Category: Patients

[vc_row][vc_column][vc_column_text]AIHW spokesperson Dr Adrian Webster said that good oral health is fundamental to general health and wellbeing. Without it, a person’s general quality of life and the ability to eat, speak and socialise is compromised, resulting in pain, discomfort and embarrassment.

‘However, for many Australians, cost may be a barrier to ensuring they receive the care they need, when they need it,’ he said.

The report, Oral health and dental care in Australia, draws together data from a variety of sources to explore the oral health of Australians and their use of dental care services.

Recent data published by the Australian Bureau of Statistics shows that in 2017–18, half (50%) of Australians aged 15 and over said they had seen a dentist over the past 12 months. However, a national study of adult oral health conducted by the University of Adelaide found that in the same year, about 2 in 5 (39%) said they avoided or delayed visiting a dentist due to the cost, and this was more common among people who were not covered by private health insurance.

‘More than half (52%) of people without insurance said they avoided the dentist because of the cost, compared with about 1 in 4 (26%) people with insurance,’ Dr Webster said.

Even those people who receive dental treatment using their private health insurance can face substantial out-of-pocket costs. For example, the median out-of-pocket cost after using their health insurance for a full crown was $786. However, there was a great deal of variation between patients, with some paying as little as $26 out of their own pockets, and others paying $1,989.

Other, more routine procedures also saw great variation in out-of-pocket costs even after private health insurance payments.

‘The median out-of-pocket cost for people using private health insurance for a preventive service to remove plaque or stains was $16, but some patients paid up to $82, while others paid nothing,’ Dr Webster said.

Today’s report also suggests that some Australians are more likely to see cost as a barrier than other groups. For example, Aboriginal and Torres Strait Islander people were more likely to report avoiding the dentist due to cost than non-Indigenous Australians (49% compared with 39%), and females were more likely than males (43% compared with 35%).

‘Visiting a dentist regularly has many benefits. These visits provide an opportunity for preventive dental care, which can stop problems developing, and can facilitate treatment to repair or reverse damage to teeth and gums,’ Dr Webster said.[/vc_column_text][/vc_column][/vc_row]

[vc_row][vc_column][vc_column_text]The GDHP is currently chaired by India. Mr Lav Agarwal, Joint Secretary, Ministry of Health and Family Welfare, Government of India is the GDHP Secretariat Lead.

Mr Agarwal said “Sharing digital health information is now more important than ever as individual nations and the global community respond to the challenges of the COVID-19 pandemic.”

“These White Papers will provide both participant and non-participant countries and territories with guidance on the key digital health enablers that can lead in improving the health and well-being of citizens at national and sub-national levels through the best use of evidence-based digital technologies.”

The reports provide insights, guidance and information on cutting edge digital innovation for digital health workers, governments and organisations providing digital health services, and the communities they serve across the globe.

They are a valuable source of information that provide a catalyst for positive change, with insights and international comparisons of our digital health systems with countries around the world.

One key trend of GDHP members’ digital health systems are efforts to empower citizens to have greater involvement in the management of their own healthcare. This is evidenced in Australia in statistics published by the Australian Digital Health Agency which show consumers are uploading and viewing more of their My Health Record documents.

Chief Medical Adviser at the Agency and Chair of the Evidence and Evaluation work stream for the GDHP, Clinical Professor Meredith Makeham, said the Agency had supported and led the development of the White Papers over the past year, working with more than 30 countries from around the world.

“International collaboration is critical to improving health outcomes for all,” she said.

“Many countries and territories are still at the beginning of their digital health journey, so providing insights in key areas of common interest through our GDHP participation is fundamentally beneficial and supports our goals to improve health and well-being for people.”

“Our experiences with the COVID-19 pandemic have highlighted the importance of international engagement, and the critical role that digital health technologies play in ensuring that people have access to their healthcare providers and services. Digital health has never been more important.”

“I want to highlight the role Australia has played in establishing the GDHP as the inaugural Chair of the partnership and host of its first summit in early 2018. Since then we’ve benefitted from the opportunity to share valuable insights on digital health service delivery for our citizens that have been informed by the cutting-edge work of GDHP participants around the world,” she said.

Comments from other GDHP Work Stream Chairs:

Dr Don Rucker, National Coordinator for Health IT, US Department of Health and Human Services said “Sharing information using health data standards for interoperability is necessary to advance public health reporting and research which are key parts of an evidence-driven response to pandemics. Now, more than ever, increasing collaboration and sharing best practices around the world, not just within countries and territories, is critical to advance interoperability together globally.”

Shelagh Maloney, Executive Vice President, Engagement and Marketing, Canada Health Infoway and Chair Clinical and Consumer Engagement work stream said “Over the last decade there has been a universal shift in thinking; one where there was little to no support for providing citizens with access to their information, to present day, where we are accelerating efforts to provide citizens access to information in an equitable and secure manner. As governments around the world grapple with this new reality, and citizens in many jurisdictions are asked to remain home for public health, it has never been more critical for citizens to access their health information remotely: wherever and whenever it’s needed.”

The four GDHP White Papers are:

• Advancing Interoperability Together Globally
• Citizen Access to Digital Health
• Benefits Realisation: Sharing insights
• Foundational Capabilities Framework & Assessment

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[vc_row][vc_column][vc_column_text]Medibank falsely advised 849 members with ahm’s “lite” or “boost” policies who had lodged claims or enquired about their coverage, that they were not covered for joint investigations or joint reconstruction procedures, when these policies in fact entitled them to coverage for these procedures. At least 1,396 enquiries or claims were incorrectly rejected.

Medibank admitted this breach occurred because it failed to include 186 joint investigation and reconstruction services in its claiming system for the ahm “lite” policy between February 2013 and July 2018, and failed to include 26 such services in its system for the “boost” policy between February 2017 and July 2018.

Despite Medibank identifying in June 2017 that some service codes had not been included, Medibank rejected 370 enquiries or claims over another 13 months, until the conduct ceased in July 2018.

The services involved included critical services, such as spinal surgery, pelvic surgery, hip surgery and knee reconstructions, as well as procedures on fibulas, elbows, heels, wrists, kneecaps and jaws.

“Medibank’s false statements to consumers were a serious breach of our consumer law. These representations were made for more than five years in many cases, and affected hundreds of customers who were denied the cover they were entitled to under their existing Medibank policies for joint procedures that they required,” ACCC Chair Rod Sims said.

“Some Medibank policy holders incurred extra out of pocket expenses for major medical procedures, some delayed having these joint procedures and managed their pain, while others ‘upgraded’ their Medibank policies at an additional cost when they didn’t have to.”

Medibank self-reported this conduct to the ACCC in August 2018 and has since notified about 130,000 current and former policy holders. It invited them to make a complaint or seek compensation. By 22 June 2020, Medibank had paid more than $775,000 in compensation to 175 affected members, including some who upgraded their policies unnecessarily based on the false information.

“Businesses who self-report breaches of the Australian Consumer Law are not exempt from ACCC enforcement action, but the penalties ordered by the court will take their cooperation into account,” Mr Sims said.

Medibank has undertaken to the ACCC that it will contact about 670 policy holders who have not already taken up Medibank’s offer for compensation and provide them with a further chance to claim. Medibank will also pay these members an additional $400 as a one-off payment.

Anyone who may be eligible will be notified by Medibank and will have six months to make a claim on the ahm website at https://members.ahm.com.au/joint-claims or can contact ahm on 134 246 or 1300 484 395.

Medibank has also undertaken to review its compliance procedures, and amend its incident management procedures.

Medibank cooperated with the ACCC’s investigation, admitted liability and made joint submissions to the Court with the ACCC.[/vc_column_text][/vc_column][/vc_row]

[vc_row][vc_column][vc_column_text]Research Australia, the national peak body for health and medical research, has released the first report in its COVID-19 series showcasing the incredible breadth of Australia’s COVID-19 research.

“Australians are rightly proud of our world-leading vaccine projects. There’s incredible work being done beyond the lab too – everything from guidelines for breastfeeding mothers to filters that have the potential to remove the coronavirus from air conditioning systems,” said Research Australia CEO, Nadia Levin.

“The true range of COVID-19 medical research is not evident to the researchers themselves, let alone governments and the general public who are relying on our medical researchers to get us through this pandemic.

“In this report we look at over 200 research projects to demonstrate the depth and breadth of COVID-19 research underway in Australia right now,” Nadia Levin said.

The volume of coronavirus medical research is testament to long-term investment in Australia’s medical research capacity, but that it had come at a cost.

“The sudden ‘downing of tools’ that must happen when researchers are called upon to pivot their research towards an urgent pandemic throws existing projects, and their funding, off course. Like other parts of the economy, health and medical research is suffering.

“Research Australia is already talking to its members about how we re-design a medical research system which can withstand these crises because there is a very real possibility COVID-19 won’t be the only pandemic we see in our lifetime,” Nadia Levin said.[/vc_column_text][/vc_column][/vc_row]

[vc_row][vc_column][vc_column_text]While social distancing and high rates of testing remain the best ways to limit the spread, the Sax Institute researchers behind the modelling say the smartphone app could be “insurance” against reignition of the pandemic.

The modelling, published in the peer-reviewed journal Public Health Research & Practice, uses evidence on factors such as the speed and characteristics of the virus’s spread to project likely consequences for case numbers under various scenarios.

The ‘baseline’ scenario assumes a 50% monthly decline in social distancing and a 5% monthly drop in testing intensity going forward – the authors’ estimate of what was happening in May when the paper was written. Their model finds that if 61% of the population in this scenario downloaded the COVIDSafe app onto their phones, the number of infections in a second wave would be 55% lower than if there were no app.

In contrast, the current app uptake level (27%) would have a much smaller effect, resulting in only 24% fewer cases between April and December 2020, the modelling shows.

The research team, led by the Sax Institute’s Dr Danielle Currie, Senior Simulation Modeller, and Dr Michael Frommer, Senior Adviser, say the potential alternative to an effective response centred on social distancing, testing and contact tracing assisted by the app is that “restrictions on travel and social interaction…may need to be re-introduced”.

Dr Frommer said the model projections should be a clarion call for state and federal governments to redouble their efforts in promoting the app to the public as well as ensuring that any lingering technical issues are swiftly resolved.

“Testing and social distancing will exert the biggest influence on controlling the curve of the second wave, but the tracking app can play a very important role,” he said.

“At our current uptake levels, the app will help with contact tracing, but not significantly. What our work shows is that if we can push uptake to around three-fifths of the population, then it will make a huge difference. It would halve the number of people getting COVID-19 in the event of a second wave and decrease the death rate as well.”

The study involved an extensive literature review of the epidemiology of COVID-19, case-finding practices and factors that could affect the uptake of the app, and finally the development of a robust system dynamics model based on the behaviour of the virus and its interaction with social, behavioural, and policy factors, using pandemic data from Australia and across the world. The model projects the number of people infected by the virus through to the end of the year. It can be adjusted to account for different rates of testing, intensity of social distancing and uptake of the tracking app.

The modelling study is part of a special themed issue of Public Health Research & Practice on the public health lessons we are learning from the COVID pandemic.

In a Perspective article for this issue, Professor Julie Leask and Dr Claire Hooker, both of the University of Sydney, argue that better risk communication could have reduced the controversy around school closures in Australia due to the pandemic. Events leading up to the school closures created a “near perfect storm of fright factors”, they write, escalating people’s fear while reducing their trust in those working to manage the problem. The authors offer a step-by-step guide in managing communications during health crises such as the COVID-19 pandemic.

Two other COVID-related articles in this issue of Public Health Research & Practice find:

• A cross-disciplinary effort is needed to understand the prevalence, predictors and consequences of loneliness and social isolation brought on by social distancing during the COVID-19 pandemic
• A global checklist can point the way towards effective communication during a public health crisis such as the COVID-19 pandemic.

In an editorial for this issue, the journal’s Editor-in-Chief Professor Don Nutbeam, Principal Senior Adviser at the Sax Institute and Professor of Public Health at the University of Sydney, writes that maintaining the fragile consensus between governments, their scientific advisers and their citizens is critical to the successful control of the virus.

“The consensus will be sustained by mutual trust built on effective communication – between scientists and policy makers, and between governments and their populations.”[/vc_column_text][/vc_column][/vc_row]

[vc_row][vc_column][vc_column_text]Out of date contact details that healthcare providers have about healthcare services and other practitioners can mean that patients’ medical documents and information is not able to be sent from one healthcare provider to another. In a world where consumers can no longer be a conduit for delivering a referral letter or test result to another provider, and where our postal services are over capacity, an up to date electronic registry is more important than ever.

The Australian Digital Health Agency has built a Service Registration Assistant (SRA) to solve this problem. The SRA keeps healthcare service and practitioner information up to date with changes to contact details available immediately to authorised users.

Healthcare organisations can update their details in the SRA once, and this will automatically send these new details to all organisations they have authorised to receive their information. This might include hospitals, pathology and radiology services, public service directories, secure messaging providers and more. The SRA avoids the need for an organisation to update their information in multiple places and eliminates the need for hundreds of other directories around the country to manually keep their directories up to date.

Dr Steve Hambleton, a General Practitioner and Agency Clinical Reference Lead,  noted that “not only will this innovation bring about efficiencies for practice support staff who will only have to update changes in practice information once, it will increase confidence at the point of care that all of the incoming information about our patients will be there, and that our outgoing address book is complete and up to date”.

Initial results from a trial of the SRA in Northern NSW has shown significant improvements in communications between healthcare providers. To date, of 187 practitioners who participated in the trial and shared their details with the Northern NSW Local Health District (NNSWLHD), 186 had to change or update their details during the trial period.

For the NNSWLHD, having the most up-to-date contact information is essential to ensuring hospital discharge summaries get to the right person as quickly as possible.

Discharge summaries can include information about a patient’s assessment, treatment plan and progress notes from their hospital clinician, and a digital copy is sent via a secure service to the patient’s nominated GP. This helps the GP to continue post hospital care through follow up appointments.

Interim CEO of the Australian Digital Health Agency, Bettina McMahon said maintaining accurate provider address details was a longstanding challenge across the Australian healthcare sector.

“What is great to see is that the necessary, reliable and timely sharing of patients’ healthcare information between their healthcare providers is being improved by this latest feature of Australia’s digital health system,” she said.

“Healthcare providers all over Australia are enthusiastically using digital health so we want to make things as easy and efficient for them as possible. This tool will bring the benefits of digital health to more Australians.”

The trial is a partnership between the Agency, the NNSWLHD and the North Coast Primary Health Network (NCPHN).

CEO of NCPHN Julie Sturgess said “The opportunity to trial the SRA means local healthcare providers are able to be at the forefront of innovation in digital health to drive better patient outcomes. The results from the trial are really positive and we are keen to continue to work with the Agency on the next phase of the trial.”

Chief Executive of the NNSWLHD Wayne Jones said “We’re always looking at ways to improve the experience of patients in our care, and this system will help support the safe transfer of care of our patients from hospital to their GP.”

Australian Association of Practice Managers’ CEO Nicholas Voudouris said “Practice managers play a key role in ensuring a patient’s healthcare providers – wherever they work and whoever they work for – have accurate and timely clinical information. That is why we welcomed this trial of new technology.”

After the completion of the trial, the SRA will be expanded to provide a better-connected healthcare system, improve the transfer of care between healthcare providers and give healthcare providers more timely and complete information to support the care of their patients.[/vc_column_text][/vc_column][/vc_row]