Thursday, November 27, 2014

Review Of The Ongoing Post - Budget Controversy 27th November 2014. No Sign Of Stopping!

Budget Night was on Tuesday 13th May, 2014 and the fuss has still not settled by a long shot.
It is amazing how the discussion on the GP Co-Payment just runs and runs. Some more this week.
Here are some of the more interesting articles I have spotted this 26th week since it was released.
Tony Abbott is still complaining just how hard it is being to make budget progress and reports of huge budget blowout also featured - said to now be $40B.
The Government response to Ebola seems to be finally lifting off with the new hospital in Africa to open in a week or so.

Late Note: The co-payment story has become very, very blurred in the last 24 hours and no one knows what is going on! There are only 4 sitting days left before Parliament rises till February 2015! 

General.

G20: Tony Abbott 'whingeing' about domestic agenda on world stage

Opposition leader Bill Shorten says Australian PM made ‘weird and graceless’ opening address on the carbon tax, asylum seekers and budget problems
Tony Abbott has highlighted his domestic political agenda during an opening address to world leaders in Brisbane, citing the abolition of carbon pricing, the hardline stance on asylum-seeker boat arrivals and “massively difficult” budget measures.
The Australian prime minister conceded his counterparts could raise any topic they wish in the G20’s closed-door leaders retreat – despite his wish that it remain economics-focused – after intense pressure from Europe and the US for stronger action on climate change.
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Tony Abbott talks Senate woes in front of world leaders

Phillip Coorey Chief political correspondent
Prime Minister Tony Abbott has bemoaned his budget woes to the leaders of the world’s richest nations, telling them the Senate won’t pass his higher education reforms or Medicare co-payment.
In an opening address to G20 leaders, which the opposition has slammed as “graceless and weird’’, Mr Abbott said it was proving “massively difficult’’ to get the budget under control.
The G20 leaders have signed off on a commitment for each country to grow its economy by 2.1 per cent over five years. The government’s budget measures are part of Australia’s plan to achieve this.
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Australia suffers another cringeworthy moment during G20 summit

Date November 17, 2014 - 6:40AM

Robyn Dixon

The adolescent country. The bit player. The shrimp of the schoolyard.
For Australians it's not so bad - most of the time - to be so far away, so overlooked, so seemingly insignificant as to almost never factor in major international news. The lifestyle makes up for it.
But occasionally, there's an awkward, pimply youth moment so embarrassing that it does sting. Like when 19 of the world's most important leaders visit for a global summit and Prime Minister Tony Abbott opens their retreat on Saturday with a whinge about his doomed efforts to get his fellow Australians to pay $7 to see a doctor.
And then he throws in a boast that his government repealed the country's carbon tax, standing out among Western nations as the one willing to reverse progress on climate change - just days after the United States and China reached a landmark climate change deal.
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Briefing to the incoming Minister of Health 2014

Link to Resource:

12 November 2014
Executive summary
This briefing provides you, as the incoming Minister, with information on challenges and opportunities facing the New Zealand health and disability system, and how the Ministry can advise and support you to implement your Government’s priorities for health. The Ministry looks forward to discussing with you how to progress your health policies, including: providing high-quality health services; healthy communities; a strong and engaged health workforce; quality aged care and mental health services.
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Some Australians to pay more for health

  • November 18, 2014 3:11PM
SOME Australians will pay higher Medicare levies and more for private health insurance from next year.
LEGISLATION to freeze income thresholds for three years for the Medicare levy surcharge and private health insurance rebate passed parliament on Tuesday.
The freeze will be in place from July 2015.
Australians not yet paying the Medicare levy surcharge could rise over the threshold as their incomes increase, and have to pay it for the first time.
Others may move into a higher bracket.
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Budget deficit heads for $40bn

David Crowe

GLOBAL pressures are driving the federal budget towards a $40 billion deficit this year, as Joe Hockey confronts plunging iron ore prices that will wipe out revenue, just as he fights to legislate his agenda.
With iron ore prices tumbling faster than some of the gloomiest forecasts prepared for the federal budget, the Treasurer is preparing to issue an economic update within weeks, including new savings measures.
The government is also dealing with a splintering of Senate alliances that will make it more difficult to pass controversial changes such as university funding cuts and savings on family tax benefits.
While the May budget tipped an “easing” of the iron ore price over the next few years, those forecasts have now been rendered obsolete by a halving of the price over the past year.
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ABC budget cuts a story about lying, not money

5:00pm, Nov 20
Patrick Smithers Senior Editor
Don’t be distracted by the size of the cuts to the ABC. The headline story is the rolled-gold election promise that has been broken by the Prime Minister.
The Abbott government’s cuts to the ABC are neither savage nor indefensible.
Compared with decisions to charge people to go to the doctor, or to withdraw financial support for the young unemployed, they are a mere pimple on the policy landscape.
If, in the pursuit of a balanced budget, pensioners will have to make do with less and families will have to pay more at the petrol bowser, it is at least arguable that the ABC should take a trim.
Yet the cuts are important politically because they are the clearest example of an unpalatable, unavoidable truth: Tony Abbott lied to Australians to help win his way into office.
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19 November 2014, 11.38pm AEDT

An unexpected win for consumers of financial advice comes out of PUP implosion

Michelle Grattan
Australia’s financial services industry has been thrown into turmoil by the spectacular implosion of the Palmer United Party (PUP) and an independent stand by its supposed ally, Motoring Enthusiast Ricky Muir.
Wednesday night’s disallowance, by a 32-30 vote, of the government’s regulations that unwound Labor’s Future of Financial Advice measures reinstates a range of protections for consumers.
But it also means many financial advice institutions don’t have systems in place to meet what they will now be supposed to do, and thus could be in breach of the law. They’d been confident these wouldn’t be needed, thanks to the government’s watering down of Labor’s phased-in measures.
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ABC and SBS cuts are not cuts, and five other great political evasions

Date November 21, 2014 - 3:00PM

Rose Powell

Journalist

One might assume the freshly announced multimillion-dollar budget reductions to our government-funded national broadcasters would render Prime Minister Tony Abbott's pre-election promise of "no cuts to the ABC or SBS" utterly broken. But apparently not.
Both Finance Minister Mathias Cormann and Communications Minister Malcolm Turnbull stepped into the breach to explain.
Senator Cormann said Mr Abbott's promise did not refer to cuts but to "efficiency dividends", from which he said the ABC had been exempted for the past 20 years.
"The Prime Minister absolutely told the truth. We are not making cuts. What we are making sure happens with the ABC is what happens with every other taxpayer funded organisation across government."
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Sale could hurt Katya’s normal life

By NIGEL MCNAY

Nov. 22, 2014, midnight
KATYA Haynes headed to Canberra this week for testing of her hearing and cochlear implant.
The Albury girl, 5, has profound hearing loss, but the implant and plenty of family support have her keeping pace with kids her own age.
Crucial to her development, her mother Jana Kyte said, was the work of the Albury office of Australian Hearing.
But the family is concerned at federal government moves to privatise the service.
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Medicare Co-Payments.

Health Minister's Medicare claims not supported by facts

dburdon | 17th Nov 2014 6:00 AM
ARGUMENTS that the Medicare system is costing more due to patients "overusing" subsidised visits to GPs are not borne out by the facts of a major study showing how doctors are working longer hours to deal with more complex problems, according to one health policy expert.
The study by the University of Sydney's Family Medicine Research Centre last week revealed the system cost some $2.1 billion a year more in 2013-14 than it did 10 years ago.
But, the centre's Associate Professor Helena Britt said, the data showed taxpayers were actually getting a lot more bang for the buck - through an extra 35 million more GP services (36% more than in 2003-04), managing an extra 68 million health problems (a 48% rise on 2003-04).
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Victoria election 2014: Clive Palmer says election is a vote on GP co-payment, education

Posted yesterday at 2:12pmSun 16 Nov 2014, 2:12pm
Clive Palmer says the Victorian election is a referendum on the Medicare co-payment and the future of education in the state.
The leader of the Palmer United Party (PUP) outlined the party's policies at its official campaign launch in Melbourne.
The outspoken Queensland Federal MP spruiked his Victorian connections, saying he was born in the state and lived there until he was 10.
"For most of the time since federation, Victoria was Australia's premier state and it can be again," Mr Palmer said.
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Politicians dispute impact of Medicare co-payment

Nov. 17, 2014, 6:24 p.m.
MEMBER for Wagga Daryl Maguire says there will be no co-payment in NSW, slamming Labor's claim 9200 extra patients would flock to Wagga's sole public hospital.
Country Labor candidate Dan Hayes spruiked NSW Labor's new hospital data model that showed a 27 per cent increase in emergency department admissions, under the proposed $7 Medicare co-payment plan.
The region's sitting member refuted the claim.
"They will be no co-payment," Mr Maguire said.
Mr Hayes and shadow minister for health Walt Secord said the $7 GP payment cost would be too high for many Australians, who would forgo seeing a general practitioner and instead seek free, hospital services.
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Jacqui Lambie: Palmer United Party implosion creates uncertainty

THE implosion of the Palmer United Party has created a new level of uncertainty in an already obstructionist Senate which casts further doubt on the Abbott government’s ability to pass outstanding contentious proposals such as the Medicare co-payment.
Indeed, the conglomerate decision of the newly liberated Jacqui Lambie with Ricky Muir, the Greens, Nick Xenophon, John Madigan and Labor to move to disallow financial reforms already passed with PUP support signals uncertainty for existing government legislation.
An already unpredictable and fractious Senate, arguably the most difficult since Federation, has become even more unpredictable and fractious.
After chalking up a series of legislative victories in the Senate, largely with the help of bloc votes from Palmer United Party Senators dictated to from Palmer in the Lower House the Government faces a new and even more daunting challenge.
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Ebloa.

Ebola threatens global security, says Julie Bishop

  • AAP
  • November 23, 2014 12:45AM
FOREIGN Minister Julie Bishop has expressed concern about the Ebola virus outbreak at a UN Security Council meeting she chaired on the disease.
“The Security Council reiterates its grave concern about the unprecedented extent of the Ebola outbreak in Africa, which constitutes a threat to international peace and security, and the impact of the Ebola virus on West Africa, in particular, Liberia, Guinea and Sierra Leone,” Ms Bishop said yesterday in New York.
She also warned that gains made to date could easily be reversed.
The debate came as an Australian company prepared to open a treatment facility in Sierra Leone, with doctors likely to treat their first patients within weeks.
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Medical Research.

Vision for high-performance bionic eye jeopardised by lack of funds

Date November 23, 2014 - 12:15AM

Bridie Smith

Lack of funding may force Australia researchers to drop their promising work on a bionic eye.
Australian bionic eye researchers fear a lack of funding will force them to drop one of the most promising research projects in their quest to restore vision to the blind.
As the federal government calls for submissions on how to improve the country's commercialisation of research, Bionic Vision Australia has had to prioritise its focus. It will now concentrate on low-vision prototypes.
Their holy grail - a high-acuity bionic eye that would allow the blind to read large print and recognise faces - is likely to be shelved within months as there is not enough funding to get through trial stage.
"We're just about to fall into the valley of death," said Melbourne University physics professor Steven Prawer, head of materials development for the high-acuity bionic eye.
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Pharmacy Related Articles.

Profession divided over variable dispensing fees

17 November, 2014 Christie Moffat
Pharmacists are divided over whether a dispensing fee should be linked to the level of patient consultation, a Pharmacy News poll reveals.
The 2014 UTS Pharmacy Barometer, released in October, found that many pharmacists supported a consult-linked dispensing fee, with similar numbers of employed pharmacists and owners in favour of dispensing fee differentiation.
In light of the interest, Pharmacy News recently ran a poll, asking our readers whether they supported different levels of fees for dispensing based on the amount of patient interaction.
The outcome of the poll indicated that pharmacists are significantly divided on the issue – which reflects the wider trend among professional groups such as the Pharmacy Guild of Australia and the Pharmaceutical Society of Australia.
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Proposed S3 oral contraceptives 'totally inappropriate': AMA

17 November, 2014 Chris Brooker
Proposals have been tabled for a range of medicines to be downscheduled, including a number of oral contraceptives.
Among the proposals, which have already drawn condemnation from the AMA, are to move a number of oral contraceptives – including oestradiol, levonorgestrel, dropsirenone and others – to Schedule 3.
Another proposal would see herpes treatment acyclovir downscheduled from S4 to S2 in muco-adhesive tablets containing 50mg in a pack of two.
The TGA is currently calling for submissions on these and other proposals by 11 December, ahead of the March 2015 meeting of its Advisory Committee on Medicines Scheduling.
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Chemist Warehouse faces accusations of misleading discount advertising

By consumer affairs reporter Amy Bainbridge
November 18, 2014, 7:44 am
Two major pharmacy bodies say Chemist Warehouse is misleading consumers in the way it advertises its discounts on some of its products in store, as well as on dockets given to customers.
The Pharmacy Guild and National Pharmacies have each written to the Australian Competition and Consumer Commission (ACCC) and asked it to investigate, with the Guild describing it as a "matter of urgency".
But Chemist Warehouse has denied any wrongdoing.
In his letter to the ACCC, the president of the Victoria branch of the Pharmacy Guild, Anthony Tassone, pointed to two examples he believed misled consumers.
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Most GPs opposed to pharmacy consultation role: poll

17 November, 2014 Chris Brooker
The strident opposition of doctor’s groups to any extension of the clinical role of pharmacists has been borne out by a recent poll conducted by the Royal Australian College of General Practice.
The poll, which is still ongoing on the RACGP website, asks College members to vote on whether they “Support the expansion of community pharmacists’ roles to provide basic patient consultations?”
To date, the response has been an overwhelming no. In fact, of the first 100 voters, 84 voted “No, pharmacists are not medically trained and have a conflict of interest because they dispense medication”.
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Guild analysis finds deregulation call ‘deeply flawed’

19 November, 2014 Christie Moffat
Recommendations by the Competition Policy Review panel to remove pharmacy ownership and location rules have been labelled “deeply flawed” in a detailed submission by the Pharmacy Guild of Australia.
The 123-page document was commissioned in response to the Harper Review’s draft recommendations, and contains a three-pronged analysis from a range of leading consultants on whether removing ownership and location rules would advance the welfare of the Australian community.
Criticisms levelled at the Review included that it was based on a “poorly formulated public interest test”, was not based on robust or transparent evidence, did not recognise the success of the current regulations, and was developed without a clear understanding or formulation of alternatives.
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Community pharmacy passes the test

This week the Guild has lodged a significant submission to the national Competition Policy Review, responding to the Panel’s draft report released last September.
I am very proud of the Guild’s submission because it breaks new ground in establishing a range of objective measures of the true value of community pharmacy and the model under which it operates in this country.
The submission is based on a new three-pronged analysis of the community pharmacy model which confirms that it is delivering a high level of access, choice and equity for consumers.
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Comment:
I also have to say reading all the articles I still have no idea what is actually going to happen with the Budget at the end of the day. Maybe the next few weeks of parliament will clarify things this time but I doubt it. The Reps come back on soon, along with the Senate. Both rise until the new year on Dec 4, 2014 until February!
As pointed out on Insiders this week - if the Budget is not sorted in the next week or so - then the next chance is in February, 2015 - and after MYEFO - and then we are into the next Budget!
To remind readers there is also a great deal of useful health discussion here from The Conversation.
Also a huge section on the overall budget found here:
Enjoy.
David.

It Seems There Is Opportunity For Remote Telehealth To Make A Bigger Positive Difference.

This appeared last week:

Doctors call on government to expand Medicare for Telehealth

Delegates gather for annual telehealth conference
Brian Karlovsky (ARN) on 17 November, 2014 09:48
The Australasian Telehealth Society has called on the Government to expand medicare for telehealth ahead of its annual meeting.
Delegates are gathering in Adelaide today for SFT-14, the "Successes and Failures in Telehealth" conference, and the fifth Annual Meeting of the Australasian Telehealth Society, which will be opened by the South Australian Health Minister, Jack Snelling.
Telehealth is the delivery of health care services at a distance, using information and communication technology.
This conference will showcase the achievements of doctors, nurses, psychologists and all healthcare providers in using telehealth to bringing healthcare to rural and remote areas and into people’s homes, to achieve better access to healthcare and improved health outcomes.
In 2011, the Australian Government put video consultations by specialists to rural Australia on Medicare.
This means that people in the bush can see a specialist by simply going to their local general practice, rather than having to travel to the city.
This initiative has supported around 230,000 telehealth consultations. More than twice this number was predicted, so the funding set aside has been underspent, and this gives capacity to extend telehealth to a broader range of health services.
"It is still only available in some areas and needs to be put into practice much more widely to make health outcomes more equal," according to the Society.
"More than 30 per cent of Australians live in rural and remote areas, but less than 1 per cent of medical specialist consultations are by telehealth.
"Improvements in broadband communication need to be harnessed to bring more health services to these areas."
In far west NSW, remote Western Australia and in the Northern Territory, life expectancy is more than 10 years below average, and suicide rates are more than double.
The Society has called for a list of reforms to be implemented.
Lots more here:
The requests from the Society all seem sensible to me and could make a real difference at  a very reasonable cost.
Interesting the usage to date has been lower than predicted. I wonder why that was?
David.

Wednesday, November 26, 2014

ABC TV Is Reporting The Medicare Co-Payment Has Been Abandoned.

Barnacle falls off!

David

Now This Is A Very Interesting Advertisement For Clinical Usability Staff From NEHTA.

This appeared a few days ago.

Senior Clinical Usability Analyst

  • Fixed term contract position
  • Manage all clinical functionality and usability activities
The National E-Health Transition Authority Limited (NEHTA) was established by the Australian, State and Territory governments to develop better ways of electronically collecting and securely exchanging health information. NEHTA is the lead organisation supporting the national vision for e-health in Australia.
NEHTA is currently recruiting people with a desire to make a difference to health outcomes, that are passionate about the use of e-health to meet these goals and who have the relevant experience to deliver solutions in a highly complex stakeholder and technical environment. In these roles you will be working with consumers and clinicians who will be defining how models of care can be improved using the PCEHR. You will be delivering the solutions that will be in place for your grandparents, parents and your children... and for you as you engage with the public and private health system.
The Senior Clinical Usability Analyst creates value by taking responsibility for managing and securing advice, guidance and recommendations around clinical usability for eHealth products from Australian clinicians and optimising that guidance with other NEHTA business units.
Accountabilities
  • Work with the Clinical Governance (CG) safety team to ensure understanding and management of any overlaps and relationships between clinical usability and clinical safety.
  • Manage all clinical functionality and usability activities and ensure clinical safety and usability assessments and recommendations support each other and are aligned whenever possible.
  • Liaise between the NEHTA Clinical Governance Advisors (CGAs) and other NEHTA resources seeking clinical advice around the required clinical functionality and usability activities. This role will assist the CGAs in optimising the clinical input required to support these activities.
  • Work closely with CG staff and the CG Clinical Review Group (CRG) to ensure the right priorities are addressed to meet agreed deadlines for eHealth system releases and responding to queries received by CG.
  • Provide guidance and recommendations to the Clinical Functional Assurance Lead, the Clinical Review Group and relevant internal teams around the required change management and adoption activities needed for the successful role out of eHealth systems and releases .
  • Represent the CG clinical usability recommendations to internal and external stakeholders to ensure clarity and understanding.
To be successful you will have:
  • eHealth experience is highly desirable in the clinical informatics experience in an eHealth setting
  • Evidence of excellent communication and negotiation skills.
  • Health fundamentals
  • Strong knowledge and experience with health informatics
  • Knowledge and/or experience in various health sectors settings around work practices, work flow and implications for eHealth systems
  • Strong knowledge of patient care combined with sound understanding of health informatics concepts
  • Clinical decision making
  • Understanding of information requirements needed to support of clinical decision making
  • Sound problem solving skills
  • Clinical risk assessment and mitigation management
  • Ability to discuss and seek clinical advice around clinical usability matters in eHealth
  • Develop, implement, and refine clinical decision support systems
  • Strong business analysis skills
  • Qualifications in Health Informatics
This role will suit candidates who are methodical and highly organised with the ability to learn complex concepts and technical information quickly and on the go. NEHTA is an ever changing environment with something new to learn every day. If you are committed to delivery and have a willingness to learn then this role is for you.
Status: Fixed term contract to June 2015
There is more here:
The blurb is just fantastic here. Suggesting the work you can do in this job  by June 2015 will make a difference to my grandchildren and that the PCEHR will still be around decades from now has surely to be a joke.
The second thing that strikes me is the task. If the job was to redesign the PCEHR to make it useful maybe but it seems the job is just an advisory and committee job. Bureaucracy squared as far as I can tell.
Third - allowing for recruitment time and the silly season this is a four month role. Make the PCEHR usable in 4 months. Someone is dreaming.
Fourth it does seem interesting just how often informatics is talked about in the add given the relative scarcity of expertise in this domain within NEHTA over the years - quite wrongly. I reckon there should have been 2-3 of these sort of people on the NEHTA Board since it began. The outcomes might just have been rather different.
You really have to wonder just what is going on here.
David.

Tuesday, November 25, 2014

Telstra Buys Into The Aged Care Health IT Space Takes Out A Key Player. Times They Are Changing.

This appeared this week:

Aged care providers want scale in vendors too

By Natasha Egan on November 21, 2014 in Industry, Technology
Just as Australian aged care providers are undertaking mergers and acquisitions to achieve economies of scale, they are also looking for scale and stability in their suppliers, says iCareHealth managing director Chris Gray.
Mr Gray was commenting after this week’s announcement that Telstra Health has acquired the Australian arm of iCareHealth as part of its broader e-health vision to create a better system for patients, providers and funders.
iCareHealth is the only aged care software provider to offer a single person electronic health record across the continuum of aged care. Its software is used in the provision of care to 50,000 residents for clinical care management and 30,000 of those residents for medication management.
Mr Gray, who co-founded the organisation in 2002 and has been at the helm since 2007, said such transactions were a sign of things to come as Australia’s ICT aged care sector comes of age.
“The needs of the aged care providers will be for more scale and more stability within the vendor so you would have to think naturally there will be consolidation of IT providers within the aged care sector,” Mr Gray told Australian Ageing Agenda.
“That is not just in the clinical and medication side; that’s anybody that is supplying information or IT systems into the aged care industry.”
For providers it is about their financial stability as well as getting the IT they need to support their operations and for iCareHealth it is about making wider healthcare connections, he said.
“Being part of the Telstra Health vision, our role is to play the aged care part of that, particularly in residential aged care and how we connect into the pharmacy and the GP and provide all of that healthcare information about a resident to the nursing and care staff on the floor.”
While the business has a new shareholder Mr Gray said his and the rest of the management team’s roles remain the same and iCareHealth would continue to deliver the same service to its clients.
“People’s roles don’t change. It is more about connecting into the other pieces of the software puzzle that Telstra Health is bringing to it and being part of that,” he said.
Lots more here:
This is a very interesting move and certainly again indicates that Telstra is on a mission to become a major player in the e-Health domain.
It is seeming as if things continue at the present pace we will see very few significant e-Health system providers left in the private sector in only a few years’ time.
It is of note that iCareHealth provides both an electronic patient record as well as medication management in its domain as well as connectivity to GPs and Pharmacy.
By becoming a cloud based EHR provider, serviced by Telstra and Microsoft, and offering medication management as well as a clinical record for those patients it becomes a total, more advanced and nationally accessible replacement for the PCEHR as far as clinicians are concerned and facilitates clinical information sharing in what has to be a much more live and curated fashion.
I wonder how long it is before we see similar replacements for the PCEHR in other domains (chronically ill, indigenous etc.) and we can see a large $1.0B Government investment just go down the drain - with Telstra collecting a clip along the way?
Oh dear - Government picks another possible looser I fear.
David.