Saturday, 18 June 2016

Weekly Overseas Health IT Links - 18th June, 2016.

Weekly Overseas Health IT Links - 18th June, 2016.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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FHIR’s normative stage only months away; EHR vendors planning to use it

Published June 10 2016, 8:31am EDT
Industry stakeholders are starting to see light at the end of the interoperability tunnel, as major electronic health record vendors look to incorporate HL7’s emerging Fast Healthcare Interoperability Resources (FHIR) standard in their products.
With the normative version of FHIR slated for release in the spring of 2017, vendors are expected to soon implement the application programming interface (API) in their EHR systems, say observers.
The normative version of FHIR that will be available next year will be stable enough for large vendors to incorporate it into their platforms, asserts Chuck Jaffe, MD, CEO of HL7, speaking at last month’s Workgroup for Electronic Data Interchange Annual National Conference in Salt Lake City.
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Researchers: Patient safety a concern for EHR use by UK docs

Jun 10, 2016 8:16am
Some clinicians view electronic health records as more negative than positive when it comes to patient safety, according to a new study in BMC Medial Informatics and Decision Making.
The researchers, from the University of York and elsewhere, wanted to determine how the implementation of an EHR system affects patient safety in England's National Health Service (NHS). Most patient safety information was coming from the U.S., whose health system is different economically, organizationally and structurally. They interviewed 19 NHS clinicians in a maternity unit at an NHS teaching hospital in the north of England during the first year of its implementation of an EHR in 2014.
They found that significantly more challenges with the system were reported than benefits, with clinicians reporting perceived and actual increased risks to patient safety. For instance, there were concerns that the clinicians would make inputting errors due to lack of typing skills. The interviewees also expressed concern that the data being added was less detailed and accurate, since it took longer to type.
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Evidence Lacking on Efficacy of Home Health Devices

Tinker Ready, June 9, 2016

Researchers find no evidence that smart homes and home health monitoring technologies "help address disability prediction and health-related quality of life, or fall prevention."

Researchers have found no evidence that smart homes and home health monitoring help prevent falls or health-related quality of life for the elderly. 
While internet-linked devices and home health monitoring have the potential to improve care for the elderly, a review of existing evidence in the current issue of the International Journal of Medical Informatics found limited evidence of some benefits, but concludes that more research is needed into their efficacy.
The research comes after two disappointing studies that found little change in outcomes with some forms of home monitoring.
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John Halamka: Why HIT vendors are stuck in a Catch-22

Jun 9, 2016 12:45pm
Consolidation of both healthcare providers and technology vendors will play a major role in shaping the near future for the health IT industry, according to Beth Israel Deaconess Medical Center CIO John Halamka.
In a recent post to his Life as a Healthcare CIO blog, Halamka writes that in conversations with stakeholders, many foresee a "shrinking" market for software currently geared toward midsize hospitals and small group practices fueled by mergers and acquisitions of those provider organizations.
"Many smaller EHR companies will fold due to declining market share and some established incumbents with older technologies are likely to sell their healthcare IT businesses or reduce their scope," he says.
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Privacy issues pose ongoing challenge to HIEs

Jun 8, 2016 3:18pm
The legal and ethical aspects of healthcare data sharing have long been a concern for Valita Fredland, recently named vice president and general counsel and privacy officer at the Indiana Health Information Exchange (IHIE).
"I think big data raises important ethical and legal questions that in some cases haven't yet been well addressed by regulatory frameworks," she tells HealthITSecurity.com. "It's hard to anticipate some of the things that we're able to do with big data until we've done it. One then has to ask, 'Well, was that the right thing to do with it?'"
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Why providers need to quickly adopt mobile apps

Published June 08 2016, 3:29pm EDT
Some 45 years ago, Pete Townshend, lead guitarist of the fabled rock band The Who, wrote these lyrics:
“...Out in the woods, or in the city, it’s all the same to me.
When I’m driving free, the world’s my home.
When I’m mobile…”
The song “Goin’ Mobile” expressed a young man’s desire to move about freely, allowing him to experience the world in which he was traveling.
According to the research firm Statista, Americans have already gone mobile, albeit in a different way than envisioned by Pete. More than 70 percent of the U.S. population will have a mobile smartphone by 2019. That means that two out of every three people carry devices that have millions more times the computing power of the guidance systems used by NASA to get men on the Moon and has graphics capabilities that make those of the famed Cray-1 Supercomputer laughable. They can even go toe to toe with IBM’s Deep Blue computer when it comes to number-crunching ability.
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Developers set to demo the latest FHIR-based applications

Published June 08 2016, 4:17pm EDT
A conference to be sponsored by Health Level Seven International will showcase the organization’s Fast Healthcare Interoperability Resources standard for data exchange and give vendors an opportunity to demonstrate applications using FHIR.
The Ann Arbor, Mich.-based standards organization is planning an FHIR Applications Roundtable on July 27 and 28, at the Harvard Medical School in Boston.
“The roundtable is designed to build interest and get a better sense of what’s going on,” says Wayne Kubick, chief technical officer at HL7. “We think there is more usage than we have heard.”
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Babylon Health launches new AI triage tool

Ben Heather
7 June 2016
Babylon Health says it has launched the first AI capable of triaging patients; although the company acknowledges that it doesn’t always agree with clinicians.
Babylon, founded by former Circle chief executive Ali Parsa, offers mobile-based health services that cover about 300,000 users.
The biggest of these is a subscription-based remote GP consultation service, through which patients can arrange a quick phone or video appointment with an on-call GP over their mobile.
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Ewan Davis: Texas grass fertiliser and the postmodernEHR

A postmodernEHR sounds like bullsh*t, right? Well, yes: but it could just be one of the most important developments in the history of the electronic health record…
I love bullshit and, thanks to my daughter's undergraduate thesis on the subject (she got a first! and any comments about genetic predisposition will be ignored) I have picked up an understanding of the philosophical basis for it.
This means such that I can bullshit about bullshit, making me a metabullshiter. It also means that I have a nose for what my father called “Texas grass fertiliser”.
I have to say when I first heard the term ‘postmodernEHR’ this was working overtime. However, as I have learned more about what is meant by this label I have decided that it could be one of the most important developments in the history of the EHR (although it’s still a horribly pretentious term).
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Cost, Hospital Efficiency Still Major Barriers to EHR Adoption

By Sara Heath on June 08, 2016

A recent study highlights the persisting effects of cost and hospital efficiency on EHR adoption rates.

Despite potential for incentive payments, cost, as well as other challenges, remains a significant barrier to EHR adoption, finds a recent study published in JMIR Medical Informatics.
In the study, lead author Clemens Scott Kruse, MBA, MSIT, MHA, PhD, examined a bevy of literature regarding EHR adoption in order to determine the various barriers and facilitators that influence providers years following the implementation of the HITECH Act.
The literature review revealed a set of 25 adoption facilitators, which included increased efficiency, hospital size, quality, access to health data, perceived value, and ability to transfer health information.
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Healthcare Cloud Security Concerns Not Impediment to Usage

By Jacqueline Belliveau on June 08, 2016

A recent study found that 77 percent of healthcare organizations plan to increase the use of public cloud services despite significant healthcare cloud security concerns.

Public and private cloud solutions are gaining popularity in the healthcare industry, especially for data storage and network usage, despite issues surrounding healthcare cloud security and PHI data breaches.
Researchers at HyTrust recently published a study that revealed 77 percent of healthcare organizations plan to move more workloads onto a public cloud service even though healthcare data security was a major concern with cloud usage.
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Does blockchain have a role in healthcare?

Published June 08 2016, 6:44am EDT
It’s the technology that’s most closely associated with the Bitcoin, and it’s been playing a growing role in the financial industry.
Now, there’s a growing realization that blockchain technology could help answer many of the vexing questions in healthcare regarding keeping better track of patients’ electronic records and improving the security with which they’re shared.
Other capabilities of the technology could include automating workflows and offering better identity systems, for both patients and providers.
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Geospatial analytics tools bring 'another layer of understanding' to population health

The confluence of new care models and technology are enabling data scientists to pinpoint gaps in access to care, address social determinants of health, and map data that informs tactics to improve outcomes at the patient and population level.
June 08, 2016 11:22 AM
Virginia Long, a predictive analytics scientist at MedeAnalytics, said the industry is at a tipping point where payers and providers can use data in new ways to visualize trends, target intervention programs, or help adjust public policy.
We now live in a world awash in data. And with that proliferation of detailed patient information comes new opportunities to map – literally – new ways forward for better health.
More and more healthcare organizations are realizing that medical data at the point of care only tells a small part of the story.
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Special report: e-prescribing

The roll-out of e-prescribing across the NHS in England is glacial; and the sudden removal of tech fund money has all but halted its advance. Will things change as trusts progress their digital maturity and more government cash is released, asks Daloni Carlisle.
The clinical case for e-prescribing and the return on investment is pretty much proven. It reduces drug errors, improves patient safety, increases efficiency and productivity.
It’s also expensive, time consuming, and difficult to implement. Perhaps it is no wonder, then, that progress on rolling out e-prescribing is at best slow – and at worst glacial.
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E-prescribing use remains extremely low in the NHS

Jon Hoeksma and Digital Health News staff
9 June 2016
Levels of electronic prescribing in NHS hospitals remain stubbornly low, with less than a fifth of hospitals making widespread use of inpatient e-prescribing. In addition, trusts that have had e-prescribing systems the longest are making the poorest use of them.
The bleak picture emerges from NHS England’s Digital Maturity Index, which found that despite the focus on e-prescribing in successive IT strategies and two rounds of technology funding, only 19% of NHS hospitals use e-prescribing for 60% or more of inpatient prescribing.
Ann Slee, NHS England’s e-prescribing advisor, told a recent conference that it had also carried out a specific piece of work on the digital maturity of e-prescribing, which found that: “Overall use of functionality is poor. 
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Microsoft Finds Cancer Clues in Search Queries

Microsoft scientists have demonstrated that by analyzing large samples of search engine queries they may in some cases be able to identify internet users who are suffering from pancreatic cancer, even before they have received a diagnosis of the disease.
The scientists said they hoped their work could lead to early detection of cancer. Their study was published on Tuesday in The Journal of Oncology Practice by Dr. Eric Horvitz and Dr. Ryen White, the Microsoft researchers, and John Paparrizos, a Columbia University graduate student.
“We asked ourselves, ‘If we heard the whispers of people online, would it provide strong evidence or a clue that something’s going on?’” Dr. Horvitz said.
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Nanaimo doctors say electronic health record system unsafe, should be shut down

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

Nine weeks after rolling out the paperless iHealth system, Nanaimo hospital’s intensive-care and emergency departments have reverted to pen and paper “out of concern for patient safety.”

Photograph by: Sherry Yates Young , Vancouver Sun

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.
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.
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.”
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21st Century framework needed for use of HIT in behavioral healthcare

June 7, 2016 | By Katie Dvorak
The use of health IT in behavioral healthcare has fallen behind because of barriers such as lack of data standardization and concerns over privacy, but "opportunities exist to create a twenty-first-century framework for health IT use in an increasingly consumer-driven  healthcare environment," according to the authors of a viewpoint published in the June edition of Health Affairs.
One barrier, they note, is the HITECH Act, which provided incentives for implementation of electronic health records. The law didn't address behavioral health explicitly, and excluded organizations focusing on this from eligibility for financial incentives. Thus, "consumers seeking care for behavioral health conditions have not benefited from the quality and safety gains of health IT implementation," write the authors, who hail from the Department of Veterans Affairs, among other organizations.
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How IT fuels stroke care at University of Texas System

June 6, 2016 | By Katie Dvorak
The University of Texas System has several projects underway to help improve care for stroke patients--many of which center on health IT.
One such initiative is the Lone Star Stroke Consortium, made up of researchers across several University of Texas institutions, Patricia Hurn, vice chancellor for research and innovation at the system, tells FierceHealthIT in an interview.
The group represents a lot of capability to conduct outreach and pull in patients from all over the state to be enrolled in clinical trials or research, she says. Much of the outreach is done through telestroke run on a hub-and-spoke model with six major hubs that reach out to treatment centers and hospitals.
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Life | Mon Jun 6, 2016 6:56pm EDT

Biden announces U.S. project to promote cancer data sharing

U.S. Vice President Joe Biden said on Monday the "moonshot" initiative he leads aimed at finding cures for cancer was "the only bipartisan thing left in America" and called for more collaboration among researchers, doctors and government agencies to advance the cause.
Biden was speaking at the American Society of Clinical Oncology meeting in Chicago in conjunction with the launch of a new system to facilitate sharing of genomic and clinical data among cancer researchers to help promote advances in personalized treatment for the many forms of the disease.
The project, known as Genomic Data Commons (GDC), with an operation center at the University of Chicago and funded by the U.S. National Cancer Institute, is a key component of President Obama's national cancer moonshot and Precision Medicine Initiative.
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Lung cancer: Mobile app could extend life expectancy

CHICAGO: A new mobile application could help doctors better provide care to patients with advanced lung cancer, perhaps even extending life expectancy, according to a study presented in the United States. 
The app, named Moovcare, enables patient-doctor communication even at a distance, using remote monitoring to quickly detect relapses or complications. 
“This approach introduces a new era of follow-up in which patients can give and receive continuous feedback between visits,” said lead author Dr Fabrice Denis, a cancer researcher in Le Mans, France. 
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Allscripts, athenahealth top physician practice EHR satisfaction, loyalty rankings

Written by Akanksha Jayanthi (Twitter | Google+)  | June 06, 2016
For the third year in a row, both Allscripts and athenahealth have been ranked as the top vendor in user satisfaction among ambulatory providers in Black Book's latest poll — Allscripts for provider groups with 26 or more practitioners and independent practice associations, and athenahealth for physician groups with between six and 10 physicians and groups with between 11 and 25 physicians.
Additionally, Marshfield Clinic Information Services, a wholly owned subsidiary of Marshfield (Wis.) Clinic, made its first appearance at the top of the user satisfaction polls, coming in at No. 1 among users in multispecialty clinics.
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How the Internet of Things will disrupt traditional healthcare

Published June 07 2016, 4:16pm EDT
There are occasional moments in the evolution of business and technology that offer opportunities to re-think the status quo and fundamentally change the way business is done. When the application that intersects business and tech is so compelling that it can justify platform adoption, we sometimes call this a “killer app.”
The irony of the term “killer” in the healthcare context aside, distributed health just may be the killer app that drives Internet of Things adoption in healthcare.
Distributed healthcare is the idea that by physically de-centralizing healthcare services we can provide better care, with greater patient satisfaction, and do so more efficiently. The core hospital environment is very good at providing intensive, highly specialized care for acute conditions, but is inefficient at managing preventative and chronic care. Accordingly, there is a growing trend to manage these care modalities outside of the traditional hospital-based environment.
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Baseline Genomic Data Study Aims to Enroll Children

Scott Mace, June 7, 2016

As Google-spawned Baseline Study enrollment begins, it seeks to enroll a healthy population, a high-risk population, and a population of the already-sick. A Stanford executive hopes to also enroll a pediatric cohort.

As Verily Life Sciences (formerly Google Life Sciences) begins to enroll patients in its Baseline Study this month, one executive at study partner Stanford Healthcare expects to expand the study to children.
In an interview, Dennis Lund MD, chief medical officer of Lucile Packard Children's Hospital Stanford, describes the Baseline Study as "the Framingham Heart Study of the modern world."
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Dutch government to invest €20 million into e-health

Minister Edith Schippers of Public Health is allocating 20 million euros over the next four years to be invested into the promotion of e-health initiatives, she announced at E-Health Week in Amsterdam on Tuesday.
The campaign, called FastTrack eHealth Initiative, is intended to support and guide small and medium businesses in scaling up good e-healt initiatives. The aim is to get promising innovations to the patient more quickly.
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Strategic approach helps providers benefit from portals

Published June 06 2016, 6:58am EDT
The first time Debra Loggia visited her orthopedist, the practice wouldn't allow her to make an appointment until she had signed up for, and signed into, its patient portal. She dutifully did so, and filled out a detailed questionnaire so that her specialist would have all her information in advance. When she arrived at her appointment, the front desk staff handed her an iPad and said she had to fill out all the information again.
"I said, 'No, this is silly—I spent 20 minutes doing it at home!' " says Loggia, senior manager of digital transformation for Ernst & Young. She made them look up her record in the portal. When she vented to her new orthopedist about the incident, he laughed and shook his head, sharing her frustration. While the practice nominally has 100 percent participation in its patient portal, courtesy of its appointment policy, it hasn't led to greater patient engagement.
To compound her problems, Loggia says she has to log into separate portals for each specialist she sees, and there's no single source for all of her information. Her primary care practice, perhaps the logical aggregator, is in no position to play that role. It was recently acquired by a large healthcare system and had to abandon its original portal for the one belonging to its new owner, which—as far as Loggia can tell—has made little effort either to train the staff or to reach out to the patients.
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Deborah Peel: Few protections exist to prevent health data from being shared without consent

June 5, 2016 | By Judy Mottl
Tuesday marks the start of the 2016 Health Privacy Summit, a two-day summit in the District of Columbia that brings together top national and international experts to discuss global health privacy issues and real solutions. 
FierceMobileHealthcare reached out to Deborah Peel, M.D., who formed Patient Privacy Rights in 2004, to speak with her about the event and the status of patient privacy rights today. Currently, she says, healthcare data on devices is "open to more people, corporations and government agencies than we think," and not necessarily in a good way.
"It isn't just our doctors, or even just our insurance companies. Employers, researchers, data analytics companies and [others] also use and sell our health data," she says. "There are few protections to keep them from sharing our health data without consent."
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Geisinger EHR analytics project helps predict opioid overdoses

Examining electronic health record data over a 10-year period from Geisinger Health System shows socioeconomic factors have an impact on adverse effects of overdoses.
June 06, 2016 11:06 AM
Researchers at Geisinger Health System examined electronic health record data of more than 2,000 patients admitted to the hospital for overdoses between April 2005 and March 2015. The data – factoring in mental health, marital status, employment status – helps the health system predict which patients are at most risk of fatal overdoses and other complications.
Patients who were married and had private health insurance were less likely to experience such adverse effects, the research shows. But a history of addiction, mental illness and other chronic diseases were all found to be associated with fatal overdoses.
"Our study suggests opportunities for identifying patients at-risk for overdosing," said Geisinger addiction researcher and senior epidemiologist Joseph Boscarino, the study's lead investigator, in a statement. "We've found that patients who are taking a higher dose of prescription opioids combined with psychotropic medicines may need closer monitoring to avoid death and other serious complications.”
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Prescription Monitoring Programs Curb Opioid Prescribing

Nicola M. Parry, DVM
June 06, 2016
Implementation of prescription drug monitoring programs is associated with a substantial reduction in physicians' prescribing of Schedule II opioids during an office visit for pain, a new study suggests.
Yuhua Bao, PhD, from Weill Cornell Medical College, New York, New York, and colleagues used National Ambulatory Medical Care Survey (NAMCS) data to investigate the effects of recent launching of these programs on the prescribing of opioids and other pain medications. The researchers published the results of their study online June 6 in Health Affairs.
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Studies: mHealth Sensors Help Seniors Avoid the Hospital

By Eric Wicklund on June 02, 2016

Two mHealth projects at the University of Missouri are touting the value of sensors in monitoring seniors' activity and sleep patterns at home.

An innovative mHealth program at the University of Missouri is using two different types of mobility sensors to monitor seniors for trending health concerns.
MU researchers are testing radar sensors to measure daily activity levels in seniors at Tiger Place, the university’s independent living community. They’ve also developed sensors that, when placed underneath a mattress, can measure cardiac and breathing activity in sleeping seniors.
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Why EHR implementation is only half the battle

Published June 06 2016, 3:58pm EDT
The adoption of electronic health records technology over the past decade is one of the best feel-good stories for the healthcare IT industry.
This past week, the Office of the National Coordinator for Health IT reported soaring percentages in tracking the adoption of EHRs by U.S. non-federal acute care hospitals. Announced in conjunction with its annual meeting in Washington, D.C., the survey reported that adoption of basic EHRs increased to nearly 84 percent of hospitals. As recently as 2010, only 16 percent of U.S. hospitals had this technology in place.
That’s good news, and ONC notes that it’s more than just having systems installed and gathering dust. It sets certain parameters for what it considers adoption, which include having required functions in place and having those functions used by professionals.
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Why the Economic Payoff From Technology Is So Elusive

Your smartphone allows you to get almost instantaneous answers to the most obscure questions. It also allows you to waste hours scrolling through Facebook or looking for the latest deals on Amazon.
More powerful computing systems can predict the weather better than any meteorologist or beat human champions in complex board games like chess.
But for several years, economists have asked why all that technical wizardry seems to be having so little impact on the economy. The issue surfaced again recently, when the government reported disappointingly slow growth and continuing stagnation in productivity. The rate of productivity growth from 2011 to 2015 was the slowest since the five-year period ending in 1982.
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Enjoy!
David.
Baca selengkapnya

Friday, 17 June 2016

Concerns About Telstra Health Providing The National Cancer Screening Registry Just Rumble On. I Am Not Sure Why.

Concerns About Telstra Health Providing The National Cancer Screening Registry Just Rumble On. I Am Not Sure Why.

This appeared last week:

Government-Telstra cancer register deal needs screening

  • Antony Harrowell
  • The Australian
  • 12:00AM June 7, 2016
Stumbling down rabbit holes can lead to unexpected places; just ask Alice, she found herself in a Wonderland of strange characters and odd situations.
Her fall may be fictional, but it reflects the same rabbit hole in which Australians may find themselves if the latest deal between the federal government and Telstra is allowed to see the light of day without intense scrutiny. Like Alice, this is a dark comedy that may have severe consequences.
Telstra was recently awarded a $220 million contract by the government to establish a Cancer Register, which is unclear in its objective. That is, to provide “a robust IT solution-based support system for the expanded National Bowel Cancer Screening Program and the renewed National Cervical Screening Program” or a full “National Cancer Screening Register”.
Why is the federal government limiting the solution to just two and not all cancers? Is it an IT platform to assist the screening program for those cancers or is it a national register?
This needs to be answered by the government because these are two totally different outcomes, with substantially different implications: one being effectively a contact database, linked to electronic or paper-based reminders not containing sensitive information; and the other being a full personal “cancer” health record containing test results, treatments and other highly sensitive information.
It has been assumed for the federal government to award the $220m contract to Telstra, that it is only a contact database/notification platform. It’s something telcos do routinely.
Everyone receives paper-based, email or SMS notifications to inform them they are near their limits, exceeding their limits or anything else they believe is pertinent to their daily lives, so it makes sense this service be expanded to let us all know when we should be undertaking our cancer screening.
The rabbit hole we potentially find ourselves in occurs if the government deems it appropriate to place our personal medical data, cancer screening results, in the hands of a telco.
Telstra as an organisation has experienced serious data breaches and continues to struggle to operate a stable communications network, which is its core business. There will be no solace in free data days or $25 credits if this environment is breached and the personal health data pilfered.
More here:
We also had this appear.

Privacy concerns over cancer register

Australia June 9 2016
Telstra Health has won the tender to manage the National Bowel Cancer and Cervical Screening data register. The company will be responsible for collating and amalgamating the data currently stored on separate State databases into one national register and overseeing the register’s operations.
Concerns have arisen over the potential for inadvertent and unauthorised breaches of private information, heightened by recent instances of data released by Telstra.
While the exact nature of the privacy protections outlined in the tender are unknown and it remains unclear whether sufficient avenues will be available to allow consumer actions against Telstra Health as an incentive to strengthen the company’s privacy policies, the Commonwealth privacy legislation will apply to the register and any misuse of data could be an offence under the Criminal Code.
More here:
My view on all this concern is that wherever there is a database of sensitive information there is risk of breach. That being the case I would far rather have my personal information managed by professional health IT staff - as they will be with Telstra Health - rather than small public sector organisations scattered all over the country  in State-Based Registries.
To imagine Telstra Health does not understand how important it is they get this one right simply defies common sense. Be assured they will be doing their very best to get this working safely, securely and well.
David.

p.s I notice that the MD of Telstra Health (Shane Solomon) also has a strong take on why every-one should take a deep breath. See here:

http://www.theaustralian.com.au/business/technology/opinion/telstras-national-cancer-screening-register-a-big-step-forward/news-story/137eed93336bf21f6b264b616cef3d52

D.
Baca selengkapnya

Thursday, 16 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 16  Edition
The big discussion of the week has been trying to figure out which of the major parties can do the better job balancing our national budget. Hard to say who is winning.
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 - maybe in the next week or two.
Lots this week on aged care and health insurance!
More worryingly, globally there seems to be increasing worry  about the global economy.

Bill Gross says negative rates are like 'supernova' that will explode

Date June 10, 2016

John Gittelsohn

Legendary bond investor Bill Gross has warned central bank policies that pushed trillions of dollars into bonds with negative interest rates will eventually backfire violently.
"Global yields lowest in 500 years of recorded history," Gross, 72, wrote this week on the Janus Capital Group Twitter site. "$US10 trillion of neg. rate bonds. This is a supernova that will explode one day."
A supernova is a star at the end of its life that suddenly increases greatly in brightness because of a catastrophic explosion that ejects most of its mass.
Gross, who manages the $US1.4 billion ($1.9 billion) Janus Global Unconstrained Bond Fund, has argued for some time that the economy is at the end of a decades-long cycle of expanding credit that has culminated in negative interest rates, a situation he said is unsustainable.
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Not sounding all that good…..

General Budget Issues.

  • Updated Jun 7 2016 at 11:45 PM

Election 2016: Labor pledges short-term budget pain for long-term gain

Labor will all but confirm on Wednesday that it will allow the budget deficit to worsen over the next four years when it presents its policy agenda as a 10-year economic growth plan that is fairer than the Coalition's.
In a concession sure to be leapt upon by the government, Labor leader Bill Shorten and shadow treasurer Chris Bowen will rationalise leapfrogging the four-year budget cycle by arguing that "fiscal repair should be achieved over the medium term and backloaded so as not to hurt our economy".
They will recommit to releasing figures before the election, reconciling their spending and taxing measures over four and 10 years, and an estimate of when they would return the budget to balance. They will only commit to "have more saving than spending over a decade".
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Federal election 2016: Labor to release its 10-year economic blueprint, Shorten refuses to reveal how it’s to be funded

June 8, 2016 12:00am
Simon Benson National Political Editor The Daily Telegraph
BILL Shorten will chart a 10-year course for Australia’s economy that relies on education, renewable energy, a gold-plated NBN and a revival of manufacturing industries to generate the country’s long-term growth.
But the Labor leader is still refusing to reveal how he or taxpayers would fund his plan in government.
Mr Shorten will today release Labor’s 10-year economic blueprint as he seeks to blunt the Coalition’s election campaign attacks on his economic and budget credentials.
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Federal election 2016: Shorten shifts focus to the economy as Morrison highlights company tax benefits

Date June 8, 2016 - 12:00AM

James Massola

Chief Political Reporter

Bill Shorten will shift Labor's focus to the economy with the launch of a "Ten-Year Plan for Australia's Economy", in a move to neutralise the Coalition's concerted attack over economic management.
The 32-page "Ten-Year Plan" booklet contains no new policies and amounts to a summary of the opposition's promises to date, while the ALP's final election costings are still weeks away, leaving it open to further government attacks over their economic program and a so-called funding "black hole".
Treasurer Scott Morrison will return fire with new modelling prepared by Independent Economics' Chris Murphy to claim that keeping the company tax rate at 30 per cent will act as a drag on economic growth and hurt consumers.
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Federal election 2016: Shorten’s plan guarantees deeper deficits

  • The Australian
  • 12:00AM June 9, 2016

David Crowe

Labor will go to the election promising deeper budget deficits throughout the first term of a Shorten government in a high-risk political play that asks voters to accept bigger commonwealth debt in the hope of a brighter outlook over 10 years.
Bill Shorten was battling to justify the decision last night as economists rejected his claim that the higher spending was needed to spur demand and shore-up growth, turning his budget plan into a key test on economic management.
The government seized on the move to declare that Labor “could not be trusted” to balance the budget amid warnings from economists that growing debt and deficit would threaten the ­nation’s valuable AAA credit rating. In a sign of the political danger around his decision, Mr Shorten described the new stance as a delay to a “fiscal contraction” rather than stating directly that the deficits would be bigger under Labor.
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Australia's badge of honour at risk

June 9, 201612:32pm
Colin Brinsden, AAP Economics Correspondent AAP
The world's major credit rating agencies didn't cover themselves in glory during the global financial crisis.
Anyone who has seen "The Big Short" was reminded how their actions prompted overly-zealous investors to throw money at debt instruments that ended up being worthless.
But agencies like Standard & Poor's, Moody's Investors Service and Fitch Ratings still wield huge power and their analyses decide whether a country is the top dollar or an also-ran.
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Election 2016: Who has the better economic plan? Don't ask an economist

June 11 2016
Michael Gordon
Bill Shorten took his big target strategy to win government to a new level this week, injecting a mix of relief and relish into a Malcolm Turnbull campaign that has so far struggled to capture the attention, much less the imagination, of the electorate.
Having warned that the Coalition's  projected deficits over the next four years represent a threat to Australia's AAA credit ratings, Shorten and shadow treasurer Chris Bowen announced that their numbers would be even higher over the very same period.
Predictably, Treasurer Scott Morrison dubbed it a "recipe for fiscal chaos", declaring: "If you vote Labor, you are voting for higher deficits and you are voting for higher debt, a higher debt burden on future generations."
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Labor, Coalition show a deficit of fiscal policy

June 12, 2016 12:00am
Terry McCrann Sunday Herald Sun
THE very first words in Bill Shorten and Chris Bowen’s economic policy document are “We’ll put people first”.
Well, you are certainly not doing that if your whole policy framework is built around reckless spending which could condemn them ultimately to a “Greece future” — or worse, a Venezuelan one.
The bottom line of the “four years of bigger budget deficits”, which Shorten and Bowen announced midweek — to borrow a phrase from the treasurer in the Rudd and Gillard governments, Wayne Swan — is that it would turn the likelihood of Australia losing its Triple-A credit rating into a rolled-gold certainty.
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Health Budget Issues.

Election 2016: Patients may pay less for diagnostic scans as radiologists scrap campaign

Date June 5, 2016 - 5:43PM

Jane Lee

Patients could pay less for diagnostic scans such as mammograms and ultrasounds, with radiologists abandoning their public campaign against the Turnbull government's planned cuts to bulk-billing incentives at the last minute in exchange for a review of the sector.
The Australian Diagnostic Imaging Association planned to launch a public campaign on Saturday, warning that thousands of Australians with cancer would avoid getting tested if the cuts went ahead, because scans would become more expensive. 
Radiologists were going to ask patients to sign a petition opposing the cuts in the final weeks of the federal election campaign, similar to the pathology sector's own campaign against the cuts, which are expected to save $650 million in total over four years.
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Medicare: diagnostic imaging sector trades bulk-billing cut for rebate rise

Sector agrees to Coalition’s $650m cut over four years, but up to $50m more will be spent after review of Medicare rebate
The Coalition has agreed to review the freeze on the rebate for diagnostic imaging, and the sector wants Labor to do the same. Photograph: Alamy Stock Photo
The diagnostic imaging sector has accepted a cut to bulk-billing incentives in return for a review expected to increase the Medicare rebate and a promise the rebate will be unfrozen in future.
In December the Coalition government announced a plan to cut the bulk billing incentive for diagnostic imaging and scrap it for pathology services, saving $650m over four years.
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Health system cares for big insurers, big pharma

  • Doron Samuell
  • The Australian
  • 12:00AM June 7, 2016
Australia spends around $150bn a year on healthcare.
Although there are some differences between the major parties on health policy, all sides embrace the concept of universal healthcare.
But beyond the simpler slogans that dominate the public debate, very few of us who deal with the system are happy with the way it’s working.
In reality, it is riddled with lopsided and illogical arrangements that benefit a small number of vested interests, and militate against the interests of the great majority of the population.
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Federal election 2016: ‘ending Medicare freeze is top priority’

  • The Australian
  • 12:00AM June 8, 2016

Sean Parnell

Michael Gannon hopes the AMA could play a positive role in future funding talks.
The new Australian Medical Association president Michael Gannon believes he has to be mindful of the budget deficits and not ask for “more, more, more” funding for public hospitals.
But the Perth obstetrician, who took over from Brian Owler last month, is ­focusing his efforts on ending the Medicare freeze, which the Turnbull government extended in the budget to save another $1 billion.
Dr Gannon said yesterday the freeze on GP rebates, in particular, was the “number one issue” for the AMA. He expressed concern GPs would be forced to charge vulnerable patients or move to areas where patients could afford to pay.
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McGorry says mental health care becoming a field of broken dreams

  • Patrick Mcgorry
  • The Australian
  • 12:00AM June 10, 2016
Is it time to question the dogma that mental health care should be fully integrated and unprotected within mainstream healthcare?
At a recent mental health forum, I heard a story that crystallised the issue for me. A father ­described how his 17-year-old daughter — let’s call her Lily — gradually had become withdrawn and taken to her bed. She became anxious and depressed.
She was taken to GPs, emergency departments and a range of other professionals and, though she had been functioning extremely well before becoming ill, was responded to negatively by health professionals, even given a label of personality disorder. Her parents were confused and overwhelmed and got no support.
Then Lily had a seizure. This was investigated and, after a lumbar puncture and brain scans, viral encephalitis was diagnosed. The fact she now had a “medical” (genuine) illness rather than a psychiatric one transformed not only her treatment but also the attitude of health professionals. She was now a “deserving” patient.
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Health Insurance Issues.

  • Jun 8 2016 at 11:45 PM
  • Updated Jun 8 2016 at 11:45 PM

Election 2016: Health funds must change or face 'disaster' says Graeme Samuel

by Ben Potter
A new way of calculating health insurance premiums that could limit increases to 2.5 per cent a year and an official website to grade health policies from "junk" to "platinum" are being pushed by Graeme Samuel, an adviser to the government's private health insurance review until a few months ago.
Mr Samuel will call for wholesale deregulation of government-dictated rebates for medical implants or "prostheses" in a speech on Thursday. 
Health insurers estimate they are overcharged by about $800 million a year by medical implant makers and Mr Samuel will argue that the best way to impose competitive discipline on the healthcare market is by "empowering consumers to make informed decisions".
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Federal election 2016: Health reforms to force insurers to send single bill

Samantha Maiden, national political editor, Herald Sun
June 12, 2016 12:00am
PRIVATE health insurers will be forced to offer patients a single bill listing all out-of-pocket charges to avoid bill shock under government ­reforms to rank cover as gold, silver and bronze.
Health Minister Sussan Ley will announce the changes today also confirming that plans to charge smokers and the overweight more for health insurance have been shelved.
The announcement follows consultation with the public over how to fix “junk” health cover after families complained of feeling ripped off and confused by private health insurance.
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Government promises to create a tiered private health system that's fairer

June 12, 2016
THE Coalition Government has pledged to simplify private health insurance by creating three categories of health policies consumers can easily understand.
The government will establish gold, silver and bronze health policy categories if re-elected on July 2 and set minimum standards for the 40,000 private health insurance products on the market. Patients will also retain the current private health insurance rebate.
The coalition said on Sunday that it conducted surveys in which 70 per cent of its 40,000 respondents said they struggled to make changes to their private health insurance policy.
Two-thirds of respondents also said they were not getting value for money from their plans.
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Aged Care Issues.

Estia hit as sector scrutinised

  • The Australian
  • 12:00AM June 8, 2016

Kylar Loussikian

Sarah-Jane Tasker

Estia Health has been forced to allay market concerns about the possibility it will come under ­increasing federal government scrutiny, a day after The Australian revealed health bureaucrats were eyeing the rapid growth in the company’s patient funding.
In a statement to the Australian Securities Exchange, Estia said it was “regularly audited” but had “materially more accurate claims than the industry average ... over the last two years”.
Estia shares fell nearly 11 per cent yesterday following reports of a government move to clamp down on funding.
The company attracted the ­attention of short-selling hedge funds, with Sydney-based VGI Partners confirming it was one hedge fund involved.
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Aged-care providers ‘maxing’ on funding: HammondCare head

  • The Australian
  • 12:00AM June 9, 2016

Sarah-Jane Tasker

Kylar Loussikian

The head of a not-for-profit aged-care provider has warned that many in the sector are “maxing out” on the federal government’s funding system, amid confusion over warnings about over-­claiming in the sector.
Stephen Judd, chief executive of HammondCare, said while he was not defending providers that over-claimed, he thought those ­accused of the practice were not “rorting” but maxing out on a system the government had given them. Dr Judd said the aged-care funding model rewarded pro­viders for keeping residents frail, rather than promoting wellness.
“I don’t think ... there is any fraud going on, but I do ­believe people are maxing out on a system they have been given by the Australian government,” he said.
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  • Updated Jun 11 2016 at 8:08 AM

Aged Care in Australia: someone's going to pay

The collapse in the share price of Australia's biggest aged care provider, Estia Health, over the past fortnight has raised serious questions about how profitable and realistic growth prospects are for a sector so reliant on the country's aging population and government funding. 
The demand for aged care led to the completion of $1.5 billion worth of new construction in 2014 – an increase of 69 per cent on the previous year, according to the Department of Health. Net assets in the sector were up 10 per cent on the previous year to $11.2 billion and revenues have also grown to $14.8 billion a year. Some analysts estimate that close to $22.5 billion worth of aged-care facilities will need to be built before 2031 to accommodate the growing demand.
The big listed providers Estia Health, Japara Healthcare and Regis Healthcare have all floated on the stock market in recent years, enjoying plenty of investment support and government funding.
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Aged care and fast money an unhealthy mix

  • The Australian
  • 12:00AM June 11, 2016

Andrew White

Kylar Loussikian

It took Quadrant Private Equity less than a week after the federal budget to get out of the aged-care business.
Quadrant had formed the Estia Health business barely five months before it floated on the stockmarket in December 2014 and had been entitled to sell the rest of its shares, which came out of escrow in November last year.
But such was the performance of the stock — it reached almost $8 a year later — and so rosy the outlook for a largely government- funded industry serving an ageing population that Quadrant, one of the sharpest operators in the local venture capital market, held on.
Last month’s budget, however, appears to have changed its view.
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Superannuation Issues.

  • Updated Jun 6 2016 at 8:18 PM

How the Labor and Liberal plans to tax retirement balances will affect you

Liberal and Labor both plan to restart taxing wealthy retirees' superannuation. 
Analysis by actuarial consulting firm Rice Warner shows that voters with $2 million or more in super savings will be better off under Labor's policy in years when investment market returns are 6 per cent or less, but could pay more than three times as much tax when returns are more than 8 per cent. 
The research also shows that under Labor, retirees with super balances of about $1 million could be hit with a tax on their earnings in years when their investment returns were 8 per cent or higher. 
However, Labor's approach to taxing big super balances in retirement also provides more flexibility for self-funded retirees to rebuild their pension balance if markets tank, Rice Warner head of superannuation research Nathan Bonarius said. 
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As super takes a hit, family trusts rise again

  • Will Hamilton
  • The Australian
  • 12:00AM June 7, 2016
The proposed changes around superannuation and the ensuing erosion of faith in the savings system have led to discussion about alternatives to superannuation. With this comes consideration of the increased use of family and discretionary trusts as a vehicle through which to hold and accumulate wealth.
Many advisers are witnessing increasing demand from clients seeking advice about investment strategies that are effective alternatives to superannuation — or that may sit beside a superannuation investment strategy — one of which is indeed trusts.
Another is property investment, which can be approached as a direct investment that might be negatively geared or through investment in a real estate investment trust (REIT). Whatever the approach, there are alternatives to superannuation that can enable investors to build and manage wealth.
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Federal election 2016: QC’s group lobbies for super changes

  • The Australian
  • 12:00AM June 8, 2016

Glenda Korporaal

Leading Melbourne QC Jack Hammond is expected to launch a lobby group today to campaign against the Coalition government’s proposed superannuation law changes.
Mr Hammond will speak at a Melbourne meeting of lawyers and judges tonight and is expected to announce the formation of a group called Save Our Super which will call on the government to “grandfather” the impact of proposed superannuation changes on existing superannuation account holders.
The changes announced on budget night include imposition of a $1.6 million cap on the amount of money that can be moved into a tax-free super account, an immediate lifetime cap of $500,000 for post-tax contributions to superannuation, cutbacks in the attractiveness of transition to ­retirement schemes, higher taxes on super contributions for people earning more than $250,000 and higher taxes on payouts under ­defined benefit superannuation schemes above $100,000 a year.
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Government will ‘look at’ deals signed before changes to super

  • The Australian
  • 12:00AM June 10, 2016

Glenda Korporaal

Kelly O'Dwyer has called on the Greens to announce the full details of their superannuation policy.
The federal government would look at situations where people had entered into binding legal contracts who might be hit by the proposed superannuation changes when it was drafting the legislation, Assistant Treasurer Kelly O’Dwyer said yesterday.
“We will have a period of consultation to make sure there are no unintended consequences from the legislative changes,” she said.
“If someone has made a binding legal agreement before budget night, the government will look at that situation in the design of the legislation.’’
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Pharmacy Issues.

PM makes commitment to community pharmacy

Prime Minister Malcolm Turnbull has expressed his support for community pharmacy in a letter to the Pharmacy Guild, saying a returned Coalition government would ensure funds allocated under the Pharmacy Trial Program and 6CPA will deliver the best health outcomes.

The PM says the Coalition supports the current model of pharmacy ownership, and supports reforms that will allow pharmacists to take on a greater role in allied health.
Mr Turnbull says that the Coalition is “proud Australia’s community pharmacy sector is considered world-leading.
“It is a truly public-private partnership that is underwritten by the capital investments made by small business pharmacy owners around Australia and the commitment and hard work of their staff.
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Xenophon attacks 'flawed' co-payment

8 June, 2016 David Rowley 
Senator Nick Xenophon has condemned the $1 PBS co-payment as "flawed" and future co-payments as "damaging and unnecessary".
In a letter to pharmacists, addressed to the Pharmacy Guild, the South Australian independent says the $1 discount, introduced in January, misleads pensioners and concession card holders into thinking they're getting cheaper medicine when in reality they’re having their access to the safety net delayed.
This comes at the expense of their local pharmacy, he says, adding that it also breaches the universality of subsidised medicine, with rural and regional pharmacies unable to pass on the discount.
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I look forward to comments on all this!
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David.
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