Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Saturday, April 04, 2015

Weekly Overseas Health IT Links - 4th April, 2015.

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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Patient EHR Access Can Increase Provider Workloads

MAR 27, 2015 7:34am ET
Giving hospitalized patients access to their electronic health records during hospitalization increases provider workloads, but not as much as anticipated.
That is the finding of a hospital-based study conducted at the University of Colorado in which 50 patients were provided with tablets during their hospital stays and were able to view their EHRs via a patient portal. The results of the study, published in JAMA Internal Medicine, show that enabling patients to view their EHRs did not create additional work for doctors or nurses.
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Health Information Exchanges Show Little Evidence of Benefits

MAR 27, 2015 7:42am ET
Though health information exchanges are supposed to improve the speed, quality, safety and cost of patient care, there is little evidence of these benefits in existing HIE studies.
That is the conclusion of a research paper, published in this month’s issue of the journal Health Affairs, in which researchers reviewed 27 studies looking for evidence that HIEs increased efficiency, reduced healthcare costs or improved outcomes.
While researchers found that 57 percent of published analyses reported some benefit from HIE, they also reported that articles employing study designs having strong internal validity—such as randomized controlled trials or quasi-experiments—were significantly less likely than others to associate HIE with benefits.
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Interoperability: Just ahead or still far off?

Posted on Mar 27, 2015
By Bernie Monegain, Editor-at-Large
At no other time in history has there been such a concentrated push for interoperability as there is today.
Perhaps the need has become more obvious since the widespread adoption of electronic health record systems. Maybe the industry has gotten a second wind. Maybe the movers and shakers are finally impatient to make it happen. It could be simply that the stars are aligned.
Whatever the reason, interoperability is center-stage. It doesn't mean that it is done, or that the road to interoperability will be an easy ride. But, suddenly industry insiders seem more abuzz and determined to push forward.
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Security for Healthcare ‘Internet of Things’ Must Be Addressed Upfront

MAR 26, 2015 7:39am ET
The explosion of networked medical devices and sensors that connect, communicate or transmit information through the Internet hold tremendous promise if security is built into the infrastructure from the outset, according to a new report.
While networked medical devices linked to the “Internet of Things” pose potential security risks, they are outweighed by the potential benefits to society from these devices that are “wearable, temporarily ingested or even embedded in the human body for medical treatment, medication, and general health and wellness.” That is the conclusion of the report by Intel Security (which owns security software vendor McAfee) and the Atlantic Council, a nonpartisan international affairs policy organization.
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Allscripts, Cerner top EHR user satisfaction rankings

March 26, 2015 | By Marla Durben Hirsch
Allscripts, Cerner and CPSI all retain the top spot in their respective markets for user satisfaction, according to the latest report from market research firm Black Book Rankings.
The annual report, released March 18 and based on thousands of ballots from technology and nursing staff at 702 hospitals, found that CPSI retained the No. 1 ranking for hospitals under 100 beds, rural hospitals and critical access hospitals for the fifth year in a row. Cerner retained the top spot for community hospitals of 101-250 beds for the same time period; it also came out the best for hospital systems.
Allscripts was the top dog for the second year in a row in the 250-plus category; it edged out Epic last year, according to an announcement on the report.  
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EHR inaccuracies threaten patient safety

March 26, 2015 | By Marla Durben Hirsch
Electronic health records are not doing a good job of creating accurate and clear graphs of patient information, which may adversely impact patient safety, according to a new article in the Journal of the American Medical Informatics Association (JAMIA).
The researchers, from the University of Texas Health Science Center, Baylor College of Medicine and elsewhere, evaluated the graphical displays of lab test results in eight EHRs. They used 11 objective criteria, such as title of graph, legends, and x and y axis scales and labels. Six of the EHRs were certified by the Office of the National Coordinator for Health IT, one was an EHR prototype and one was the U.S. Department of Veterans Affairs' EHR system.   
The results were discouraging. There was little standardization among the graphs, and none of them met all 11 criteria; three of them only met five criteria, according to the authors. One plotted data in reverse chronological order, and one plotted data at unequally spaced points in time. Three didn't display the patients' IDs directly on the graph, and only two allowed users to see, hover over or click on a data point to see values of x and y coordinates. 
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The case for expanding API use in healthcare

March 26, 2015 | By Dan Bowman
While the proposed rule for Stage 3 of Meaningful Use and the accompanying certification rule emphasize the use of application programming interfaces (API) for sharing health information with patients, that outlined proposal doesn't go far enough, according to Ashish Jha, a professor of international health at the Harvard School of Public Health.
Jha, writing for the Health Affairs Blog, says if the federal government is serious about fixing the poor usability of EHRs, the systems must be opened up much more robustly.
"[Office of the National Coordinator for Health IT] should require that any vendor that enjoys federal subsidies for its products make its full suite of APIs widely available for third-party products," Jha says. "If these APIs become widely available, third-party vendors will build the tools that currently limit EHR utility and value."
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Govt hopeful on patient access target

26 March 2015   Rebecca McBeth
The government is optimistic about meeting an April deadline for patient access to online records, despite January figures revealing that thousands of practices were yet to offer the service.
The government is optimistic about meeting its April deadline for patient access to online records, despite January figures revealing that thousands of practices were yet to offer the service.
Health secretary Jeremy Hunt has pledged that all patients who want it will have online access to their GP record by 31 March 2015. The government scaled back the pledge in October 2013, requiring GP practices to provide access to only the brief information held on their Summary Care Record.
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Health Information Exchange: Lessons From Libraries

by Charis Baz Takaro Thursday, March 26, 2015
Health information exchange: Congress has encouraged it, the business case is strong and the public assumes it is happening behind the scenes. But on the ground, medical staff fight this war with fax machines and frantic calls to medical record departments.
But what if a lab test only had to be done once, and then everyone had access to the results? What if real-time referrals included pertinent notes and results, transmitted directly as structured data into the specialist's electronic health record system?
Instead, we're living a nightmare. In many cases the primary care provider's office prints stacks of paper from the EHR to fax to the specialist's office, where it is scanned in heaps as unstructured data into the chart. How much human effort supports this system? And what benefit do we derive from this information given its form and volume?   
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Public Opinion Screams 'Share My Data, With No Fees'

MAR 25, 2015 7:57am ET
Nearly 75 percent of American adults surveyed believe it is very important that their critical health information should be easily shared between physicians, hospitals and other healthcare providers, according to a survey released by the Society of Participatory Medicine and conducted by ORC International.
The survey also revealed that 87 percent of respondents are overwhelmingly against any fees being charged to either healthcare providers or patients for the transfer of critical health information. However, nearly 20 percent of those surveyed felt that they, or a family member, experienced a problem receiving medical care because their health records could not be shared between different healthcare providers.
 “What this survey points out is that when critical health information can’t be shared across medical practices and hospitals, patients are put at risk,” said Daniel Z. Sands, M.D., co-founder and co-chair of the Society of Participatory Medicine.
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Q&A: Robert Wachter on health IT's 'hope, hype and harm'

Posted on Mar 25, 2015
By Mike Miliard, Editor
"The interviews really brought it to life; it was fun to do," says Robert Wachter, MD, describing the 90 or so people, from across the healthcare industry and beyond, he spoke with for his probing and sometimes provocative new book, The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine’s Computer Age (McGraw-Hill), which looks at the consequences – intended and unintended – of the past five years of electronic health records.
Wachter – associate chair of the department of medicine at the University of California, San Francisco; practicing physician; patient safety guru; hospitalist pioneer and blogger – casts a wide net, exploring the sprawling and multi-faceted evolution taking place across this enormous industry these past few years through a series of well-reported and engagingly written vignettes.
He explores the EHR's effect on the physician note and patient experience at the point of care; the successes – and excesses – of HITECH and the meaningful use program; the battle for marketshare and mindshare of pugnacious vendors such as Epic and athenahealth; the impact of big data and supercomputers on doctors and the care they deliver; the changes in store thanks to increasingly engaged and empowered patients.
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The role of artificial intelligence in personalized medicine

March 25, 2015 | By Susan D. Hall
Scientists at Carnegie Mellon University and the University of Pittsburgh are using artificial intelligence in their quest to provide individualized treatments, according to a Computerworld article.
As part of the Pittsburgh Health Data Alliance, the University of Pittsburgh Medical Center has agreed to fund the project for six years at between $10 million and $20 million per year.
It's taking data from electronic health records, diagnostic imaging, prescriptions, genomic profiles, insurance records and even wearable devices to create healthcare plans not only by disease, but also for specific types of people.
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The disturbing truth behind the Premera, Anthem attacks

March 24, 2015 | By Dan Bowman
As details continue to emerge following the recent hack attacks on payers Anthem and Premera--in which information for close to 90 million consumers combined may have been put at risk--perhaps the most disturbing revelation of all is that, in both instances, neither entity appears to truly take security seriously.
Premera, for instance, knew three weeks prior to the initial penetration of its systems in May 2014 that network security issues loomed large. A report sent by the U.S. Office of Personnel Management's Office of Inspector General detailed several vulnerabilities, including a lack of timely patch implementations and insecure server configurations.
The findings were so bad, they prompted OPM to warn Premera, "failiure to promptly install important updates increases the risk that vulnerabilities will not be remediated and sensitive data could be breached." In addition, OPM told the Mountlake Terrace, Washington-based insurer that failure to remove outdated software would increase the risk of a successful malicious attack on its information systems.

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Health, fitness connected device services market to hit $1.8B by 2019

By: Jonah Comstock | Mar 24, 2015        
Juniper Research predicts that connected healthcare and fitness device services will produce $1.8 billion in annual revenues by 2019, according to a new report, a sixfold increase from 2015, which has predicted revenues of $320 million.
The services market is due to explode because in order to succeed, connected fitness devices will have to shift their focus from just hardware, to software and services author James Moar writes.
“Connected fitness and health devices provide a way to collect biometric data, not interaction platforms,” he said in a statement. ‘People want to interact with the devices at the app level – the draw is the information. Because of this, and the omnipresence of sensors, the importance of the hardware will diminish at a much faster rate than other CE market segments.”
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Survey: Doctors and Patients See Benefits in Mobile Apps

March 24, 2015
Nearly half (46 percent) healthcare professionals say that they will introduce mobile apps to their practice in the next five year, according to the Plano, Tex.-based Research Now Group.
The survey included 500 healthcare professionals and 1,000 health app users in the U. S. Healthcare professionals were asked whether they currently use smartphone technology in their medical practice; whether they thought it was beneficial and for which types of patients; and under what conditions they thought it had the greatest potential. The health app users were asked which types of apps they use and how they feel about using smartphone technology in relation to their health.
The research found that 86 percent of healthcare professionals believe that health apps will increase their knowledge of patients' conditions. What’s more, 96 percent of users think that health apps help to improve their quality of life, and 72 percent of healthcare professionals believe that health apps will encourage patients to take more responsibility for their health.
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Growing up fast

Companies wanting to play in the community and child health space have been investing in their IT systems, so they are ready to step out into the big world of integrated care, mobile working, and – even – patient-led record keeping. Daloni Carlisle reports.
Community and child health IT have always been the poor cousins of acute sector IT, with fewer systems to choose from, less investment from suppliers and less investment from the NHS.
But the last couple of years have seen a change with a number of suppliers investing substantially to improve their offering. The reason is twofold.
The end of the National Programme for IT means contracts are up for renewal – some 30 in the South and London and 180 more in the rest of England. Community providers are also looking for mobile solutions that are able to share data with other systems.
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Ready for the next generation of EHRs?

Posted on Mar 24, 2015
By Bernie Monegain, Editor-at-Large
The time is now for a "3rd Platform EHR," according to IDC -- systems that operate primarily in the cloud and provide more flexibility than today's "2nd Platform" client/server technology.
"The 3rd Platform, with cloud as its foundation, is widespread and growing across the country today," but mostly for discreet elements of healthcare, such as population health, IT operations and patient engagement, IDC analyst Judy Hanover writes in a new IDC Health Insights report, "Business Strategy: Crossing the Innovation Gap from 2nd Platform to 3rd Platform Acute Care Systems — the athenahealth and BIDMC Collaboration."
IDC sees 3rd Platform systems as "characterized by ease of access, and ubiquitously available applications that can be securely accessed from multiple endpoint devices, coupled with the use of commodity infrastructure available from service providers through software-as-a-service, platform-as-a-service, and analytics-as-a-service offerings, among other constructs," according to the report.
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The biggest IT barriers to push for Precision Medicine

March 24, 2015 | By Katie Dvorak
President Barack Obama's Precision Medicine initiative hinges on gathering data from millions of individuals, but there are challenges the healthcare industry will face when it comes to collecting that information, says Niam Yaraghi, a fellow in the Brookings Institution's Center for Technology Innovation. 
Interoperability and security are two issues plaguing the industry, which also will play a role in Obama's initiative, the aim of which is to increase the use of personalized information in healthcare
The first problem is the inability for electronic health record systems to share information seamlessly, Yaraghi writes at Brookings' TechTank. With the current lack of interoperability of EHRs, it seems highly unlikely the industry will be able to obtain a complete medical history of one million Americans, he writes.
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FirstLine’s app will send a doctor in person if call, text, video isn’t enough

By: Aditi Pai | Mar 23, 2015        
San Francisco-based FirstLine Medical has launched its doctor consultation service, called FirstLine, available via iPhone app. The offering allows patients to call, text, or video chat with a doctor, similar to other doctor consultation offerings, but FirstLine goes one step further — if users choose, they can also request a doctor to make an in-person visit to their home or office.
FirstLine is backed by e.ventures and Great Oaks Venture Capital.
The app launched a beta in late 2014. FirstLine CEO Bryan O’Connell told MobiHealthNews that already the app has more than 20,000 users.
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Study: Switch from manual to electronic transactions could save healthcare $8B

Written by Kelly Gooch | March 23, 2015
Transitioning from billions of manual to fully electronic business transactions between healthcare providers and health plans can potentially result in significant cost savings and efficiencies.
But how much progress has been made? How much remains? 
That's what nonprofit alliance CAQH examined in its newly-released 2014 CAQH Index research report. The report reflects 2013 data from participating health plans representing 112 million enrollees — almost 45 percent of the privately insured U.S. population — on more than four billion transactions.
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Cloud Adoption Gains Traction

Scott Mace, for HealthLeaders Media , March 24, 2015

Physician practices and ambulatory care sites have been gravitating to the cloud for years, but Web-based services are now finding hospital-based and even industrywide applications.

This article appears in the March 2015 issue of HealthLeaders magazine.
While no cloud-based electronic health record software of note for hospitals has yet to emerge on the scene, cloud-based ambulatory EHRs continue to gain traction, storage remains a strong cloud option, and intriguing new analytics options are tapping the versatility of cloud technology.
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ONC Expanding HIT Certification Beyond Meaningful Use

MAR 23, 2015 7:30am ET
Seeking to accelerate health information technology interoperability among providers not eligible for the electronic health records meaningful use program is the focus of a newly proposed rule from the Office of the National Coordinator for HIT.
ONC released the rule on March 20, the same day that the Centers for Medicare and Medicaid Services released a proposed rule for Stage 3 of the meaningful use program.
The ONC rule establishes new and voluntary 2015 Edition certification criteria for other health information systems, called Health IT Modules. A proposed Base EHR definition specific to the 2015 Edition would include fewer measures to report and targets care settings beyond the ambulatory and inpatient environments, such as long-term post-acute care, behavioral health and pediatrics.
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Reaction to Stage 3? Guarded

Posted on Mar 23, 2015
By Bernie Monegain, Editor-at-Large
The reaction to the long-anticipated Stage 3 meaningful use rules has been slow in coming – not surprising, given that the Centers for Medicare & Medicaid Services released them around 3:30 p.m. Eastern Time on Friday, March 20.
CHIME, the College of Health Information Management Executives, was the first to comment. Other organizations, such as the American Medical Association and the American Hospital Association, both vocal in asking the government for flexibility in the program, have not yet weighed in with statements.
"CHIME is closely evaluating both the CMS meaningful use rule and the ONC certification rule," the organization said in a Friday statement issued soon after the rules were released. "Based on our initial review, we are pleased to see flexibility built into the Stage 3 proposed objectives.
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Patient-centered medical homes lack effective tools for care coordination

March 23, 2015 | By Susan D. Hall
To serve patient-centered medical homes (PCMHs), health IT needs to evolve from digitized patient record repositories into interoperable electronic collaboration platforms to further care coordination, according to research published in the Journal of the American Medical Informatics Association.
In interviews with 28 people involved in three PCMHs, the researchers found that the individuals developed workarounds to make up for the functionality that their IT systems lack.
A basic need identified in the study includes monitoring tools that manage panels of patients and allow PCMHs to risk-stratify patients based on multiple types of data--clinical and claims--to identify and track those most in need of care coordination.
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Stage 3 Meaningful Use rules ambitious but burdensome, providers say

March 23, 2015 | By Dan Bowman
While the Centers for Medicare & Medicaid Services' proposed rule for Stage 3 of Meaningful Use represents an ambitious attempt to jumpstart interoperability in the healthcare industry, there are concerns that it could be a difficult row to hoe for providers.
For instance, John Halamka, CIO of Beth Israel Deaconess Medical Center in Boston, in a conversation with FierceEMR, said that his concern is that the thresholds proposed are not aligned with what is achievable in the marketplace today.
Specifically, Halamka (pictured right), who also serves on FierceHealthIT's Editorial Advisory Board, called the following "stretch goals:"
  • More than 25 percent of patients seen by an eligible professional (EP) or discharged from a hospital or emergency department (ED) must "actively engage" with their electronic records
  • For more than 35 percent of patients seen by an EP or discharged from a hospital or ED, a secure message must be sent using the EHR's secure messaging function or in response to a secure message sent by the patient
  • Patient-generated data from a nonclinical setting must be incorporated into the EHR for more than 15 percent of patients seen by the EP or discharged from a hospital or ED
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Stage 3 meaningful use proposed rule and certification criteria released

Posted on Mar 20, 2015
By Mike Miliard, Editor
The new Stage 3 meaningful use rules proposed by the Centers for Medicare & Medicaid Services seek to give providers more flexibility, simplify the program, drive interoperability among electronic health records and put the focus on improved patient outcomes.
  • The Stage 3 proposed rule can be read here.
  • New 2015 Edition IT certification criteria can be seen here.
CMS says the Stage 3 rules are meant to drive better-quality, more cost-effective and coordinated care by improving the way providers are paid and – crucially – bolstering better information sharing.
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Meaningful Use Stage 3 Proposed Rule Detailed

Scott Mace, for HealthLeaders Media , March 23, 2015

The proposed rule aims "to create more transparency on cost and quality information, bring electronic health information to inform care and decision making, and support population health," says HHS Secretary Sylvia M. Burwell.

The Centers for Medicare & Medicaid Services on Friday afternoon released the proposed rule for Stage 3 of Meaningful Use.
The agency, in a media statement announcing the move, said the proposed rules "will give providers additional flexibility, make the program simpler, and drive interoperability among electronic health records, and increase the focus on patient outcomes to improve care."
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IBM invests in EHR system to advance Watson

Beth Walsh
Mar 22, 2015
IBM has invested in Modernizing Medicine, a provider of cloud-based, specialty-specific EMR systems and other technologies that capture structured data, track outcomes and deliver clinical decision support.
The investment aims to accelerate adoption of Watson cognitive computing in healthcare, according to a release. This is the latest direct investment that IBM has made through its $100 million fund to seed Watson innovations. The investment caps $20 million in Series D funding secured by Modernizing Medicine, raising its overall funding total to $49 million.
Over 5,000 healthcare providers in the U.S., including approximately 30 percent of dermatologists, use Modernizing Medicine’s platform. According to the recent 2015 Black Book Market Research report, the company’s EMA Dermatology solution ranked first overall in the dermatology space for the second consecutive year.
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Complexity of DEA Rules Hindering E-Rxing of Controlled Substances

by Bonnie Darves, iHealthBeat Contributing Reporter Monday, March 23, 2015
The big push toward electronic prescribing of controlled substances hit a bump in the road this month when New York Gov. Andrew Cuomo (D) rolled back the deadline for mandatory e-prescribing in the state by one year, to March 2016.
The state e-prescription mandate, which was set to take effect March 27, was adopted as part of New York's Internet System for Tracking Over-Prescribing, or I-STOP, Act. The state law served as a jumpstart nationally for entities affected by the Drug Enforcement Administration's 2010 interim final rule allowing e-prescribing of controlled substances. But doctors and other health care professionals had lobbied lawmakers for the extension, noting that many electronic health record systems lack proper federal certification for e-prescribing of controlled substances.
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Records of all government hospital patients to be available on database 

With all patient information to be centralised and made accessible over a large network of hospitals and laboratories, life will soon become much easier for the patients in government hospitals. 
The Union Ministry of Health and Family Welfare is all set to bring in the National e-Health Authority (NeHA), for which the officials have already prepared a concept note. 
It will shortly be given the final contours. 
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NeHA's integrated health information system to help the sick

Neetu Chandra Sharma   |   Mail Today  |   New Delhi, March 22, 2015 | UPDATED 09:02 IST
The National e-Health Authority (NeHA) will help cut down on repeated medical tests that patients are subjected to before treatment in India. With all patient information to be centralised and made accessible over a large network of hospitals and laboratories, life will soon become much easier for the patients in government hospitals.
The Union Ministry of Health and Family Welfare is all set to bring in the National e-Health Authority (NeHA), for which the officials have already prepared a concept note. It will shortly be given the final contours.
"One of the major challenges faced by patients in India today is that whenever he visits any healthcare provider he is typically subjected to a certain number of tests before the care provider initiates a treatment plan for his/her condition. If a visit is required to another healthcare provider for either the same or another care setting, the patient is likely to be put through the same process of examination, testing and treatment unless s/he diligently carries around his medical records," said Jitendra Arora, director of the e-governance division in Health Ministry.
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Enjoy!
David.

Thursday, April 02, 2015

2016 Budget Watch. Parliament Closed Until Budget Day. The Leaks Begin!

Last Budget Night was on Tuesday 13th May, 2014 and it is still not finalised -apparently $27Billion still unresolved!
We now look forward to see what we might see next time. I am sure that it will be fun.
Budget Night is May 12, 2015.
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Articles looking forward and back this week include.

General Budget Issues.

A roadmap for the 2015 Budget: increasing tax revenue!

The Conversation 21 March 2015, 6:00am
Discussions of tax usually focus on tax rates, not on tax bases. But both offer possibilities to increase the total tax take, says University of Melbourne Economics Professor Peter Lloyd (via The Conversation).
PRIME MINISTER Tony Abbott has suggested that people will find the 2015 Federal Budget “pretty dull and pretty routine”, which has been interpreted as meaning the Federal Government is likely to continue its approach of cutting expenditure.
An odd feature of the budget discussion is the absence of measures that would increase total taxation revenue. This is a one-sided approach to preparing a budget.
A change in the size of the budget deficit can be achieved either by increasing tax revenues or by reducing total expenditures. I take as given the need to reduce the size of the structural budget deficit. So too is the need for reform of major expenditures such as health and income transfer programmes.
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Editorial: It’s the time for ‘safety first’ politics – the electorate won’t take too much pain

  • The Editor
  • The Sunday Mail (Qld)
  • March 22, 2015 12:00AM
IT’S no coincidence that the Palaszczuk Government hasn’t picked a fight with anyone yet.
Learning a big lesson from the former Newman government, Ms Palaszczuk has adopted a steady-as-she-goes approach to legislative reform and getting on with the job of governing Queensland.
This will be a far different government to that of the LNP.
Over the past decade, politics has changed forever in Australia.
Gone are the days of governments having a big enough majority to believe they will be there for the long haul.
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Hockey to explain Budget path

Nick Butterly and Shane Wright Canberra
March 23, 2015, 12:35 am
Deep dismay among Liberals at the Abbott Government's confused economic message will force Treasurer Joe Hockey to give a special address to the party room.
Mr Hockey is likely to face a meeting of coalition MPs tomorrow where he will make a statement on the nation's finances and make clear whether the Government will push ahead with its stalled program of cost cutting.
After years of warning that Australia was facing a "Budget emergency", Tony Abbott abruptly changed his rhetoric last week to say the situation was now "manageable" and predicted the coming May Budget would be "pretty dull" and "routine".
This change in language came despite a predicted worsening Budget bottom line, with falling commodity prices and the failure to get key policies through the Senate set to blow out this year's deficit beyond $40 billion.
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There will be cuts in budget says Josh Frydenberg

  • AAP
  • March 22, 2015 2:43PM
JUST because Prime Minister Tony Abbott says the budget will be “dull”, it doesn’t mean there won’t be spending cuts says Josh Frydenberg.
The Assistant Treasurer says the government remains “absolutely” committed to cutting government spending.
“We have to lower it and ultimately we are cutting it,” Mr Frydenberg told Network Ten today.
But Labor finance spokesman Tony Burke said it would be better to have a 10-year plan to fix the budget that accurately identifies the problem to turn it around.
“There’s no point doing some massive, immediate fiscal consolidation that just hurts consumer confidence and has an ongoing impact on unemployment,” Mr Burke told ABC TV.
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Business worried by budget approach

  • AAP with a staff reporter
  • March 23, 2015 8:30AM
Business groups are becoming increasingly uneasy about the Abbott government's relaxed approach to its second budget.
"The last thing we need ... is another year of paralysis and doubt about what the government can do," Australian Industry Group CEO Innes Willox told ABC Radio on Monday.
Prime Minister Tony Abbott has said Australians should expect a "quite dull" budget in May.
Mr Willox said "clean air and some very clear objectives" should be the budget priority over the next year to address structural problems in the economy.
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Joe Hockey to tart up the budget with lipstick

Date March 24, 2015 - 2:23AM

Peter Martin

The Treasurer moans about Labor’s budget tricks, yet considers a similar sleight of hand.
Never have I less looked forward to a budget. The one due in seven weeks is going to make me feel dreadful; not because of what it will do, but because of what it won't do.    
Last year's budget (Abbott's and Hockey's first) genuinely attempted to bring spending and income into line. Sure, it gave away revenue by axing the mining and carbon taxes (fulfilling an election promise) but it also wound back the growth in pension payments, froze family payments and indexed fuel excise so it would grow over time.
Its gaping hole was any action on winding back Australia's gargantuan and expanding network of tax concessions, most of which are for superannuation. Treasury's most conservative estimate has the concession for contributions to super funds costing $15.5 billion this financial year, climbing to $18 billion over three years. The tax concession for the earnings of funds costs $12 billion and is set to almost double to $22 billion. By way of comparison, Medicare costs $20 billion.
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Staying on message is vital to sustainable finances

The political constituency for repairing the structural defects in the federal budget is neither large nor steadfast, especially as the Abbott government keeps opting in and out of the reform movement.
On Tuesday, Joe Hockey told parliament the May budget, now less than seven weeks away, would be “responsible, measured and fair”. Yet in a presentation to Coalition MPs, the Treasurer said he would get the budget back to surplus “as soon as possible”. That’s irresponsible, lazy and unfair to future taxpayers. Economists can vacillate and obfuscate, but this lack of urgency and precision is as discomfiting as a Wayne Swan budget speech. Mr Hockey told colleagues all new spending would be offset by savings. Where have we heard that before? Oh yes, that comes from the failed treasurers’ little book of talking points.
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Apparent Leaks.

Tax on bank deposits in federal budget

by Phillip Coorey, Lisa Murray and James Eyers
The federal government is planning a tax on bank deposits at the May budget in a move that will raise about $500 million a year but which bankers warn could be passed on to customers.
Sources have told AFR Weekend that the government is set to proceed with the bank deposits insurance levy, first proposed by the former Labor government, to shore up revenue and to act as an alternative to forcing banks to hold extra capital as insurance against collapse. 
Tony Abbott has ruled out going after households in the May 12 budget following the negative reaction to measures in the 2014 budget.
The bank tax, as proposed by Labor ahead of the 2013 election, where it lost government, would be a 0.05 per cent levy on every deposit of up to $250,000. It was scheduled to start on January 1, 2016, and budgeted to raise $733 million in its first 18 months of operation. 
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Political Instability.

Budget, state troubles hit Liberal brand: Kemp

Rick Wallace

The Abbott government’s unpopular 2014 budget has been blamed as a contributing factor to the Victorian Coalition’s electoral defeat last year in a frank post-mortem delivered by party elder and former federal minister David Kemp today.
Dr Kemp said Joe Hockey’s 2014 Budget had damaged “perceptions of the Liberal brand” and some of the decisions of the Abbott government on fuel excise and other issues had stifled the premier Denis Napthine’s chances of winning a second term in November 2014.
“There can be no doubt that federal perceptions impacted on the result,” he said.
“The campaign occurred in a context where the Liberal Party’s standing federally, and in each state, had declined significantly.
“The poor reception of the 2014 federal Budget led to another decline in public perceptions of the Liberal brand.
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Tony Abbott’s fate is largely in Treasurer Joe Hockey’s hands

Chris Kenny

For Tony Abbott, today’s NSW election will be like a medieval witch trial — if Mike Baird sinks everyone will blame Abbott but if the Premier floats the commentators will praise him for prevailing despite the Abbott drag.
Truth be known, a solid performance by the NSW Coalition has to be seen as another fillip for Abbott, who has been steadily recovering since his spill scare.
Defining a strong performance is the difficulty because after the shock of the Queensland election any state government might be forgiven for accepting any win, regardless of the margin. The Baird government is up against a dispirited, undermanned and ideologically aimless NSW ALP that has been tainted by serious corruption.
And while the nation is gripped by economic uncertainty, Baird has seen his state regain its place at the economic vanguard of the nation. Yet Baird has significant factors working against him. There is the natural return of the electoral pendulum to some normality after Labor suffered the worst loss in Australian political history four years ago.
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Health Budget Issues.

Medicare freeze to cost Australians $10 for each GP visit

Date March 23, 2015 - 12:15AM

Jenna Price

The decision to freeze Medicare payments until 2018 will cost Australians about $10 -double the government's failed copayment - every time they visit the doctor.
Doctors say the freeze will affect the quality of care. General practitioners will be forced to either charge patients more for consultations because medical practices can no longer absorb the cost of running local medicine or see more patients to ensure consistent income.
New research published in the Medical Journal of Australia on Monday today reveals that GPs' income will decline for each consultation. GPs will be at least $4 worse off for each patient, but because they usually only charge a gap to non-concessional patients, they will be forced to charge a minimum of $8.43 or absorb the cut of 7.1 per cent.
Chris Harrison, lead researcher and senior research analyst at the Family Medicine Research Centre at the University of Sydney, says: "The government is now forcing GPs to hold the hat out."
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23 March 2015, 6.15am AEDT

High cost of GP rebate freeze may see co-payments rise from the dead

WWith GPs facing greater economic pressure and the health minister considering legislative change to make it easier for GP to charge them, GP co-payments, like Lazarus, may rise again from the dead.

Authors Christopher Harrison, Clare Bayram , Graeme Miller, Helena Britt

Prime Minister Tony Abbott has declared that GP co-payments are “dead, buried and cremated”. This contrasts with health minister Sussan Ley’s desire to “reduce the number of bulk-billed consultations to people who can afford to pay something”.
So, what is likely to emerge from Ley’s Medicare reform consultations?
In a paper published today in the Medical Journal of Australia, our new modelling shows the freeze on Medicare fees paid to GPs will leave doctors A$8.43 worse off per consultation with non-concessional patients by 2017-18. That’s a bigger shortfall than the now-abandoned A$5 rebate cut – and is likely to prompt many GPs to start charging a co-payment.
Currently, legislative restraints mean that GPs are only able to charge the government directly for patient care (bulk-billing) if they do not charge the patient a co-payment.
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Name and shame high-charging specialists to rein in excessive fees: ex-Abbott advisor

Date March 23, 2015 - 11:40PM

Dan Harrison

Health and Indigenous Affairs Correspondent

Medical specialists who charge exorbitant fees should be "named and shamed" in a bid to rein in excessive charging, according to a former advisor to Tony Abbott.
Policy consultant Terry Barnes, who advised Mr Abbott when he was health minister in the Howard government, also argues government should define what constitutes unreasonably high fees, and make debts on these unenforceable.
Mr Barnes, who kickstarted debate about a Medicare co-payment with his 2013 submission to the Commission of Audit, told a private hospitals conference in Melbourne on Monday that patients should be allowed to assign their choice of specialist and hospital to their health fund or an advocate, to help them get a better deal.
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Budget uncertainty ‘placing lives at risk’

7:15am, Mar 25, 2015
Kaitlin Thals PM News Reporter
Mental health and disability groups are uncertain whether funding for critical support services and programs will continue past June 30.
Uncertainty lies with thousands of Australians seeking help.
Disability and mental health groups say funding uncertainty related to the federal government’s upcoming budget is putting people’s lives at risk.
Thousands of Australians seeking help for mental health problems and disability are unsure if funding for critical support services and programs will continue past June 30.
Treasurer Joe Hockey reportedly told his party room on Tuesday that the savings he will propose in the May budget will be “responsible, measured and fair”, but fears about cuts to funding have motivated 70 mental health groups to combine forces.
The groups, including Mental Health Australia, Headspace, and the Black Dog Institute, wrote an open letter to Mr Abbott and Health Minister Sussan Ley, with a clear message –  “ensure the continuity of services or risk a mental health system failure in the very near future”.
The letter says: “We have not received any definitive advice regarding the future of programs.”

Public hospitals pass the buck on cost of scans to federal government

Sean Parnell

An investigation has identified 77 public hospitals where X-rays, scans and expensive diagnostic tests have been wrongly billed to Medicare.
The widespread and, in some cases, fraudulent cost-shifting has embroiled about one in 10 public hospitals in Australia, adding another dimension to the ongoing debate over federal-state funding agreements. The Abbott government has caused ructions in the health sector by scaling back funding agreements by billions of dollars, freezing Medicare rebates and imposing other cuts.
Documents obtained by The Australian under Freedom of Information laws show the 77 hos­pitals relieved pressure on their budgets by billing hundreds of thousands of dollars worth of ­diagnostic imaging to Medicare each month. Funding agreements require such services to be paid for by the state government, with some money from the commonwealth, not diverted into a payment system meant for commonwealth-funded primary and private healthcare.
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ACT health spending still rising sharply, federal funding not keeping up

Date March 28, 2015 - 11:00PM

Ben Westcott

Reporter at The Canberra Times

ACT Health Minister Simon Corbell says steps have been taken to bring the budget under control, but the federal government had yet to recognise the ACT's special status as a provider for a larger region.
NSW patients utilising ACT hospitals for healthcare havecaused territory health spending to continue to rise, leading the ACT Health Minister to call once again for the territory to be paid according to its role as healthcare provider for the region.
Between 2007 and 2013, ACT government spending on hospitals rose by 4.9 per cent per person, the highest of any jurisdiction in Australia and 2 per cent above the national average.
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Pharmacy Issues.

Was the 5CPA a funding black hole?

24 March, 2015 Chris Brooker
A Guild leader has taken to task claims in a GP publication that $15 billion in pharmacy funding has been "lost in space".
Anthony Tassone, president of the Pharmacy Guild of Australia (Victoria) says the Fifth Community Pharmacy Agreement delivered equity and access to medicines, rather than being a "$15 billion black hole" as claimed by Australian Doctor.
In a letter, Mr Tassone (pictured) said: "Far from a ‘$15 billion black hole’ the 5th community pharmacy agreement helped deliver equitable access to lifesaving medicines across a national network of over 5000 pharmacies in our geographically sparse and diverse country.
"What is even more remarkable is that the superior accessibility of community pharmacy is achieved despite there being 15% less pharmacies than medical centres. That is the efficient distribution that results from the pharmacy location rules".
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Pharmacy Guild asked to explain how it spent hundreds of millions taxpayers money

  • March 26, 2015
  • Sue Dunlevy
The Pharmacy Guild could have to explain how it spent hundreds of millions in taxpayer funds after the Greens requested an audit investigation.
It comes after an audit report this month revealed the Pharmacy Guild could not say how many staff it employed with $29 million taxpayer funds it was given for administration.
The audit was told some chemists were counting SMS reminders to patients that their scripts were ready to be picked up as “clinical interventions” that attracted a taxpayer fee.
And it found a $1.50 per script was paid to chemists to swap cheaper medicines for those with a premium was paid even when there was no swap.
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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 2016 Budget (or the Government) at the end of the day.
Nonetheless I am sure there will be lots of fun to observe over the next few weeks.
Enjoy.
David.

Wednesday, April 01, 2015

Telstra Is At It Again! Buying More Companies and Applications In The E-Health Domain. Interesting Purchase This Time.

This popped up last week:

Telstra buys UK firm Dr Foster

Mitchell Bingemann

Telstra notched up its 15th investment for its growing Health division after the telco acquired British-based health analytics business Dr Foster in the latest step towards turning its stand-alone health unit into a billion-dollar-a-year business.
The company paid about $15 million to acquire the Dr Foster business, which works with public and private healthcare organisations to improve internal care processes by measuring variations in hospital errors.
“It can be used to identify areas where patient mortality or patient length of stay or patient readmission is more than it should be given the complexity of the individual patient,” Telstra Health managing director Shane Solomon told The Australian.
“It identifies areas of strength and weakness adjusting for the risk of the patients. Hospitals use this to look at areas where they are doing better than average … and conversely they can identify where they are doing badly and identify which areas they need to pay attention to.”
In Britain, where Dr Foster was established in 1999 by two journalists, the service is also used as a tool of accountability to publish information on the quality ­of UK National Health Service ­hospitals.
But Dr Solomon said there were no such plans to use the tool in a similar way in Australia. “In Australia, so far, our customers have preferred to use it as a quality improvement tool within hospitals rather than a public tool,” he said.
“If you have a blame culture people go to ground, they won’t own up to things. The real public good here is that people who survive in hospitals are those that should survive.”
Under the acquisition, Telstra will pick up 100 staff and two offices, one in London and an analytics unit in the Imperial College London, which is a highly respected medical research institute in Britain.
More here:
There is also coverage here:

Telstra just bought a health analytics company in a deal reportedly worth up to $50 million

Alex Heber Mar 27, 2015, 9:17 AM
Telstra has acquired a health analytics company in a deal reportedly worth $40-50 million as it builds out its health tech division.
UK-based Dr Foster was snapped up by Telstra Health after it previously secured distribution rights to the company’s software, which is used by healthcare providers to rank and compare performance of hospitals and staff.
Telstra has not disclosed the terms of the deal but the AFR reported industry sources indicated the telco had paid between $40 million and $50 million for the company.
Part-owned by the UK Department of Health, Telstra Health will continue to build out the Dr Foster business in Australia and the UK, as well as pursue international opportunities. The company already has contracts in place at 15 hospital services in Australia.
In October 2014, Telstra launched its new healthcare unit. It expects health spending to grow to $200 billion by 2020 and sees Australia struggling to provide reliable services in the face of an ageing population and a rising instance of chronic diseases.
More here:
This story (from their website) explains what Dr Foster is and does:

Our story

Operating in England, continental Europe, the United States, Asia and Australia we work with a wide range of organisations and clients, including healthcare providers and commissioners/payors, clinicians and managers. Our products, people and services provide actionable insights and inform decision-making by leadership teams.
Health systems in most countries today face significant challenges, of which one of the greatest is to “do more with less”. They need better information to identify the changes that are required to ensure that they are sustainable, and to really engage doctors and managers on the change journey. Understanding variation is one key aspect of this; reducing unwarranted variation by improving performance will deliver better care for patients and save money.
We work across health economies to monitor and benchmark performance – nationally and globally – against key indicators of quality and efficiency, drawing on multiple datasets (including administrative data and hospital theatre data) in innovative and pioneering ways. We work closely with the Dr Foster Unit at Imperial College London and all our metrics, methodologies and models are published in full. We adhere to a Code of Conduct that prohibits political bias and requires us to act in the public interest. The code is monitored by the Dr Foster Ethics Committee.
There is more here:
The case studies make interesting reading:
It will be very interesting to see how the company prospers (or not) under its new owners.

Late Update - Today 1/4/2015 we have been told another one has gone - they have bought the telemedicine company Anywhere Healthcare! 
David.