s Weekly Australian Health IT Links | I2P: Information to Pharmacists - Archive
Publication Date 01/04/2010         Volume. 2 No. 3   
Information to Pharmacists

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Newsflash Updates for April 2010

Newsflash Updates

Regular updates from the global world of pharmacy.
Access and click on the title links that are illustrated.

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Audit Your Future

Neil Johnston

Given the current climate regarding the PBS, now would be an excellent time to audit all your business processes and develop strategies to overcome imbalances that are occurring and will continue to occur for some time.

A specific area of audit is the prescription $ value as a ratio of total sales.

This index has been drifting out of balance for some years now so those pharmacy managers who have become complacent about this index will have to work out a quick correction.

Always in times of political pressure on PBS prices, pharmacists have expanded their commercial sales.

However, competition is so tough between the major retailers and warehouse style pharmacies, it is hard to find a niche to compete in.

But there is always a solution - find it!

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The Great Debate - an informed comment

Peter Sayers

Following on from the Rudd/Abbott debate on health reforms a great deal of expected commentary resulted.
One of the better versions was published in theage.com.au and is found at this link:
The article was written by Trevor Carr, who is chief executive of the Victorian Healthcare Association, that represents public hospitals, rural and regional health services, community health services and aged-care facilities in Victoria.
He states:
"The focus on beds and waiting lists ignores the role of primary care.Reform should move the health system from its current simplistic emphasis on hospitals and waiting lists to a system of interlinking elements that include acute care, primary care, early intervention, health promotion and illness prevention."

That statement is so sensible it is hard to think in any other terms. When Nicola Roxon first took up her position as Minister for Health and Ageing she came out in strong support of prevention, which meant a large slab of primary health care that pharmacy expected to be part of.
Her first foray was to establish GP super clinics.
They have been progressively introduced, but establishment costs seem to be a problem.
Also, the role of pharmacy within these clinics has never been properly negotiated or thought through.

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For Sigma, Time is Running Out

Peter Jackson

Siege mentality seems to have paralysed senior managers and executives at the troubled Sigma Pharmaceuticals, the Melbourne based pharmaceutical wholesaler.

On the 19th March 2010, Sigma chairman John Stocker prepared the market for a shock prior to when it was expected to release its results a week later, but then subsequently delayed until March 31, 2010.
The results are expected to show a write down of all company assets to bring them into line with reality. Share trading remains suspended since February 25, 2010.

As recently as September 2009 Sigma gained an ASIC clearance to raise money without a full cleansing statement and enquiries are being made as to what part the company auditors, Price Waterhouse Cooper, played in this clearance.
Sigma raised approximately $290 million at that time.
The longer Sigma delays in giving a full explanation of its finances, the more the market will speculate and worst-case scenarios will continue to emerge.

The market was looking for a profit of about $92 million, but this year it will lose at least $150m after some $250m in goodwill impairment charges.

Goodwill is the amount paid over the book value of the assets.
It works if you generate better profits from the assets, or big brand names are involved, but it is not an asset in the conventional sense of a cash-producing item.
Market analysts have pinpointed three “black” holes in the company’s operations, which in combination may have tipped the company into a financial crisis.

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Location Rules Dented

Peter Sayers

There has to be something wrong when one-third of a local community signs a petition to get something done.
Such was the case in the Victorian town of Colac when three local women decided that the service from the two local pharmacies (having a common owner) had dropped to an unacceptable level, and that prescription prices had also reached an unsupportable level.

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Primary Health Care Organisations - What's in it for Pharmacy?

Neil Johnston

The Pharmaceutical Society of Australia (PSA) recently criticised the Pharmacy Guild of Australia (PGA) for not being open in their negotiations involving the Fifth community Pharmacy Agreement, after it discovered that professional service funding was being “skewed”.
As a result the PSA entered into direct discussions with government to claw back some of the funding the PGA was directing towards eRx systems in the guise that this was a professional service (but was really all about gaining ongoing revenue for the PGA executive).
The PSA was able to alter the balance towards true professional service activities and in so doing, showed an initiative that indicated that it would be involved in the leadership of the pharmacy profession.
After all, it does represent all pharmacists.

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The Other Side of the Counter

Peter Sayers

Consumers of pharmacy services are becoming more vocal in specifying the type and quality of service they require.
And they are making their demands felt, both individually and collectively.
Earlier this month we saw the community of Colac in Victoria rise up against a repressive business model that was being delivered – poor prescription service and poor prices.
Now we are seeing the Consumer Health Forum organisation raising concerns in a discussion paper just released, about the uneven delivery of services under the Fourth Community Pharmacy Agreement (4CPA) and they are asking for greater accountability under the 5CPA.

Comments: 1

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Pharmacy and the new health reforms.

Staff Writer

Health reforms proposed for implementation in mid-2010 focus primarily on doctors and hospitals.
For the moment it is difficult to see where pharmacy will fit in, and more importantly whether pharmacy will be ready to fit in.
The PSA has hinted that it has had some input with government and has stated it is developing a green paper, but unless it changes colour quickly and becomes a white paper, it means that pharmacy will have little to offer government.
The fact that the PGA was quick to jump in and identify eRx as a major pharmacy contribution belies the fact that it is a system deficient in some standards and because of that, will never be accepted by other health professions if they were to be involved with it.

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NZ and Australian pharmacies have similar problems

Staff Writer

It would seem that pharmacy in New Zealand has a lot of similarities to Australia as the following news item details.
Surely the message must get through to the decision-makers sooner rather than later?
Health programs in both countries generally have the feel of being pressure cookers about to explode with neither government seeming to have the political will to take the first simple steps i.e. actually make a decision

Source: Voxy News EngineNZ
NZ Pharmacists Can Fill Gaps To Help Reach Health Targets

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Cold Hands & Feet - It's not just an NZ problem

Staff Writer

Ever since I have known my wife, she has complained of cold hands and cold feet.
I am pleased to find that the Kiwis have discovered a reason for this.
However they think the problem is confined to Kiwi women, but I am able to tell them the problem is already existing across the Tasman.
However, the problem does have its serious side, so the story is well worth following: 

Source: nzherald.co


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Aged Care Reforms - All Talk and no Action

Staff Writer

Reform in health care seems to be an intractable problem.
The pace at which it is being introduced means that aged care facilities as we know them currently will collapse.
What then happens to the most vulnerable section of our ageing population?
Pharmacy has an ability to generate a “pharmacy in the home” program, but there is no coordinated effort to start this type of program. 
Instead, there are too many power plays within pharmacy treading on boundaries between the profession and the physical infrastructure.
Compounding the problem further is a grab for “turf” between the professions.
The patient is way back getting lost in the sunset.
But optimism still exists.

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World first in preventing eating disorders

Staff Writer

The only eating disorder prevention program in the world to show long-term success when trialled on early teenagers has just been released by the Flinders University School of Psychology. Media Smart is an eight-lesson program that focuses on the manipulation of images in the media, building self-esteem and teaching young people how to analyse and challenge media messages.

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Compound screening for drug development made simpler

Staff Writer

The identification of compounds that could be promising candidates for drug development has become easier following research by the Walter and Eliza Hall Institute’s medicinal chemistry group.
Dr Jonathan Baell
and Dr Georgina Holloway have developed a series of ‘filters’ that can be used to weed out those molecules likely to come up as false positives when screening a chemical library for compounds that could be useful in drug development.

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Scientists in hot pursuit of first new drug for global killer in 50 years

Staff Writer

Researchers at the University of Sydney's Centenary Institute have announced that they have made an exciting discovery that could lead to the first new drug for Tuberculosis (TB) in almost 50 years

Dr Nick West, of the Mycobacterial Research Group, is looking at the genetics of TB in the hope they will reveal a way to reduce the impact of one of the deadliest diseases in the world.
Dr West said when someone is infected with TB they either become sick immediately or the disease stays inactive.
"Unfortunately, the antibiotics we use to fight TB aren't effective against latent TB and can only be used when the disease becomes active," he said.
"This is a major problem as 1 out of 10 people who have latent TB will develop the active disease, becoming sick and contagious."

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New clinical guidelines to prevent cerebral palsy

Staff Writer

A University of Adelaide researcher has announced new national guidelines recommending that women at risk of early preterm birth use magnesium sulphate to protect their babies from cerebral palsy.

Professor Caroline Crowther from the University's Discipline of Obstetrics and Gynaecology and the Robinson Institute says the clinical practice guidelines are based on overwhelming evidence over the past 14 years that magnesium sulphate is effective in protecting the fetus.

"Five trials, including one funded by the National Health and Medical Research Council, confirm this finding," Professor Crowther says.

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Sigma releases financial results

Staff Writer

Thursday afternoon, 31st March 2010.

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Thalidomide treats hereditary blood disorder

Staff Writer

Thalidomide, the sedative blamed for tragic birth defects, treated a rare inherited blood disorder, according to recent experiment reports.
Around one person in 10,000 has a disorder called hereditary haemorrhagic telangiectasia, or HHT, which causes frequent, hard-to-treat nosebleeds.

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Climate change to shed light on dengue fever

Staff Writer

Queensland University of Technology (QUT) research into the impact of climate change on dengue fever may lead to better control of the mosquito-borne disease.
Researchers from QUT's School of Public Health are examining the relationship between climate change and the incidence of dengue in the northern Queensland city of Townsville and the capital of Bangladesh, Dhaka, combined with their rapid socio-environmental changes.

Comments: 1

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Lachlan Rose - New Face on NSW Branch Committee of PSA

Staff Writer

Manly Vale pharmacist Lachlan Rose has been appointed to the NSW Branch Committee of the Pharmaceutical Society of Australia to replace Alison Roberts who has resigned to move interstate.
Lachlan is a community pharmacist at Manly Vale on the North Shore of Sydney and is a current member of the NSW Early Career Pharmacist Working Group, having previously held the position of President of the NSW Young Pharmacists Committee of the PSA.
While holding this position Lachlan contributed articles on student activities and opinion in i2P.

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iPhone application to scan for food allergens

Staff Writer

Allergy sufferers could soon be able to use their iPhone to scan a food’s barcode at the supermarket to determine whether it’s safe to eat.
The application being developed by Deakin University, GS1 Australia and Nestlé, will allow consumers to instantly access detailed product information including allergens such as wheat, egg, peanuts and shellfish directly from their iPhone.

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Sigma Battles On

Staff Writer

Sigma is not yet out of danger and control is vested in its bankers.
Shareholders will be excluded from dividends in favour of debt reduction and the banks will be monitoring management decisions for some time to come.

This certainly reduces management flexibility but fortunately for Sigma its banks waived the breaches of covenants and renegotiated their facilities with re-set covenants, presumably agreeing with Sigma that its underlying results – a profit of $67.7 million was sound. Sigma doesn’t face principal repayments until early next year.
An unusual aspect of the overall result was that while underlying earnings were down 15.5 per cent, sales were up 4.5 per cent.
That can be attributable to the increased competition and discounting towards the end of the year to January that triggered the review of intangibles but Sigma also referred to some self-inflicted damage.

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Dementia Day Care Should Help

Staff Writer

Dementia is a major health issue in Australia and is increasing in line with the ageing population.
One of the better government initiatives has been to plan and set up a range of Dementia Day Care Centres, the first of which has opened in Orange, NSW.
Given that over a lifetime we seemingly start and end in a similar state (i.e.childlike) it seems natural to find solutions for dementia patients in paralleling early childhood solutions.
We have Day Care for children now well established.
Day Care for adults will relieve the pressure for many carers and family members who act as carers.


Source: Australian Ageing Agenda

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RACGP Launches e.Health Futures

Staff Writer

Electronic health communications have had many obstacles to overcome, but we now appear to be on the home stretch.
Fumbling by government has been the main problem, because they did not seem to know what they wanted, leaving many private enterprise vendors trying to guess their way into the future.
This has proven very costly and extremely inefficient.
Even when the government formed NEHTA to plan and smooth the way, the right people did not seem to be at the helm.
Now NEHTA is talking to a range of major players and the e.health agenda is suddenly coalescing as it should have done, some years back.

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Sigma still in turmoil

Staff Writer

Sigma continues to struggle to maintain its viability and obviously needs a “white knight” to come to its rescue with an offer of a friendly merger or takeover.
It is believed that some interest has developed for a transaction of this type, but may be less likely with most of the principal architects of the company's decline still in place
With the recent resignation of Mr Elmo de Alwis, attention is now turning to John Stocker (chairman) and Mark Smith (chief financial officer).

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Poor Document Assembly Processes Cause Problems

Staff Writer

The US is well advanced in the delivery of electronic health summaries and their promised benefits.
However, protocols are being found deficient to preserve the integrity of the documents.
Short cuts in the assembly of a document involving a "cut and paste" from other documents are introducing inaccuracies damaging to the content as a whole.
The danger in "cut and paste" is that an error can be perpetuated and multiplied many times with the potential to cause major harm.
It would seem that a discipline has to be exerted through proper training, particularly by new users.

Australia has the ability to put the training steps in place in advance, to eliminate this potentially serious problem.

Doc calls EHR copy and paste function a "modern medical illness"
Source: Healthcare IT News


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Wanneroo GP Super Clinic gets go ahead

Staff Writer

A funding agreement between the Australian Government and Edith Cowan University will see the $10 million GP Super Clinic established in Wanneroo.
Edith Cowan University will now work with the City of Wanneroo and the North Metro Area Health Service to begin designs and develop business arrangements and clinical services.
The Wanneroo GP Super Clinic, which is being jointly funded by the Western Australian Government, will deliver additional health services to the area to take pressure off the Joondalup Health Campus, and ensure local families can get the health care they need.

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RACGP response to CoAG agreement on health reform

Staff Writer

The Council of Australian Governments Meeting (CoAG), with the exception of Western Australia, agreed to establish a National Health and Hospital Network at this week’s CoAG meeting. The National Health and Hospital Reform Commission has recommended the development of a person centred, strong, equitable, integrated primary health care system and the college is pleased that CoAG has taken this challenge up. The CoAG communiqué is available at www.coag.gov.au.

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Suddenly the PGA discovers "Pharmacists"

Neil Johnston

A media release published this week indicates that there will be an oversupply of pharmacists of around 2009 in surplus within five years.
The release was based on a recent survey of which the author details appear in the news report below.
The last survey into the Pharmacy Workforce circa 2003 indicated there would be a shortage of pharmacists.
i2P reported on that survey and commented:
” The long awaited workforce report from the Third Agreement has arrived and the news is gloomy for those wanting an early retirement or thinking about cutting their hours back. By 2010 we'll be 3000 pharmacists short of meeting demand and as far as ever from filling the gaps.
I strongly recommend any pharmacists who intend to be practicing anytime in the next 10 years read though this report (A Study of the Demand and Supply of Pharmacists, 2000 - 2010). “
Goto link:
Well, we are progressing into 2010 and the projected shortfall of pharmacists did not happen.
Why then should we believe the current projection?
To develop some thoughts on this issue we have asked Mark Coleman to comment on the Pharmacy  News report published on the 24th March 2010 which follows:

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Weekly Australian Health IT Links

Dr David More

articles by this author...

From a Medical IT Perspective: I am vitally interested in making a difference to the quality and safety of Health Care in Australia through the use of information technology. There is no choice.. it has to be made to work! That is why I keep typing. Disclaimer - Please note all the commentary are personal views based on the best evidence available to me - If I have it wrong let me know!

Visit my blog http://aushealthit.blogspot.com/

This blog has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on how things are progressing in e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Weekly Australian Health IT Links - 28-03-2010. 

Here are a few I have come across this week.
Note: Each link is followed by a title and a paragraph or two. 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 payment.

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General Comment:

Things appear to have settled down a little after the utter waste of time we saw with the ‘Great Health Debate’ on Tuesday.

I really think it is just a joke that with an election coming in the next 5-6 months that the Labor Party is playing duck and drakes with releasing the details of its plans for the Health Sector. I fully understand why the States are being a bit hesitant is signing up to the plan when the details are not yet properly out there.

I especially would like to understand just how the proposed Heath Hospital Networks will interact with the Primary Care Sector, Private Hospital Sector and so on.

Of course I would also like to understand how e-Health will fit with all these new plans.

The Labor spokespeople keep saying they have a detailed plan, but I really don’t see significant detail just yet.

Of course we also presently have a substantial vacuum with respect to what the Opposition is planning. I have to say given Tony Abbott has 5 years of experience as Health Minister, I would have expected some decent policy be announced by now, and it needs to come soon.

On another topic it is interesting to see various interest groups coming out with comments in e-Health. It is really important we have an informed debate of all the topics around e-Health before we see too much in the way of legislation enacted. The more discussion and debate the better in my view.

Sadly there do seem to be some commentators who are not all that deeply across the issues they are spruiking. An example is the comment here from the College of Pathologists.

“They cite errors in the labelling of pathology results that have been linked to an estimated 150,000 to 200,000 identification mistakes every year.”

See article below.

Sadly there is no comment I could find on just how many of these ‘labelling errors’ will be fixed with the HI Service. I really struggle to see the linkage and I have to say the level of error in labelling seems to suggest some other major systemic issues. That is really a huge number of mistakes!



Security fears may delay e-health patient identifier reforms until after election


March 22, 2010

A CENTREPIECE of the Rudd government's health reforms - the electronic patient identifier system - is at risk of delay until after the election amid concerns over security and privacy.

To shore up support for the e-health scheme, advocates have compiled dozens of examples of how the patient identifiers would save lives and end long delays in locating patient records for effective treatment.

They cite errors in the labelling of pathology results that have been linked to an estimated 150,000 to 200,000 identification mistakes every year.

The Royal College of Pathologists of Australasia has warned that such mistakes can endanger lives and have called for the urgent use of the identifiers.



Hackers try to capture patient bank details

2nd Apr 2010

Andrew Bracey

GPs are being warned to remain vigilant in protecting patient files after one Melbourne practice encountered a computer virus that breached its security provisions and attempted to access patient bank details.

Melbourne GP Dr Graeme Baro said despite firewalls and antivirus software, his machines and servers contracted a virus, which had been designed to seek out patient bank details and send them back to a remote source. The virus, however, did not succeed in sending any patient information out of the practice.

“A couple of computers were having trouble with their functions… so our IT person checked and found a lot of viruses in them. We have firewalls to protect us but [viruses like this] can apparently still get in,” Dr Baro told MO. “[I’m told] one of the viruses was trying everything to get the information out – multiple times per second.”



New standards must not hurt GPs’ hip pockets

22nd Mar 2010

Shannon McKenzie

NEW practice accreditation standards must not require GPs to invest in expensive new equipment or set tougher e-health criteria, doctors have told the RACGP.

As part of a review of the Standards for General Practice, the RACGP last week released the results of an online member survey, which asked GPs and practice managers how the standards could be improved, and what should or should not appear in the next edition.



Pharmacy urges support for e-health Bill

25 March 2010 | by Simone Roberts

The Australian Pharmacy Liaison Forum has called on all sides of politics to support the Rudd Government's controversial Healthcare Identifiers Bill now before Federal Parliament.

The forum, representing the full range of pharmacy education and professional activity in Australia, met in Canberra this week and unanimously expressed support for the passage of the legislation. The legislation allows for unique 16 digit number to be assigned to all health care providers and consumers by the middle of this year.

"Individual healthcare identifiers within a strong privacy framework are vital building blocks to the introduction of national electronic health records," the forum said in a statement released yesterday.



College Of GPs Urges Politicians To Deal With Future Of Australia's Healthcare Now

23 Mar 2010

At a time of major health reform debate, the Royal Australian College of General Practitioners (RACGP) is urging Australia's politicians to make e-health and the implementation of a national Healthcare Identifiers Service a priority. Dr Chris Mitchell, RACGP President, said that individual healthcare identifiers and healthcare provider identifiers are the key that will unlock e-health for Australians.

"Without improvements in e-health and medical information management systems we will continue to expose patients to unnecessary risks, including adverse events and medication errors. Major cost saving can be achieved from a reduced number of tests and better management of chronic diseases supported by evidence-based guidelines," Dr Mitchell said.

"Every person in Australia should receive care that is informed by an electronic medical record. The passage of the Healthcare Identifiers Bill 2010 is an essential step to enable e-health innovation and efficiency.



Facebook linked to rise in syphilis


March 26, 2010 - 1:27PM

A British public health expert has blamed Facebook for a resurgence of the sexually-transmitted disease syphilis, but Australian STI researchers have called the claim "far fetched".

Data published by several British newspapers this week indicated that cases of syphilis had increased fourfold in Sunderland, Durham and Teesside - the areas of Britain where Facebook is most popular.

Professor Peter Kelly, director of public health in Teesside, told The Sun newspaper that "social networking sites are making it easier for people to meet up for casual sex".



iSOFT wins two-year contract renewal with NHS body worth $9.8 million

Sydney – Tuesday, 23 March 2010 – iSOFT Group Limited (ASX: ISF), Australia's largest listed health information technology company, today announced that NHS Shared Business Services (NHS SBS) has extended its contract for iSOFT Business Solutions to host its Oracle finance and purchasing applications by an additional two years.

This latest contract, worth £6 million ($9.8 million), extends the original $47.8 million agreement, signed in March 2008, to 2016. It expands the services offered and includes new HP hardware and infrastructure and a move to Oracle Release 12. The contract is for services only and excludes licenses.

NHS SBS provides services such as accounts payable, debt collection, bank account reconciliation, and account reporting for 30% of all NHS organisations. iSOFT has provided NHS SBS with a fully hosted managed service since 2002.



3D haptics to help surgeons feel the cutting edge

AUSTRALIAN researchers are developing a universal simulator to bring a realistic sense of touch to simulations for medical procedures, defence and policing.

The simulator is based on force feedback technology, or haptics, which in its simplest form is used in arcade games to give players a sense of touch -- such as feeling the forces when going into a corner in a driving game.

Deakin University robotics engineer James Mullins has been developing the technology with the goal to make a simulation so close to the real thing that it can be used for training purposes.



Hunter region trials Intel home-care unit

Karen Dearne

From: The Australian

March 23, 2010 12:00AM

HEART patients in the NSW Hunter region are the first to trial an in-home monitoring system with potential to revolutionise medical care of people living with chronic illness.

Developed by Intel, the Health Guide home-care unit and online support system has been piloted by a private home-care service, Hunter Nursing, and 50 patients with congestive heart failure or chronic obstructive pulmonary disease.

Participants took a daily reading of their own blood pressure using a cuff attached to the device, and the data was automatically sent for review by medical professionals at Hunter Nursing, says director Margaret Scott.



In pictures: Intel monitors Australia's e-health

By Georgina Swan



Health bill papers `fall off' government websites

COMPUTER glitches on two government websites were blamed for key documents on the controversial Healthcare Identifiers Bill going walkabout last week.

Last Tuesday, following revelations in The Australian that Medicare Australia had provided the Senate inquiry on the HI bill with new details on suspected staff snooping, the document detailing data privacy breaches disappeared from the Senate Community Affairs committee website. Also missing were three National E-Health Transition Authority responses, posted the previous day, to questions on notice from the Senate inquiry.

The committee secretary said computer glitches had caused some documents to "fall off" the page for most of Tuesday.



Benzo use not affected by e-intervention

by Jared Reed

The move towards e-health is ramping up but when it comes to notifications about medicines and prescribing habits, it seems GPs might be suffering from alert fatigue, or they place a higher trust in their own clinical judgement.

Over a six-month period, Queensland researchers emailed GPs, nurses and pharmacists three fact sheets about benzodiazepines, with the aim of decreasing their use in aged care facilities towards “more appropriate” prescribing.



Rudd roasts Conroy over the national broadband report

KEVIN Rudd is believed to have told Communications Minister Stephen Conroy to come up with a strategy within two weeks to take the heat out of the political crisis building up around the government's $43 billion national broadband project.

Canberra sources said the directive followed a "difficult" meeting between Rudd and Conroy after the Prime Minister was shown a copy of the controversial $25 million implementation study into the development of the national broadband network.

Conroy has dismissed Senate demands to table the 500-page report prepared by KPMG and McKinsey & Co, arguing that he intends to discuss its findings with cabinet colleagues first.



Conroy's internet censorship agenda slammed by tech giants


March 23, 2010 - 4:38PM

Australia's biggest technology companies, communications academics and many lobby groups have delivered a withering critique of the government's plans to censor the internet.

The government today published most of the 174 submissions it received relating to improving the transparency and accountability measures of its internet filtering policy.

Legislation to force ISPs to implement the policy is expected to be introduced within weeks. The filters will block a blacklist of "refused classification" websites for all Australians on a mandatory basis.




Posted by Dr David More MB, PhD, FACHI at Sunday, March 28, 2010

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