

SHUT UP DOCTORS.  IT''S PERFECTLY SAFE, sayeth the administration.

The doctors, who fear reprisals, spoke to the Times Colonist on condition of anonymity.

If doctors did not fear reprisals I'd have a full time job writing on EHR debacles.  I could almost have one now.

The $174-million system started with a 10-year, $50-million deal for software and professional services signed in 2013 with Cerner Corporation, a health information technology company headquartered in Kansas City. Thus far, the company has been paid close to $12 million. The remaining $124 million is to be spent by Island Health for hardware, training and operating the system.

I wonder just how much graft there may be, driving what seems an international phenomenon of bad health IT with doctors and nurses complaining (e.g., examples of mayhem at http://hcrenewal.blogspot.com/2013/07/rns-say-sutters-new-electronic-system.html), patients being harmed and dying (e.g., ECRI Deep Dive study at http://hcrenewal.blogspot.com/2013/02/peering-underneath-icebergs-water-level.html), yet hospital execs and government officials gleefully moving full steam ahead.

The system is being used in Nanaimo’s hospital, Dufferin Place residential care centre (also in Nanaimo), and Oceanside Health Centre in Parksville.

Since March 19, mobile touch-screen computer console carts have been rolling around hospital hallways. Voice-recognition dictation software immediately transcribes a doctor’s verbal notes into a patient’s electronic record, and scanners track each bar-coded patient bracelet around the hospital. But doctors complain the new technology is slow, overly complicated and inefficient.

Today's clinical IT is needlessly and blindingly complex.  But hospital executives are, in my increasing view, too ignorant to recognize the necessity of simplicity in critical functions such as clinical medicine.  Their jobs are child's play in comparison.  (I should know; I once was a health IT  executive after having practiced medicine for a number of years.)

“The iHealth computer interface for ordering medications and tests is so poorly designed that not only does it take doctors more than twice as long to enter orders, even with that extra effort, serious errors are occurring on multiple patients every single day,” wrote one physician at the Nanaimo hospital.

In view of current warnings and that which is known, and has been known for many years from the literature about bad health IT, each and every adverse outcome of injury that occurs represents hospital executive gross negligence:

Gross negligence is a conscious and voluntary disregard of the need to use reasonable care, which is likely to cause foreseeable grave injury or harm to persons, property, or both. It is conduct that is extreme when compared with ordinary Negligence, which is a mere failure to exercise reasonable care.  http://legal-dictionary.thefreedictionary.com/gross+negligence

I leave it to the reader to classify patient deaths.

“Tests are being delayed. Medications are being missed or accidentally discontinued.”

My mother and other patients in whose litigation I have provided informatics expertise were injured and/or died from precisely that type of mistake.

Doctors can’t easily find information entered by nurses, the physician wrote.

There are also complaints about the pharmacy module of Cerner’s integrated system — the only joint build between Island Health and Cerner.

iHealth implementation staff brought in to input orders for physicians this week entered eight drug mistakes on one day and 10 on another, while there were no mistakes in the paper orders, doctors said. “If the experts can’t enter it correctly, what is the average Joe going to do?” one doctor said.

Suffer, and take on all the liability, of course.

Another problem, they said, is patients’ drug orders disappearing from the system.

Australian informatics expert Jon Patrick wrote of such issues in 2011 as at this link: http://hcrenewal.blogspot.com/2011/03/on-emr-forensic-evaluation-from-down.html.  His technical paper was ignored, and pushback for having written it draconian.

Here's the administration's view:

... But Island Health spokeswoman Antoniette O’Keeffe said the system is safe and doing what it’s intended to do.

To hell with the doctors concerns and with the patients.

“We are not going back to paper,” she said. “We can’t go back to paper. We don’t have the mechanics to go back to paper.”

I'll be generous about the stupidity represented by that statement.  What she means is, we've jsut blown tens of millions of dollars on computers.  We'd get out asses kicked by the Board if we admitted we blew it and went back to paper.

Island Health acknowledges that documentation for staff doing emergency-department patient intake was a challenge, noting Nanaimo is the busiest emergency department on the Island.

A mere "challenge."  How about "was not possible in a 24 hour day?"

Nanaimo has some of the top physicians in the country and “we respect the feedback they are giving us, and so we are listening to them and we are tweaking and modifying the system,” O’Keeffe said.

We respect their feedback.  They say it should be shut down, but "the system is safe and doing what it’s intended to do."

Challenges include getting medication orders into the system, getting clinical staff trained, work flow and documentation, O’Keeffe said.

More staff have been added to speed up admissions and others are working around the clock in the intensive-care and emergency departments to input handwritten physician orders into the system, O’Keeffe said.

Cerner is working with Island Health staff, “and they’ll be here until we get this fully implemented,” O’Keeffe said.

Ms. O'Keefe. bad health IT is never "fully implemented."  (e.g., http://hcrenewal.blogspot.com/2013/11/weve-resolved-6036-issues-and-have-3517.html) Instead, clinicians learn to work around bad health IT, except when the risk of doing so slips through and patients get maimed or killed.

Island Health credits the system’s electronic warnings for catching about 400 human-caused medication errors and conflicts at three sites, saying it’s a sign that the system is working. It will produce a warning, for example, if the dosage is too high for a patient’s weight, if the drug is not appropriate for a particular disease or if there’s a drug conflict.

Across the country, thousands of medication mistakes are made daily due to human error, “and this system is designed to catch them,” O’Keeffe said.

Doctors respond that so many irrelevant flags pop up, it creates confusion, while the computer loses or duplicates drug orders.

Ms. O'Keefe and her administration are obviously blissfully unaware of how health IT can cause medication errors en masse impossible with paper, e.g., "Lifespan (Rhode Island): Yet another health IT 'glitch' affecting thousands", http://hcrenewal.blogspot.com/2011/11/lifespan-rhode-island-yet-another.html.  Of course, many hospital executives are ill-informed, lacking the curiosity of  the average scientist or physician.

The system was a decade in the making for Island Health. Twenty-three clinical teams were involved in developing various components and there was user-group testing, modifications and feedback, O’Keeffe said. Training has gone on for the last year, she said. “You can only bring a system so far and then you have to put it in a real environment to test it.”

At best - test it - yes, on unsuspecting human subjects known as patients, doctors and nurses.  The ones who are harmed and the ones who die are worthy human sacrifice for the glory of computing, eh, Ms. O'Keefe?

At worst - what is wrong with this industry that each and every installation of this technology is an experiment?

Is it that the technology has exceeded the intellectual horsepower of available personnel?  In my experience that has seemed to be the case.

By the end of the implementation, it’s expected family doctors will also be able to access patient files started in acute-care settings. Island Health is working on that component now, O’Keeffe said. Once the system is working smoothly in Nanaimo, it will be installed in the north Island and then Victoria hospitals in 12 to 18 months, O’Keeffe said.

Runaway trains cannot be stopped.

Canadian lawyers, take note.

-- SS

Addendum: An Op-Ed on this matter is here:

http://www.timescolonist.com/opinion/op-ed/comment-new-computer-system-a-detriment-to-health-care-1.2264274  

It is grim, written by a doctor under a pseudonym (Dr. Winston Smith is the pseudonym for a doctor in Nanaimo - that says much about fear of retaliation):
One health record. Making care delivery easier for health-care providers. Safer health care. These are the claims Island Health has made publicly for its new electronic health-record system iHealth, introduced initially at Nanaimo Regional General Hospital in March and intended to roll out across Vancouver Island in the coming months.
These are goals physicians share — many of whom enthusiastically use electronic records in their clinics. Despite “bumps in the road,” Island Health claims the implementation of the system is going well.
But these claims are untrue. iHealth does not provide a single health record: It offers no less disjointed and poorly accessible a collection of patient information in differing programs and sites than the previous system.
The system is cumbersome, inefficient, not intuitive — and not simply because it is a new system, but because of its very nature. It’s like trying to make a DOS-based computer work like an Apple or Windows-based system: You can perform many of the same functions, but it is slow, takes multiple steps and is inefficient.
Even the youngest generation, who have grown up with computers, and those with computing science degrees can’t make it work effectively.
The system’s ordering function is faulty and requires multiple separate steps and choices to order a simple medication: A processing issue safety experts know is highly likely to cause error.
And the system sometimes makes default changes in medication orders without the knowledge of the ordering physician. Single orders for medications disappear from the record, so that duplicate orders are initiated by unknowing doctors.
The consequence of these problems is that hospital-based care delivery is slower, more inefficient, more prone to error. Health-care providers are found interacting with their mobile computer monitors in already overcrowded hallways rather than providing direct patient care.
Nurses and doctors have less of a holistic appreciation of their patients and their illnesses because of the disjointed complexity of the electronic record rather than the simple navigability of the previous paper record and charting.
And communication with the computer system has supplanted direct discussion between health-care team members: Like trying to manage complex illnesses through text messages.
Health-care delivery is slower, so surgical operations are cancelled or delayed and patients leave the emergency department without being assessed; patients are not seen in a timely fashion or at all by specialists; medication errors are regular, so patients are medicated inappropriately or even overdosed; and some of our most experienced and valued health-care providers opt for early retirement or leave rather than continue the frustration and moral distress that this system has generated.
And the effect of iHealth is not restricted to the hospital, as some specialists have reduced their outpatient service because of the increased workload iHealth has caused.
In short, health care is not easier or better. The quality of care is worse and access is reduced. Improvements can be made and have been, but the system is fundamentally flawed. The impact on work efficiency and quality will never return to previous levels — a fact even the Island Health iHealth “champions” acknowledge.
Worse, iHealth is unsafe and dangerous. Medicine strives to be evidence-based, but there’s no evidence electronic record systems improve quality of care, and plenty of evidence they do the opposite — particularly this one.
Doctors have expressed their concerns to Island Health. Rather than suspending the system, the health authority’s response has been simply to delay its rollout beyond Nanaimo. It’s OK to let our community suffer while they tinker.
Dr. Brendan Carr, the CEO of Island Health, tells us he’ll “do whatever it takes to make this work,” even while continuing to risk worsening quality of care and expending more of our taxpayer dollars — $200 million so far, a fraction of which applied to delivery of health-care services could provide inordinately better health-care outcomes than any electronic record can do.
The medical community has finally taken matters into our own hands in the interests of patient safety, quality of care and access. A number of departments are refusing to continue using the system and instead returning to the previous one.
Why does Island Health not withdraw this system? In sum, they’ve spent a lot of taxpayers’ dollars on iHealth, a product of Cerner, which has been sued by hospital systems in the United States.
And as with many such systems, the objective has not been better patient care, but has been more Orwellian: Improved administrative data and control — no wonder Island Health is loath to give it up.
Well, Dr. Carr, the patient should be paramount. I and my family and my community are not expendable. No electronic record system should be introduced that will not explicitly improve health care, patient safety and access.
Any deterioration in health care is not an acceptable outcome. Suspend the iHealth experiment. Stop wasting taxpayer dollars. Sue for our money back for having been sold a lemon (as other jurisdictions have done).
Spend our tax dollars on services, infrastructure and equipment that will improve health care, not make it worse.
Dr. Winston Smith is the pseudonym for a doctor in Nanaimo.
- See more at: http://www.timescolonist.com/opinion/op-ed/comment-new-computer-system-a-detriment-to-health-care-1.2264274#sthash.rWwQcJZA.dpuf

... The system is cumbersome, inefficient, not intuitive — and not simply because it is a new system, but because of its very nature. It’s like trying to make a DOS-based computer work like an Apple or Windows-based system: You can perform many of the same functions, but it is slow, takes multiple steps and is inefficient.

Even the youngest generation, who have grown up with computers, and those with computing science degrees can’t make it work effectively.

The system’s ordering function is faulty and requires multiple separate steps and choices to order a simple medication: A processing issue safety experts know is highly likely to cause error.

And the system sometimes makes default changes in medication orders without the knowledge of the ordering physician. Single orders for medications disappear from the record, so that duplicate orders are initiated by unknowing doctors.

Deadly.

The consequence of these problems is that hospital-based care delivery is slower, more inefficient, more prone to error. Health-care providers are found interacting with their mobile computer monitors in already overcrowded hallways rather than providing direct patient care.

This was not what the pioneers intended.

Nurses and doctors have less of a holistic appreciation of their patients and their illnesses because of the disjointed complexity of the electronic record rather than the simple navigability of the previous paper record and charting.

That sums up a major problem with today's health IT well.

The medical community has finally taken matters into our own hands in the interests of patient safety, quality of care and access. A number of departments are refusing to continue using the system and instead returning to the previous one.

This type of revolt, showing who really owns the hospital, needs to become commonplace.

Why does Island Health not withdraw this system? In sum, they’ve spent a lot of taxpayers’ dollars on iHealth, a product of Cerner, which has been sued by hospital systems in the United States.

And as with many such systems, the objective has not been better patient care, but has been more Orwellian: Improved administrative data and control — no wonder Island Health is loath to give it up.

Indeed.

The CEO is himself a physician:

Well, Dr. Carr, the patient should be paramount. I and my family and my community are not expendable. No electronic record system should be introduced that will not explicitly improve health care, patient safety and access.

This anonymous doctor needs to speak to my mother, who I visited yesterday along with my father, on U.S. Memorial Day - at the cemetery after her encounter with bad health IT.

Read the whole Op Ed at the link above.

-- SS
New computer system a detriment to health care
New computer system a detriment to health care
Baca selengkapnya
I Wonder Why We See Such Angst Regarding Telstra Working On The National Cancer Screening Register.

I Wonder Why We See Such Angst Regarding Telstra Working On The National Cancer Screening Register.

This announcement appeared a few days ago.

National Cancer Screening Register

Following a competitive tender process that commenced on 10 August last year, the Federal Department of Health has appointed Telstra Health to develop and operate the new National Cancer Screening Register.
Page last updated: 26 May 2016
26 May 2016
Following a competitive tender process that commenced on 10 August last year, the Federal Department of Health has appointed Telstra Health to develop and operate the new National Cancer Screening Register (the Register), which will support the renewed National Cervical Screening Program and the expansion of the National Bowel Cancer Screening Program.
The commitment to establish a national cancer screening register was first announced in the 2015-16 Budget. Following a detailed Request for Tender (RFT) process, a contract for the service provider was signed on the 4th May 2016.
The Department of Health will now work with Telstra Health to implement the Register. There will also be significant collaboration with the Department of Human Services and the state and territory governments to transition nine separate cancer screening registers into a single National Cancer Screening Register. The Register is expected to be operational to align with the commencement of the renewed National Cervical Screening Program on 1 May 2017.
The Register will create a single view for Australians participating in cervical and bowel cancer screening, meaning for the first time: one record for each participant.
By integrating the Register with GPs’ desktops, GPs will be able to identify patients’ screening eligibility and history to support real time clinical decision-making. Health professionals, including pathology providers, will have improved access to their patients’ information.
It is estimated that over the next four years, streamlined invitation and reporting will benefit approximately 1.4 million women aged 25 to 74 years (both HPV vaccinated and unvaccinated), who will be invited to participate in cervical screening and almost 10 million eligible Australians aged 50 to 74 years, who will be invited to participate in bowel screening.
The register will be established under national legislation and the data included in the register continue will be owned by the Commonwealth (Health Department) and cannot be used for any other purpose. Any misuse of data could be an offence under the Criminal Code. All data are subject to privacy laws such that only personal information that is directly related to the Register may be collected, used and disclosed.
It should also be noted that the core software on which the Register will be built is already in use in Australian clinical settings and has built-in provisions to protect and hold patient and clinical information securely. All data will be stored in Australia in secure data storage facilities.
The Department of Human Services was eligible to participate in the tender, but did not apply.
Here is the link:
Within a day or so of this appearing we had panicked articles like the following.

Telstra attacked over $220 million cancer screening register contract win

The Federal Government has awarded a contract - estimated to be worth up to $220 million - to Telstra Health to construct and manage a new National Cancer Screening Register, a decision which has been attacked by union peak body the ACTU and not-for-profit Group, Pro Bono Australia, in defence of a Not For Profit which unsuccessfully tendered for the contract.
Under the five-year contract tendered by the Department of Health Services, Telstra Health’s growing health services business will develop the national bowel cancer register, as well as eight state and territory based cervical cancer registers, into a single digital cancer screening register.
Critics, including some in the healthcare sector, have raised data privacy and governance issues over the awarding of the contract to Telstra, although under the contract the government will retain ownership of the intellectual property and data stored on the new register, which is expected to start operating in the first half of 2017.
But, the ACTU has attacked the decision, accusing the Government of turning over a “sensitive national cancer screening register”, and claiming it is just the first step in the “selling-off of Australia’s public medical records system to corporate operators”.
More here:
and here:

Health consumer groups warn Telstra could profit from cancer register

Date May 26, 2016 - 5:29PM

Jane Lee

Legal affairs, health and science reporter

Public health and consumer groups have questioned whether Telstra and other private companies could profit from millions of Australians' cancer screening records.
Fairfax Media has reported that Telstra Health - a division of the listed company - has been awarded a government contract to manage a new national cancer screening register next year.
The register - merging data from nine non-profit run registers - will allow GPs to access a single record of their patients' cervical and bowel cancer screening history. It will also show their eligibility for future tests from next May. 
Telstra Health's managing director, Shane Solomon, said this would make it easier for patients to keep up to date with upcoming screenings through mail and potentially mobile text messages, and would overcome duplication when people changed doctors or moved interstate.
The Department of Health released a statement on Thursday to assuage privacy concerns, saying federal laws would ensure that "the data included in the register (will) continue to be owned by the Commonwealth and cannot be used for any other purpose".
Mr Solomon said Telstra would not charge for access to data and denied that it could be used to help develop the company's products.
The company said in a statement that people would be allowed to access their own records online, and that their GPs would need consent to do so.
Yet consumer health groups warned more information was needed about how the contract protected patient records from commercial gain.
Alison Verhoeven, chief executive officer of the Australian Healthcare and Hospitals Association said that while the register could increase the number of people screened for cancer, it was unknown who would control access to the data and publish public reports.
Ms Verhoeven said she was concerned that  "a proliferation of private organisations could be housing data many of us hold dear in a commercial environment over which there is very little control and capacity to contribute to."
More here:
and here:
Thursday, 26th May 2016 at 11:15 am

Telstra Health Wins Multi-Million-Dollar Contract Over NFPs

Telecommunications giant Telstra has been chosen over Not for Profits to be awarded a multi-million-dollar contract to manage a new National Cancer Screening Register (NCSR) in a move some members of the public have called “privatisation by stealth”.
The contract, which has reportedly been allocated $178.3 million over five years, is expected to be announced by Health Minister Sussan Ley on Thursday.
The controversial move – which follows a public tender call which closed on 8 October 2015 –  will see sensitive medical records placed under corporate management and signals an end to the current state-based registers for cervical cancer screening programs and the national bowel cancer screening register.
Previously the responsibility of compiling and maintaining the registers had fallen to state-based Not for Profit organisations, including the Victorian Cytology Service which was overlooked for the national contract in favour of Telstra, despite its experience in the field.
Fairfax Media has reported that Telstra Health has approached VCS for access to its expertise, staff, and other resources.
VCS Associate Professor Marion Saville said they were disappointed with the decision.
“We can confirm that VCS was shortlisted for the NCSR. We are of course very disappointed in the outcome of the tender process considering our longstanding expertise in operating successful cancer screening registers,” Saville said.
“As an organisation we will continue to work constructively towards the goal of protecting Australians from the impact of cancer through screening.
More here:
It seems to me that all these complaints are either sour grapes from organisations that missed out on the work or are from individuals who have not realised that there are clear plans in place to protect personal information and that already their myHR information is probably in the hands of commercial for-profit contractors such as Accenture.
With the protections outlined in the press release it seems to me all this is hysterical over-reaction from individuals who don’t understand how careful and risk averse the DoH is! The system is being developed by people who already operate patient registries and are fully aware of the sensitivity of the information and the risks to their reputation (and their clients) if something goes wrong. Additionally the whole program is being led by and academic cancer clinician who knows both the risks and the benefits of what is being done.
Of course, virtually all your private information is already controlled by people in the private sector such as GPs, Google, Banks and so it goes on. As our Reserve Bank Governor said recently I reckon people should possibly ‘chill out’.
Let’s just wait till be see what emerges before becoming anxious and concerned!
David.
Baca selengkapnya