ACN endorses Nursing and Midwifery Digital Health Capability Framework

“There is no denying the delivery of health care is changing, in large part due to technological advances,” Australian College of Nursing CEO, Adjunct Professor Kylie Ward FACN said.

“Digital health has the potential to bring about vast improvements in how healthcare is delivered, where people can access quality care, and health outcomes. This potential can only be realised if we have a workforce that is ready to adopt digital health tools and services and maximise the benefits.

“The goal of the Capability Framework is to ensure the nursing workforce can confidently utilise digital health technologies.”

ACN was represented on the Framework’s Advisory Committee by Adjunct Associate Professor Naomi Dobroff FACN, Chair of the ACN Nurse Informatics Community of Interest and Aaron Jones, Chair of the ACN Chief Nursing Information Officer Community of Interest.

“This work gives everyone involved in healthcare a guide as to the skills and knowledge nurses and midwives need to deliver health in a digital world,” Adjunct Professor Dobroff explained.

“I am particularly pleased a Framework specific to nurses and midwives has been developed not only because our profession makes up over 50 per cent of Australia’s health workforce, but because it recognises the leadership role nurses and midwives have.

“Nurses and midwives play a critical role in ensuring that clinical information and communication systems are designed and used to deliver high quality, coordinated care to Australians across all aspects of the patient journey.

“The Framework outlines the capabilities each of us as individual professionals, our workplaces and our educational organisations, such as ACN, who are required to extend our digital health development to develop all nurses.”

Reflecting the nursing profession’s enthusiasm for adoption of technology and innovation, the Australian College of Nursing has added a specific digital health unit to some of its Nursing Graduate Certificate courses. Learning outcomes include being able to appraise how clinical communication occurs in a digitalised health care system.

“In terms of technology take-up, nurses are vital, but more importantly we need nurses to take a leadership role, which is a domain in the Framework, in order to make sure digital health successfully enhances patient care,” Adjunct Professor Ward said.

“Technology cannot replicate the complex and holistic care provided by nurses, but it can help expand the profession’s scope of practice and delivery of best practice care to all Australians.

“Nurses provide care all day, every day, across every care setting and are best placed to assist in reimagining the delivery of healthcare aided by technology.

“Therefore, we commend the Framework and look forward to playing a role in making sure it inspires broader digital expertise within the nursing profession by providing free online educational resources at the foundational level of learning to all nurses and midwives on the ACN website next year.”[/vc_column_text][/vc_column][/vc_row]

TELEHEALTH MUST BE THE START OF THE HEALTH ‘REVOLUTION’

“The Health Minister, Greg Hunt, has described the expansion of telehealth as a ‘revolution in the delivery of primary care’ which we strongly support,” the CEO of the Consumers Health Forum, Leanne Wells, said.

“The COVID-19 pandemic has shown the strength, and the opportunities for more public investments to improve Australia’s health system.

“It has shown the link between the health of the community and of the economy is inextricable.

“Telehealth has been stimulated by the pandemic to trigger easier and safe access to doctors and we look forward to further developments after the six month extension to March 2021 expires.

The telehealth disruption shows that transformative change is possible in healthcare and we hold great ambition for the scope of services that will be possible under the 10 Year Primary Health Care Plan currently in development.

“But the pandemic has also shown up the dramatic failings of the aged care system that has brought too many avoidable deaths and too much suffering.

“The lesson for Australia should be that we need to invest much more in a publicly-funded and effectively regulated system.

“The Government says it is making a record investment in health over four years of $467 billion, up by $32 billion on last year’s figures.

“It is to spend $2.4 billion on telehealth a development that just nine months ago would have seemed unbelievable.”[/vc_column_text][/vc_column][/vc_row]

COVID-19 A DOUBLE BLOW FOR CHRONIC DISEASE PATIENTS

There has never been a more dangerous time than the COVID-19 pandemic for people with non- communicable diseases (NCDs) such as diabetes, cancer, respiratory problems or cardiovascular conditions, new UNSW Sydney research has found.

Among the adverse impacts of the pandemic for people with NCDs, the study found they are more vulnerable to catching and dying from COVID-19, while their exposure to NCD risk factors – such as substance abuse, social isolation and unhealthy diets – has increased during the pandemic.

The researchers also found COVID-19 disrupted essential public health services which people with NCDs rely on to manage their conditions.

The study, published in Frontiers in Public Health recently, reviewed the literature on the synergistic impact of COVID-19 on people with NCDs in low and middle-income countries such as Brazil, India, Bangladesh, Nepal, Pakistan and Nigeria.

The paper, which analysed almost 50 studies, was a collaboration between UNSW and public health researchers in Nepal, Bangladesh and India.

Lead author Uday Yadav, PhD candidate under Scientia Professor Mark Harris of UNSW Medicine, said the interaction between NCDs and COVID-19 was important to study because global data showed COVID-19-related deaths were disproportionally high among people with NCDs – as the UNSW researchers confirmed.

“This illustrates the negative effect of the COVID-19 ‘syndemic’ – also known as a ‘synergistic epidemic’ – a term coined by medical anthropologist Merrill Singer in the 1990s to describe the relationship between HIV/AIDS, substance abuse and violence,” Mr Yadav said.

“We applied this term to describe the interrelationship between COVID-19 and the various biological and socio-ecological factors behind NCDs.

“So, people are familiar with COVID-19 as a pandemic, but we analysed it through a syndemic lens in order to determine the impact of both COVID-19 and future pandemics on people with NCDs.”

Mr Yadav said the COVID-19 syndemic would persist, just as NCDs affected people in the long-term.

“NCDs are the result of a combination of genetic, physiological, environmental and behavioural factors and there is no quick fix, such as a vaccine or cure,” he said.

“So, it’s no surprise we found that NCD patients’ exposure to NCD risk factors has increased amid the pandemic, and they are more vulnerable to catching COVID-19 because of the syndemic interaction between biological and socio-ecological factors.

“The evidence we analysed also showed there was poor self-management of NCDs at a community level and COVID-19 has disrupted essential public health services which people with NCDs rely on.”[/vc_column_text][/vc_column][/vc_row]

HALF OF AUSSIES WOULDN’T FEEL CONFIDENT USING DEFIBRILLATOR, NEW SURVEY REVEALS

The new survey of 7000-plus Australians also suggests a lack of awareness about automated external defibrillators. Nearly one in three people had never heard of the lifesaving device often found in public places such as shopping centres, schools and gyms.

The Heart Foundation has released its results on Restart a Heart Day to spread the word that anyone can use an AED to help save a life, without fear they will cause greater harm to the patient.

Early CPR and access to a defibrillator can significantly increase your chances of surviving a cardiac arrest, which is when a person’s heart stops beating. The patient will become unconscious and stop breathing normally, or at all.

A defibrillator checks the heart rhythm and can apply a measured electric shock to restore the heart to its normal rhythm. It will only deliver a shock if necessary, which means you cannot hurt someone by using a defibrillator.

The key findings of this year’s survey of 7200 Australian adults include:

  • 52% would not feel confident using an AED if they thought someone was having a cardiac arrest, while 41% would feel confident.
  • 60% had heard of an AED; 32% had not; and 8% were unsure.
  • Women were less likely to feel confident about using an AED than men (38% versus 45%).
  • Young adults were more likely to feel confident about using an AED than older Australians.

Heart Foundation General Manager of Heart Health, Bill Stavreski, urged Australians not to feel hesitant about using the lifesaving device in an emergency.
There’s a fear factor around defibrillators, but they are designed to be user-friendly and you don’t need to have medical training to help save a life.
“The step-by-step recorded instructions will guide you, and even if it turns out the person is not having a cardiac arrest, using the AED will not hurt them.”

Few people will survive a cardiac arrest without immediate treatment. About 25,000 people have a cardiac arrest out of hospital each year in Australia, but it is estimated as few as 5% will survive to be discharged from hospital.

“You should call 000 for an ambulance immediately if you think someone is in cardiac arrest. Check for a response and if they are breathing. If they aren’t, use an AED if one is available. If not, start CPR with chest compressions – you don’t need to use mouth-to-mouth if you are not comfortable,” Mr Stavreski said.

“Bystanders can be reluctant to step in if they haven’t been trained in CPR, but any attempt at resuscitation is better than none. Time is everything, because for every minute without defibrillation to restart the heart, chances of surviving drop by 10 per cent.”

Three in four cardiac arrests are caused by heart events, such as a heart attack, or underlying heart conditions.

We encourage more Australians to learn what action they can take to save someone’s life, including learning the signs of cardiac arrest and how to perform CPR, but we can all also take pre-emptive action to protect our own heart health.

“If you are 45 years and over, or from 30 if you’re Aboriginal or Torres Strait Islander, talk to your GP about a Heart Health Check to understand your risk of heart disease.”[/vc_column_text][/vc_column][/vc_row]

VIRTUAL HOSPITAL A NEW WAY OF CARING

With authors from RPA (Royal Prince Alfred) Virtual Hospital and Sydney Local Health District (SLHD), the latest Perspectives Brief from AHHA’s Deeble Institute for Health Policy Research, rpavirtual: a new way of caring, was released this week.

“Established as the first virtual hospital in NSW, rpavirtual was launched in early 2020 as a sustainable solution to increasing demand for healthcare in Sydney—and then the COVID-19 crisis hit”, said RPA Virtual Hospital General Manager Miranda Shaw.

“Expanding on existing digital infrastructure and workforce, rpavirtual was able to implement its COVID-19 model of care in just six days.

“Within 7 months our workforce has grown from six nurses, to a multidisciplinary service of over 50 medical, nursing and allied health teams.

“One of the most remarkable features of rpavirtual has been its ability to pivot to deliver hospital type monitoring in the community using digital innovations, underpinned by robust clinical models of care,” said Ms Shaw.

“Video consults, remote monitoring technologies, escalation pathways and patient access to the Virtual Care Centre 24/7 allows our care teams to identify patient deterioration in a timely manner.

Only 6 % of rpavirtual patients who have tested positive for COVID have required hospital admission, compared to NSW hospitalisation rates of 10%.

There is also the issue of COVID-19 negative patients in quarantine who have needed complex clinical care. In the absence of rpavirtual, these patients would have required hospital presentation and admission.

“This model of virtual care has the potential to cut the number of unnecessary Emergency Department presentations, reduce a patient’s length of stay in hospital, and has the ability to empower patients, especially those with chronic illness, to lead a better quality of life,” said Ms Shaw.

“The experience of a rapidly expanding virtual health service has been eye-opening for many, including for rpavirtual’s Information and Communication services, who have played a critical role in the hospital’s patient-centred, technology-enabled design.”

Ms Verhoeven said patients accept and respond well to comprehensive, supportive care delivered though virtual technologies. The positive benefits experienced through rpavirtual should be considered by governments in the development of virtual care strategies more broadly.

“Patients rightly expect that the positive benefits experienced through virtual healthcare during COVID- 19 will continue now and into the future.”

The rpavirtual: a new way of caring Perspectives Brief is available here.[/vc_column_text][/vc_column][/vc_row]

Private health insurance premiums are going up this week. But the reasons why just don’t stack up

[vc_row][vc_column][vc_column_text]At a time when many policy-holders are facing financial stress and many elective surgeries or treatments suspended or delayed, this month’s price rise isn’t justified. With a further price rise already set for April 2021, it would be fairer to delay any fee hike until then.

  1. Increasing costs of hospital and health care — false

Costs of hospital and health care paid by private insurers have reduced substantially in 2020, not increased, according to the latest figures from the Australian Prudential Regulation Authority. That’s because many elective surgeries and routine extra care (such as dental check-ups) were suspended.

Private insurers paid reduced hospital treatment benefits in two consecutive quarters. They dropped 7.9% in dollar terms in the March 2020 quarter, compared with the December 2019 quarter. They fell another 12.9% in the June 2020 quarter, compared with the March 2020 quarter.

Private insurers’ payments for general treatment (also known as ancillary or extras) benefits dropped even more. They fell 32.9% in the June 2020 quarter, compared with the March 2020 quarter.

Some may argue the reduction in benefits paid is because substantially fewer people had private insurance in 2020. But this is not true.

While there was a small drop in the number of people with private health insurance in the first half of 2020, this was by less than a percentage point: the number of hospital memberships fell by only 0.4 percentage points. There was a similar drop in the number of people with extras cover.

  1. Increase in claim frequency — false

Another reason for the price rise is there have been more claims over a given time, or an increase in claim frequency. This, again, is not true this year.

Private insurers paid for 16.7% fewer hospital treatments in the June 2020 quarter compared with the March 2020 quarter. That’s a 4.1% reduction in the 12 months to June 2020.

Private insurers paid out 28.4% fewer extras claims in the June 2020 quarter, compared to the March 2020 quarter. This was a 9.8% fall over the 12 months to June 2020.

In Victoria, services are only gradually returning to full capacity from November. So it will be a long while before claims return to pre-pandemic levels.

People have also been avoiding seeking needed health care because they are afraid of contracting the coronavirus, or cannot afford out-of-pocket costs due to increased financial stress. This would be another reason for the numbers of claims decreasing, not increasing.

  1. More chronic disease, an ageing population — no data supporting this for the next 6 months

In the long run, these claims are correct and premiums should increase gradually over the coming years because of the ageing population and growing incidence of chronic conditions.

However, they’re not likely to change enough in the next six months to justify a premium increase now.

Here’s what should happen

Some insurers are already providing discounts for families in financial hardship, such as people receiving JobSeeker or JobKeeper. Others offer discounts or waive price rises to people who pre-pay their policies for up to 12 months. More insurers should do this.

Providing financial relief and delaying the October premium increase will not only help customers but also help private insurers in the long run.

Increasing premiums twice in six months (October 2020 and April 2021) during an unprecedentedly difficult time can backfire, especially if the reasons to support the increase do not stack up.

When premiums increase, young people are more likely to drop private health insurance. This will drive up premiums further for everyone. This in turn will lead to more young and healthy people dropping their cover.

Consequently, it may cause a “death spiral”, driving private health insurance out of business.[/vc_column_text][vc_zigzag][vc_column_text]

This article originally appeared on theconversation.com.

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Corporate Health Insurers Raise Premiums

[vc_row][vc_column][vc_column_text]Corporate health insurers are being accused of increasing their premiums, not to increase patient outcomes, but rather to line their own pockets.

APRA’s mandatory private health insurance reporting data shows in the three months to June, corporate health insurers raked in gross mega-COVID-profits of $1.03 billion, despite bringing forward $1.4 billion in deferred claims, which has been labelled clever accounting to hide real profits. The data also shows a 15.8% rise in management expenses, which include employee bonuses are now at a record high of $650.1 million, every three months.

The Medical Technology Association of Australia (MTAA) has said the Federal Government and MedTech innovators are playing their part in trying to reduce the rise of insurance premiums. Specifically, an October 2017 Agreement, between the MTAA and Minister for Health, Greg Hunt, was signed to provide Australians with private health insurance a saving of $1.1 billion in payments for medical devices, over four years.

Private Healthcare Australia (PHA), the industry lobby group for corporate health insurers, have said that a reduction in device prices would lead to a decrease in insurance costs. Despite this claim and the signed Agreement, it appears corporate health insurers are continuing to raise their premiums for struggling families, regardless of the MedTech industry’s $1.1 billion olive branch.

Professor for Health Economics at the University of Melbourne, Yuting Zhang, recently wrote “the reasons insurance companies are using to justify their price rise don’t stack up”.

Not all insurers seem to be rising their premiums. HBF and some smaller funds have decided to cancel their 2020 premium increases, knowing that during COVID-19, it is not the time to make it harder for their customers.

MTAA CEO, Ian Burgess, has called on corporate insurers to ditch their premium increases and return the money to families who need it most.

“MTAA and the Government delivered $1.1 Billion in savings, now is the time to pass this on in full: insurers must forgo their premium increase, give money back to Aussie Mums and Dads – it’s time they put people before profits.”[/vc_column_text][/vc_column][/vc_row]

AHHA CALLS FOR BETTER COVID-19 DOCUMENTING

[vc_row][vc_column][vc_column_text]The COVID Screen Audit study has been published in Australian Health Review, the journal of the Australian Healthcare and Hospitals Associations (AHHA).

Research team leader and professor at the University of Melbourne, David Story, said the study analysed the admission records of 2,197 patients who underwent elective and non-elective surgery at two major Melbourne hospitals between 1 April and 10 May 2020.

“Despite the national imperative to screen for COVID and communicate the results, the documenting of COVID-19 screening fell short of our proposed lower acceptable limited on 85% in almost all surgical groups,” Professor Story said.

“We are not saying screening wasn’t done – that that the information wasn’t readily available for clinical teams caring for some patients.

“The percentages of surgery patients observed to have had both COVID-19 screening and temperature documented could be improved, from 72% among elective patients and 38% among non-elective patients.”

The study found that documenting screening varied markedly across surgical groups. In particular, it found that non-elective surgical patients had the lowest rate of documenting and also the highest rate of COVID-19 related history and signs.

Identifying surgical patients with SARS-CoV-2 and COVID-19 disease is important for several reasons, including that patients with COVID-19 may have more complications and greater mortality after surgery. COVID-19 may also further increase the already increased risk for complications and mortality among non-elective patients.

Professor Story added that the results of the COVID Screen Audit were likely to apply to other Australian hospitals, and noted both hospital had instituted far more rigorous documenting during Victoria’s second wave of the pandemic.[/vc_column_text][/vc_column][/vc_row]

$12.5m enables new research approach to Parkinson’s

[vc_row][vc_column][vc_column_text]“The outcomes of this research promise to provide new insights into the genetics of what determines the development and progression of Parkinson’s disease, “said Professor Deniz Kirik, Faculty of Medicine, Lund University who will be the lead investigator on the research project for the University of Sydney as an Honorary Professor for the duration of the research.

ASAP seeks to support international, multidisciplinary, multi-institutional research teams to address key knowledge gaps in the basic disease mechanisms that contribute to Parkinson’s. The initiative is focused on understanding the dynamics of Parkinson’s from its earliest stages and before it presents as a fully-recognisable condition.

The research being funded is focused on how mutations and/or deletions in specific genes result in a high probability of developing Parkinson’s disease (PD), suggesting their critical role in the health and survival of specific brain cells.

“Curiously, it is not yet clear how specific types of brain cells are functionally impacted by genetic mutations that result in the neuronal loss defining Parkinson’s. The research supported by this grant will address that,” said Professor Kirik.

Previously, affected cells have mainly been examined as cultured cells in petri dishes but this project will focus on using cells from patients with Parkinson’s to study them in the environment of the living mouse brain. This is a completely new way of exploring the cellular components and underlying biology of the disease. The researchers will then explore how gene editing could address the underlying basis of the disease.

“This generous grant allows Professor Kirik to build new research capabilities in neuronal transplantation at the University of Sydney, and collaborate on genomics and human neural stem cells with myself and Professor Carolyn Sue from the Kolling Institute,” said Professor

Glenda Halliday, one of the lead researchers from the University of Sydney’s Faculty of Medicine and Health and member of the University’s Brain and Mind Centre.

“It will also build on Professor Kirik’s strong collaborations with Professor Claire Parish and Associate Professor Lachlan Thompson at the Florey Institute in Melbourne, and Jennifer Johnson at NysnBio in California.”

Professor Sue, Executive Director, Professor and Director of Neurogenetics, Kolling Institute, University of Sydney said: “We have world- leading expertise in this field and have been selected to take part after a worldwide search for innovative programs to speed up the search for new treatments for Parkinson’s disease. The program illustrates the importance of our translational research at the Kolling Institute, where we can directly incorporate scientific breakthroughs to improve clinical care for our patients.”

The research team members are:

 Project lead: Professor Deniz Kirik, Faculty of Medicine Lund University, Sweden, has over 25 years’ experience in the development of cell and gene therapy for treatment of neurodegenerative diseases, with special emphasis on Parkinson’s disease. He has made significant contributions to cell therapy for PD which have been instrumental in taking novel treatments into clinical testing. (Professor Kirik and his team will eventually be based at the University of Sydney for the duration of the research, once COVID conditions permit).

Core leadership and Collaborators:

  Professor Glenda Halliday,NHMRC Senior Leadership Fellow, Faculty of Medicine and Health and Brain and Mind Centre, University of Sydney. Expertise in the development of neurodegenerative disorders including Parkinson’s disease and the role of Lewy bodies (clumps of proteins that form in the brain). Her current work focuses on how proteins identified through genetic studies are involved in neurodegeneration.

Professor Carolyn Sue, Executive Director, Professor and Director of Neurogenetics, Kolling Institute, University of Sydney and Director of Neurogenetics at Royal North Shore Hospital, University of Sydney. A clinician-scientist, whose research team combines the use of genomics, molecular neuroscience, and adult stem cell models to identify pathogenic mechanisms and develop targeted therapies for Parkinson’s disease and other related neurodegenerative disorders.

Professor Clare Parish, The Florey Institute of Neuroscience and Mental Health, Victoria is a developmental neuroscientist with 20 years of experience in Parkinson’s disease research. Expertise includes using advanced stem cell-based therapies for neural repair in Parkinson’s disease. She has an international reputation in improving the safety and functional integration of stem cell-derived neural transplants for Parkinson’s disease.

Associate Professor Lachlan Thompson, The Florey Institute of Neuroscience and Mental Health is a neurobiologist specialising in neural transplantation both as a therapeutic approach for brain and spinal cord repair, and as a way to understand the properties of neurons generated from human stem cells. He is the inaugural co-chair of the Asia-Pacific Association for Neural Transplantation and Repair.

Jennifer Johnston, CEO NysnoBio, California, has been studying neurodegenerative disease for the last 20 years. NysnoBio is a biotech company focused on the modulation of the parkin enzyme pathway for critical unmet medical needs in neurology and oncology (Parkin plays an essential role in maintenance of brain cells that create dopamine, which degenerate in Parkinson’s disease).[/vc_column_text][/vc_column][/vc_row]

Colin McFarlane’s Story – Life with a Heart Valve Implant Since 1973

[vc_row][vc_column][vc_column_text]After waiting six months for the valve to arrive from the United States, Colin was operated on at RPA by pioneering heart surgeon Bruce Leckie, and told he would need the valve replaced in 10 to 15 years.

“But once we got to 15 years, everybody threw their hands up in the air and said ‘pick a number, we don’t know’,” Colin says.

“So, here we are in the 47th year. It seems like it’s indestructible.”

But it almost never happened.

In 1958, retired engineer Miles Lowell Edwards, who had suffered rheumatic fever himself as a child, had set out to build the world’s first artificial heart.

Edwards presented the concept to Dr Albert Starr, a young surgeon at the University of Oregon Medical School.

Starr thought the idea was too complex and encouraged Edwards to focus on developing an artificial heart valve instead.

Within weeks, Edwards was sending Starr prototypes built in his home workshop.
And then in September, 1960, they had incredible success when the caged ball design was implanted in a 52-year-old man who underwent a “spectacular recovery and return to normal life”.
Last month, Colin and his daughter, Cheryl, visited Edwards Lifesciences in Macquarie Park tell his story – and thank the people who saved his life.

“We were told dad had a life expectancy of mid 50s,” says Cheryl.

“He’ll be 83 in February. You’ve given us a dad for a lifetime. But you’ve also given us a dad who hasn’t been sickly; a dad who has enjoyed life; who came to sports with us; who could take us on holiday.”[/vc_column_text][/vc_column][/vc_row]