Thursday, September 19, 2013

$1 billion e-health system rejected by doctors as 'shambolic'

This coincides with my experience of it.  I tried to register for it but after wasting 20 mins of my time their computer hung up on me  -- JR

AUSTRALIA'S billion-dollar e-health system is in danger of becoming an expensive white elephant with doctors refusing to use it.

A key clinical adviser to the government who quit in frustration last month has described the system as "shambolic".

And the medical software industry says the body running the system, the National E-Health Transition Authority, lacks the skills to do the job and warns patient safety could be at risk.

Dr Mukesh Haikerwal who resigned in frustration from work on the e-health record says he's uploaded 150 patient records on to the system but "no-one can read it".

Patients who want a hospital or specialist to see their e-health record have to take their own ipad to the consultation to show the record because hospitals and specialists don't have the software to read it.

Fifteen months after e-health was launched - 888,825 Australians have signed up for an e-health record but by last month doctors had loaded only 5427 health summaries on to the system.
Only hospitals in the ACT and South Australia can currently access the record, although more are scheduled to come on board next month.

Some of the medication records loaded on to the record by the government are wrong and Dr Haikerwal says this could have grave consequences for patients who could be misdiagnosed.

The AMA says doctors or hospitals trying to use the records have less than a 0.5 per cent chance of finding anything clinically relevant.

Last month, four of the clinicians advising the government quit in frustration.

The mounting problems with the system come as it emerged that the cost of Britain's failed e-health system has reached 10 billion pounds.

However, a spokeswoman for the Department of Health said it was wrong to compare Australia's e-health record with Britain's which managed the entire stay for every patient seen or admitted to hospital all the way to their billing system.

Health Minister Peter Dutton who was sworn in on Wednesday has pledged to undertake a "comprehensive assessment" of Australia's e-health record.

Doctors are demanding the new government pay them to spend the time writing and uploading patient health summaries on to the new system and want the system simplified.

"If you are running a business time is money and you do need to recognise, to value the work of the health professionals setting up these records," Australian Medical Association vice president Professor Geoffrey Dobb said.

The control of the record must also be taken away from patients and handed back to doctors so they had confidence it was complete and comprehensive, Professor Dobb said.

"I think it is much better to have health records that are controlled by health professionals but with the capacity of consumers to access it and correct it if the information is incorrect."

The 120 member Medical Industry Software Industry Association has told the new government the body running the e-health record "lacks the governance, knowledge and skills" to do the job.

It welcomes the government's pledge to review the record and says it is worried the new system is "immature" and this could impact on patient safety.

The e-health record is meant to bring medical records into the digital age and lists a patients medications and allergies, include a health summary written by a doctor and will in the future include X-ray results, pathology results, hospital discharge summaries.


New coal mines in Tasmania!

Pretty amazing for "Green" Tasmania -- and the ironically named Mr Green is a Labor Party man.  Will a new dam be next?

THE State Government has given approval for a major new coal mine in the Fingal Valley, which it expects will create more than 100 jobs.

Energy and Resources Minister Bryan Green has formally approved the mining lease for the project.

"It's great to see this project is ready to start," Mr Green said.

The mine, proposed by HardRock Coal Mining Pty Ltd, is touted to produce more than a million tonnes of coal a year, worth an estimated $100 million.

Mr Green said he expected the $50 million development of the mine would create more than 80 construction jobs and begin before the end of this year.

He said the mine was expected to be fully operational within three years.

"This is a very significant investment and clearly demonstrates that Tasmania is open for business," he said.

"The project will not only bring valuable investment and jobs to the Fingal Valley, it will also have enormous flow-on benefits for the North East region and the broader Tasmanian economy.

"When fully operational the new mine will provide economic benefits worth almost $180 million a year to the Tasmanian economy."

He said other jobs in services, transport and maintenance would follow.

"For example, when fully operational the new mine will see a 40 per cent increase in rail traffic and exports through the Bell Bay port grow by almost 30 per cent," he said.

"The project is also expected to generate mining royalties of $6 million a year.

"This will be a new export industry for Tasmania serving the needs of the rapidly growing Asian region."

Mr Green said the Fingal Valley project was further evidence of the industry's growing confidence in Tasmania.

It follows recent mine approvals near Smithton and at Tullah and strong growth in mineral exploration.

"Work is under way on Shree Minerals' new mine near Smithton and Venture Minerals' Riley iron ore mine west of Tullah is ready to go," he said.

The Riley mine is one of three major projects Venture is developing in the far North-West and will triple bulk mineral exports through the Burnie port.

"I have also granted a mining lease for Venture's Livingstone project, also near Tullah, and the company is finalising its Mt Lindsay tin and tungsten mine," he said.

"The Mount Lindsay project will create up to 1000 jobs during construction."


Education failing the hospitality industry too

If you've experienced inconsistent or inept service or food in a restaurant recently, don't be in too big a hurry to condemn the hapless restaurateur. We are experiencing the worst shortage of skilled staff I have seen in my 40 years in the hospitality industry. Many of my clients went into the past festive season with kitchens and front-of-house teams carrying a number of "warm bodies" - staff recruited in desperation just to keep the doors open, and it is going to be worse this season.

The reasons for this situation are complex, but the seeds were sown about 20 years ago with the conversion of what were then Technical Colleges into the TAFE colleges of today. The Techs, as they were known, concentrated on practical apprenticeship training for a range of industries, while the TAFEs, as they became, quickly moved towards academic diploma and degree courses and almost became pseudo universities.

This was the time when the well-respected waiter's apprenticeship was discarded. Until then, top restaurants and hotels were supplied with a steady stream of well-trained, qualified wait staff, who moved up as they gained experience to become "professional waiters" - the highly skilled and well-paid staff you often see in our top restaurants. A percentage of these progressed to higher levels and became restaurant managers.

But as the waiting apprenticeship was disappearing, the apprenticeship in cookery started to change from an indenture to one older, experienced chef, backed by quality technical college training to the questionable system we have today. Apprentices are now free to move around from one employer to another at whim, and their training and schooling are often not meeting the needs of the industry. I have asked senior chefs I deal with if they can count on a job applicant who has finished their apprenticeship and become qualified as a cook to know the basics, and I have not had a positive answer for years.

As a result, the burden of training has fallen to the industry itself, at a time when few businesses have the money, resources or skills to train their own staff. To compound this problem, the margins in hospitality businesses have fallen to the point where chefs and managers have to be competent to manage much more tightly than they have had to in the past. Because of this they require much more thorough training than they would have 10 years ago.

The hospitality industry has also grown rapidly - too rapidly - there are now about four times the number of hospitality businesses in Australia than there were in 1990, and as the traditional training and education systems have not kept pace, those skilled staff who are available have been spread thinly and the laws of supply and demand have forced salaries upward.

Many business owners, who have traditionally counted on being able to recruit skilled, experienced staff from the pool of unemployed, have found that there is a minimal response to their advertising, and that the few skilled people who do apply are prohibitively expensive.

The high salary levels demanded by those skilled senior staff have created the situation where staff are often required to work long hours on salary for wage costs to be kept at the correct ratio to income. This, in turn, has created the situation where many older, experienced staff have opted to leave the industry to regain a work-life balance.

We are also finding that the so-called Gen Y, who have made up the bulk of casual staff, are not terribly keen on working on nights and weekends, as these hours negatively impinge on their social lives and the pay on offer does not meet their income expectations. There is also a reduced need for casual income among many young adults because they are living at home with their parents until they are much older than was common 20 years ago - so the pool of labour has shrunk at a time when the industry has sustained a major growth spurt.

These varied factors have forced many restaurateurs and cafe owners to accept staff that are far from ideal, just to keep their doors open. You may have experienced some of this yourselves - waiters with poor English language skills, a lack of hospitable personality, inconsistent delivery of your favourite meals, poor knowledge of the menu and wine lists, slow service, etc. I don't believe any reasonable business owner would accept these issues without concern - but many of them don't have a choice at the moment.

On the other hand, if you receive a flawless performance at a restaurant or cafe, you should warmly congratulate the business owner in charge, because the attention to detail, and the internal recruitment and training skills necessary to achieve this, is worthy of admiration.


Federal bureaucracy takes a small hit

TONY Abbott restored a pledge of allegiance to the Queen as he was sworn in as Australia's third Prime Minister in 84 days.  One of his first acts was to overhaul the public service by sacking top mandarins and abolishing some departments.

The biggest departure is that of Treasury chief Martin Parkinson, who leaves next year after helping new Treasurer Joe Hockey bring down his first Budget in May.

Mr Abbott told Governor-General Quentin Bryce he would lead a "problem-solving Government based on values, not ideology".

It was the fifth such ceremony this year for Ms Bryce, who has sworn in 95 MPs - 53 in four Labor reshuffles under Julia Gillard and Kevin Rudd, and Mr Abbott's team of 42.

The Australian Republican Movement criticised Mr Abbott for "returning to the past" by swearing to serve the Queen rather than just Australia. However, Republican Malcolm Turnbull made the pledge in being sworn in as Communications Minister.

Victorian MP Scott Ryan was sworn in as parliamentary secretary holding a Bible from the 1880s, passed down from his great-great-grandmother.

Josh Frydenberg used a Bible that was held by the late Sir Zelman Cowan when he became governor-general in 1977.

Mr Abbott's first formal announcement as PM was a public service shake-up, in which he axed Paul Keating's chief of staff, Don Russell, as Industry Department secretary, dumped Blair Comley from Resources, and sacked Andrew Metcalfe from Agriculture.

Mr Abbott said these changes were to remove "confused responsibilities, duplication and waste".

Stand-alone departments of Regional Australia, Local Government, Arts, Sport, Resources and Energy were abolished.

The Departments of Education and Employment have been split, Sport has been added to Health, and Arts will become part of the Attorney-General's Department.


1 comment:

Paul said...

Frydenberg used a Bible? Someone should tell Ed Husic anyone can use one.