Tuesday, April 12, 2011

Another Labor Party boondoggle coming up

A new health records system that will be incomplete and may not be accessible to your doctor!

ALMOST $500 million is being spent on an e-health record system that will not provide real-time medical information at the point of care. Instead, it will serve copies of some clinical documents uploaded from doctors' systems in a voluntary program that puts the control of access in patients' hands.

The long-awaited draft concept of operations for the personally controlled e-health record, to be released today by the Health Department, shows how clinical documents will be pulled together by a "viewing service" and displayed in a format for viewing by patients and health professionals.

Critically, the system will not support clinical decision-making and lacks sophisticated analytics capabilities.

The design gives people a great deal of control over access to records held in the Personally Controlled Electronic Health Record system and consumers will be able to add their own notes to a GP-managed health summary record.

Consumers will access the system via a portal. Doctors also will initially access patient records through a separate provider portal, although in time their systems will be integrated with the PCEHR repository.

A novel approach is the ability for individuals to set access parameters, including requiring providers to use an access code (a PIN or passphrase selected by the patient) to verify consent.

Other controls will be "include" and "exclude" lists for participating healthcare organisations and an ability to limit access to certain documents within in the record.

This ranges from the default "general access" to "no access", which restricts viewing to the original source provider of the information.

Documents loaded to the system will carry a date stamp, but it will be up to medical providers to ensure patient records are consistently updated.

Consumers will be able to identify unauthorised activity through an audit trail, and there is a process for errors to be referred to the originating provider for correction and replacement.

Where clinical documents are loaded into the wrong person's record, the system operator, initially Medicare, will work with those concerned to fix the problem.

But patients have no control over the source material held in doctors' records, and medical providers will still share patient data through existing channels.

As a secondary system that will not replace doctors' records and which may not provide a complete set of patient information, it is unclear whether GPs and others will want to rely on it. So far, it has been understood the system would pull data from wherever it is held to provide a real-time view and support interactive alerts or warnings at the point of care. But the concept of operations states: "An individual's PCEHR may not represent a complete set of health information."

In fact, the system will only contain copies of documents pushed up by treating doctors with the patient's explicit consent. It is unclear how the currency, quality and provenance of this material will be guaranteed.

But with the live and complete data still locked in doctors' clinical systems, the public health benefits of real-time interventions --avoiding adverse drug events, better management of chronic conditions and improved prevention -- will remain elusive.


Julia Gillard commits to free trade path

Some economic intelligence in evidence. Good to see

JULIA Gillard will turn to a new round of trade liberalisation to drive economic productivity, particularly in non-mining states that are struggling to keep pace with the resources boom.

Labor will also turn its back on negotiating low-quality trade deals with individual nations, decoupling trade policy from political issues under a regime that mirrors the reformist Hawke era.

The government appears to have conceded Australia has misused its quarantine system for protectionism, citing as an example its use of fears to exclude imports of New Zealand apples.

Trade Minister Craig Emerson, who was Bob Hawke's economic adviser, will announce the new policy today. It follows debate within Labor about how to tackle productivity reform without alienating voters or business. Some ministers have pressed hard for reform while others, including Wayne Swan, are understood to have called for political caution.

The Prime Minister, who has committed her government to pursuing free trade as a pathway to more jobs and prosperity, is understood to have strongly backed the trade shift, based on the argument that only economic prosperity will strengthen Labor's ability to tackle disadvantage and spread opportunity.

The 27-page trade policy document, obtained by The Australian yesterday, argues that parts of Australian which are not benefiting from the mining boom could fall further behind.

It argues that the movement of production resources such as labour, management and equipment to mining areas should "not be impeded by interventionist government policy" but notes it draws resources from non-mining regions and cities.

In the absence of reform, the paper says, such areas could be left ill-equipped to "take up the slack" after the mining boom.

"That's why an economic reform program designed to restart productivity growth as the basis for securing the competitiveness of Australian industries - mining and non-mining - is essential," the document says.

Although not all industries would strengthen, "productivity-raising economic reform gives Australian businesses a better chance of competing", it says.

The policy commits the government to a "unilateralist" approach to trade under which it would pursue trade reform irrespective of the actions of other nations. Trade would also be non-discriminatory, with Australia to spurn special two-way deals that exclude other nations from the same access.

The paper argues that such action simply diverts trade away from more efficient partners. "Trade diversion amounts to a redistribution of jobs and prosperity instead of the creation of more jobs and prosperity," the paper says. "Worse, trade diversion is inherently job-destroying and income-destroying from a global perspective."

The policy puts Labor at odds with the Greens and some sections of the trade union movement by strongly rejecting the idea of linking trade deals to political or policy concerns, such as the insistence that trade partners adopt similar standards of environmental or labour laws as Australia.

It insists Australia should ignore political imperatives, except with regard to trade deals concerning goods that were harvested or produced illegally, including those involving rare and endangered species....

Labor plans to pursue its new approach by working harder on multilateral trade deals in preference to bilateral trade deals, which were favoured by the Howard government.

However, it will continue to pursue talks for free trade deals with nations such as Japan, Korea, and China, but no bilateral deals that undermine multilateral principles will be accepted.


Premier Anna Bligh announces infrastructure charges cap to boost housing affordability

A good move. Councils have been treating new building as a milch cow

ANNA Bligh has capped infrastructure charges for new developments in a bid to boost housing affordability.

The Premier also hopes the cap, announced this morning at a Building Revival Forum in Brisbane, will help the struggling construction sector.

Councils will be limited to a maximum $28,000 charge for homes with three or more bedrooms, a saving for developers of up to $22,000. One and two-bedroom homes will have a maximum $20,000 charge, a $10,000 saving. Annual increases will be capped to inflation.

The charge is used to fund the building of new water, sewerage, stormwater, roads and park infrastructure.


Dam operators ignored weather forecasts

ENGINEERS operating south-eastern Queensland's biggest dam before the Brisbane flood based decisions on whether to release water on there being no further rain, an inquiry has heard.

As the first day of hearings into the state's deadly floods focused on dam management shortfalls, the Premier, Anna Bligh, was forced to hose down suggestions the government was hiding documents from the inquiry.

Yesterday the $15 million inquiry looked at the role of Wivenhoe Dam, which has a dual purpose of storing drinking water and minimising the impact of floods.

Under scrutiny ... the dam operator has faced criticism over water releases in the day before Brisbane flood. Photo: Dean Saffron
Its owner, Seqwater, has faced criticism over dam releases in the days before the Brisbane flood, amid claims that it did not let out water soon enough and was then forced to ramp up releases.

A senior Wivenhoe engineer, Rob Ayre, was questioned about why his team did not rely heavily on rainfall forecasts when managing water releases into the Brisbane River before the city's flood peak on January 13.

Mr Ayre said rainfall predictions were volatile and he believed it was best to rely on a no-rainfall scenario. "It's been proven to be the most reliable in the past," he said.

Mr Ayre was one of four engineers who decided on the timing and scale of hotly debated water releases into the Brisbane River based on the government-approved dam manual.

Engineers had "some communication issues" while trying to contact agencies, including Brisbane City Council, a few days before the Brisbane River peak, Mr Ayre said.


Snow arrives two months early in Victoria

Global cooling!

The wet weather which lashed southern Victoria overnight has also reached the high country, with Mt Buller, Falls Creek and Mt Hotham all reporting good snowfalls since the weekend.

With the official start to the ski season still two months away, the snow continues to fall across Mt Buller today after temperatures fell below zero last night. At 9.30am the temperature had climbed back to minus 0.2 degrees after plunging to minus 1.6 degrees. About 10cm had fallen at Mt Buller by 9am.

"Early snow is always exciting to see and it gets everyone into thinking about the season ahead," said Laurie Blampied, general manager of Buller Ski Lifts.

Snow continues to fall across the ski resort. Photo: Supplied
He said that although snow was not unusual for April, 10 centimetres was a "significant amount for this time of year".

"It's still two months until the official opening of the snow season but we love to see the temperatures dropping and snow coming to the mountain."

The snow season will officially open on the Queen's Birthday long weekend - June 11.

Falls Creek and Mt Hotham also reported snow, but Terry Ryan of the weather bureau said it was likely to melt in coming days.

"The ground is still a bit too warm for it to last," he said.

"You really need it to fall in late May to early June for it to hang around. We'll get warmer days up there by late this week and it will melt the snow which has already fallen."


No comments: