Category: Patients

Plan To Tackle Heart Disease And Stroke In Australia

Posted on | by Team

[vc_row][vc_column][vc_column_text]The National Heart Foundation of Australia has received $170,000 to develop a National Strategic Action Plan, with assistance from the National Stroke Foundation.

Heart conditions and stroke place a heavy burden in terms of mortality and disability on the Australian community.

Heart disease is the single leading cause of death in Australia, with more than a quarter of all deaths in Australia each year having heart disease as an underlying cause. In 2016, the underlying cause of death in 43,963 people was cardiovascular disease.

On World Stroke Day, it is important to remember that stroke is one of Australia’s biggest causes of mortality, killing more women than breast cancer and more men than prostate cancer, and is a leading cause of disability. Every nine minutes an Australian experiences a stroke, with 56,000 strokes occurring in 2017.

These conditions take a tremendous toll on individuals, families and friends and this national strategic action plan will recommend a way forward and assist the realisation of better outcomes for patients.

It will guide and direct the measures we need take to improve awareness, understanding, diagnosis and treatment of heart conditions and stroke in our community.

The Heart Foundation does a great job in our community raising awareness, conducting research and promoting ways to help all Australians to look after their heart. I look forward to receiving the action plan.

The Pharmaceutical Benefits Scheme (PBS) subsidises several medications used in the treatment of cardiovascular diseases. About $1.3 billion is expended annually by the Australian Government to subsidise medications for treating heart conditions and stroke through the PBS.[/vc_column_text][/vc_column][/vc_row]

Tuning Out the Tremors: How Deep Brain Stimulation Saved a Violinist’s Song

Posted on | by Team

[vc_row][vc_column][vc_column_text]His doctor diagnosed him with essential tremor, a nervous system disorder that causes involuntary shaking, and recommended deep-brain stimulation, a treatment that uses electrical currents to interfere with brain circuitry causing the unwanted movements. The procedure involves drilling a hole in the skull to implant current-delivering electrodes inside the brain. Where the electrodes are placed in the brain depends on the individual patient’s unique tremor patterns. But, in Roger’s case, his tremor was so small that his surgical team could not determine the best placement location.

The team quickly pinpointed a fitting, yet unusual, solution: Roger would remain fully awake during the placement of the electrodes. He’d also play the violin throughout the surgery, so his doctors could assess the exact impact of each test location.

At the start of the surgery, Roger began his concerto, struggling to maintain smooth control of his bow hand. Doctors placed the first electrode lead, and Roger began to play better, but well below professional standards. Doctors asked if Roger would allow them to place a second wire, to which he responded, “Why not?” Doctors placed the second lead, and Roger began to play perfectly with a perfectly steady hand. When he finished, her heard a familiar, yet distinctly different, roar of applause.

Today, Roger says his tremor is non-existent. That is, when his electrodes are switched on. Roger has a small controller – he compares it to a garage opener – that allows him to turn the electrodes in his brain on and off with the click of a button. As long as his electrodes are on, Roger can play smoothly.

The MedTech community is committed to helping people like Roger live healthier, happier, and more productive lives. Roger says in the video, “I remain very, very thankful that I have had the opportunity to have had this surgery.” MedTech will continue to deliver innovative medical technology solutions – like Roger’s deep brain stimulation therapy – so that more patients can say the same.[/vc_column_text][/vc_column][/vc_row]

Moving My Health Record Forward

Posted on | by Team

[vc_row][vc_column][vc_column_text]The potential benefits remain and much of the policy to date is sound. Trust and confidence can be improved through consideration of the recommendations of the report and further legislative amendments to reflect key recommendations.

The CEO of the Consumers Health Forum, Leanne Wells, said she expects the Government to work collaboratively to pass legislation before the opt-out period ends. There has been enormous public investment in getting MHR to this point, and CHF would welcome bipartisanship around additional amendments that further strengthen the policy intent and protections.

Policy and implementation need to align before any records are created. To meet the intent of legislative amendments to address privacy concerns, it is CHF’s view that these must be passed before the end of the mid November opt-out period, and that ideally no records should be created following the opt-out period until the implementation of those amendments is complete.

“It is heartening to see much of the advice submitted to the inquiry by CHF included in the report. Realising the potential of MHR requires the Australian people to have confidence that their health information is used for their benefit, with their consent.”

“CHF welcomes the Report’s recommendations to provide more legislative clarity around the secondary uses of MHR data, and further education and communication campaigns to improve understanding and use of MHR.

“The ‘digital divide’ is real and, as the Committee has said, it is important that additional effort is made to identify, engage and provide targeted support to vulnerable groups to ensure they can make an informed choice about opt-out and, if they stay in, know how to adjust their controls.”

“Consumer access to their own health records through MHR is a key step in the shift from health consumers as passive patients, to consumers as active partners in their own care.

“Further communication and education should continue to include benefits and assurances about safeguards and risk mitigation strategies, but most importantly, must now begin to include more information about how to use MHR, both in terms of how to manage its access controls, and how to use it as a tool to improve health.

“Many Australians are already finding the system beneficial in their circumstances. Providing avenues for better understanding and use of MHR is the essential next step in its ongoing development,” Ms Wells said.[/vc_column_text][/vc_column][/vc_row]

NEUROMODULATION SOCIETY SAYS OPIOID CRISIS SET TO SOAR UNDER PHI CHANGES

Posted on | by Team

[vc_row][vc_column][vc_column_text]Neuromodulation Society of Australia and New Zealand (NSANZ) is concerned Australian patients will be forced to upgrade, or miss-out pain management treatments with devices, under the PHI policy changes.

 “We are calling for the Government to make good on their promise, and guarantee that all existing procedures for pain management, including devices, be made available in Bronze, Silver and Gold policies,” said Dr Richard Sullivan, Pain Medicine Specialist Physician and NSANZ President, Melbourne.

“Australian strong opioid-related deaths now exceed heroin deaths by two-and-a-half-times, and estimates suggest more than a quarter of chronic pain patients are misusing prescription strong opioids.

“These numbers will increase should patients be denied access to chronic pain procedures they currently have under their existing policies,” said Dr Sullivan.

Mum-of-four, Kelly, 46, Wollongong, has been living with chronic pain for almost three decades, pain that significantly worsened following complications during surgery for a herniated disc.

“Chronic pain doesn’t just affect you, it really affects your entire family as well. I have three kids, and have just adopted my niece, and I was living on opioid patches unable to move off the couch.

“My pain management device gave me a new lease on life. I’ve gone back to work, I can run around with the kids, I can even sit and stand by myself without kids having to pull me out of the chair.

“Without my device for chronic pain, I wouldn’t have been able to work and would have lost my house.

“If my insurance didn’t cover my chronic pain device, there’s no way I would have been able to afford it. I can’t imagine what the consequences would be if other people were denied access to life-changing treatment for their chronic pain,” said Kelly.

The Medical Technology Association of Australia (MTAA) has been supportive of the Government efforts to simplify and make transparent private health insurance policies but remains concerned of the unintended consequences.

“It’s disappointing that consumers that need access to life saving and life changing medical devices will in most cases need a gold level policy to do so,” Ian Burgess CEO of the MTAA said.[/vc_column_text][/vc_column][/vc_row]

AOA URGES RECONSIDERATION OF PHI REFORM

Posted on | by Team

[vc_row][vc_column][vc_column_text]AOA President Dr David Martin said the reform process to date does not appear to be consumer focused, “Rather than focus on the consumer, the real nuts and bolts of the reform is on exclusions, where it seems to be more about what insurers are prepared to provide within certain actuarial constraints, rather than what patients with private health cover require.

“Many private patients without “Gold” insurance will only discover they were inadequately insured when they reached the stage where surgery was the required treatment. AOA members frequently report experience of patients disappointed to learn their health insurance doesn’t cover treatment by joint replacement of their disabling arthritis (when all non-operative measures exhausted). The current system seems to be going to perpetuate this confusing situation.

Bizarrely the new system covers podiatry services at lower tiers including surgery and joint replacement and prostheses insertion even though these health providers are neither specialist surgeons nor have a system of monitoring outcomes like the National Joint Replacement Registry. The NJRR has already saved about AUD$600 million over last ten years by encouraging wise prosthesis choice.

“Insurance is meant to protect people against unaffordable financial risk, but with the present model the opposite is occurring. Patients with non-Gold insurance will only be covered for cheaper medical problems and be excluded from resource intensive problems like spinal fusion and joint replacement. Joint replacement surgery is potentially a very cost-effective intervention with good improvement in quality of life sustained over decades. Patients who can’t afford to increase their cover to Gold or pay for the surgery themselves, will be forced into the public system. The result will be an enormous cost shift from the private health system to the state-run public system.”

“This makes the decision about choosing policies that rely on exclusions a major gamble,” Dr Martin said.

AOA is calling on the Government to revisit its modelling of the traffic-light classification system by putting the Australian consumer first, rather than the profit levels of Australian private health insurance companies.

“We are urging the Federal Government not to rush, or rubber stamp these reforms. It warns changes to how orthopaedic surgery is covered requires urgent and careful collaboration with the specialists who work in the field, otherwise a sub-optimal reform will occur.

“The AOA actively supports efforts to reduce policy variation and make health insurance easier for patients to understand; however, the proposed reforms will continue to leave patients open to nasty surprises about their coverage when medical treatment is required,” said Dr Martin.[/vc_column_text][/vc_column][/vc_row]

First Australian hospital embraces new world-leading radiation therapy technology

Posted on | by Team

[vc_row][vc_column][vc_column_text]ROC is part of Icon Group, Australia’s largest, dedicated provider of cancer care, and the nation’s first to offer Varian’s HyperArc high-definition radiotherapy – an end-to-end technology solution for the treatment of multiple brain tumours.

Varian developed the HyperArc technology to enable clinicians to treat multiple, well-defined tumours with high-doses of radiation therapy that pinpoint the tumours via a fully automated system.

Icon Group Radiation Oncologist, Dr Jim Jackson, Gold Coast, explains how this technology benefits both clinicians and patients.

“With HyperArc, we can treat patients with several brain tumours with pinpoint accuracy. It allows us to target the tumours, not the surrounding brain. This technology offers patients excellent tumour control, without the side effects associated with irradiating normal brain tissue.

“It is also beneficial for the patient as it is quick and comfortable. A treatment takes less than 10 minutes and there are no invasive head restraints that can be stressful for patients,” said Dr Jackson.

HyperArc utilises the capabilities of Varian’s TrueBeam linear accelerator and enables multiple tumours to be treated more efficiently via one simple, automated set-up point, with treatment lasting only a few minutes.

ROC’s first patient to receive HyperArc technology, Philippa Douglas, Gold Coast, said, “the thing that gave me peace of mind was the precision of the treatment. Knowing I was being treated with the latest technology and that the radiation was targeting my tumours with millimetre accuracy, gives me hope.”

Varian Australasia Managing Director, Chris Cowley, said Varian’s aims to bring advanced technology to cancer patients Australia-wide.

“We are delighted to be introducing this innovative technology to Australian cancer patients. By partnering with leading companies, such as the Icon Group, to deliver advanced cancer treatments to more patients, we are edging closer toward our vision of achieving a world without fear of cancer.”

An estimated 138,000 new cancer cases will be diagnosed in Australia this year, with that number set to rise to 150,000 by 2020.1 Approximately 1,750 brain cancers are diagnosed each year nation-wide, which equates to roughly one person diagnosed with brain cancer every five hours.

Icon Group CEO, Mark Middleton, Brisbane, said his company invests in the latest technology and cancer techniques for the benefit of patients and their families.

“Today marks an exciting milestone. The Varian Hyperarc technology places the Gold Coast at the forefront of exceptional cancer care, both in Australia and world-wide.

“As cancer rates continue to rise, and technology continues to progress, it is important for people to have access to state-of-the-art treatments, as close to home as possible,” Mr Middleton said.

HyperArc has also recently been installed at ROC, Greenslopes Private Hospital, Brisbane, with patients soon to benefit from the groundbreaking technology.[/vc_column_text][/vc_column][/vc_row]

Stride4stroke For Someone You Love

Posted on | by Team

[vc_row][vc_column][vc_column_text]

This November, the Stroke Foundation is challenging the community to Stride4stroke, a physical activity campaign which raises funds to support vital programs for stroke survivors and their families.

Registrations are now open and participants can set their own activity goal and fundraising target.

Queensland woman Nicola Baker will take part in Stride4stroke and will stride for her 14 year old son Jed, who had a stroke at just 11 months old.

“Jed’s stroke came as a huge shock. It not only changed his life, it changed mine too,” Nicola said.

“While life has been isolating at times and full of challenges and doctor appointments, each day is a gift. We didn’t know whether Jed would be able to go to school, let alone reach his teens.

“Jed has had three rounds of brain surgery and monitoring is just a part of life, but he is a wonderful kid who has brought me so much joy. I want to help support others in a similar position.”

Nicola will aim to walk 10 kilometres each day of November and has encouraged friends to join her. Nicola said being part of a team would ensure she walked every day and would help raise even more funds.

“Everyone I know has a personal connection to stroke – whether it be a parent, grandparent, friend or colleague. Many have seen first-hand how devastating it can be,” Nicola said.

“By taking part in Stride4stroke, we will not only be helping to raise funds to help Stroke Foundation make recovery from stroke better for families, there is the added bonus of reducing our own risk of stroke by getting active,” she said.

Stroke Foundation Chief Executive Officer Sharon McGowan congratulated Nicola on getting involved in Stride4Stroke and encouraged others to follow her lead.

“We see the impact of stroke on families, like Nicola’s, each and every day,” Ms McGowan said.

“There will be around 56,000 strokes in Australia in 2018. Stroke is one of this country’s biggest killers and a leading cause of disability.

“Frightening, stroke can strike anyone at any age, but you can make a difference.

“Every dollar raised through Stride4stroke will have an enormous impact. It will go towards vital Stroke Foundation programs like StrokeLine (1800 787 653) and follow up services which help survivors and their families transition to life back home after stroke and throughout the recovery journey,” she said.

This November who will you stride for? Get a team together for Stride4stroke or do it by yourself. Set an activity and fundraising goal and go for it! Register or donate at www.stride4stroke.org.au

[/vc_column_text][/vc_column][/vc_row]

Cancer Treatment Planning Streamlined

Posted on | by Team

[vc_row][vc_column][vc_column_text]Peter Mac is one of the world’s leading cancer research, education and treatment centres. It operates Australia’s only public hospital dedicated to caring for people living with cancer in Melbourne and provides radiation therapy services from suburban and regional sites.

The partnership with Varian means Peter Mac now has a unified radiotherapy treatment planning and oncology imaging informatics system across its campuses, providing patients with access to advanced radiotherapy treatments and longitudinal follow up of their medical images.

Nilgun Touma, Director of Radiation Therapy Services at Peter Mac said, “Eclipse will support the radiation oncology team to develop tailored treatment regimens – a task that requires absolute confidence in the accuracy of patient data and efficiency of planning workflows.

“Up until recently, Peter Mac ran multiple treatment planning systems across its five radiation therapy sites. Now, with Eclipse being live, we’ll be improving efficiency for our team and improving timeliness to care for patients at all Peter Mac locations.”

Varian designed Eclipse to streamline the creation of optimal treatment plans personalised for each patient by combining patient-specific anatomy with the best practice clinical knowledge of the institution. Multiple sources of information can be consolidated into a single comprehensive data repository, stored in Microsoft Azure and available for approximately 100 Eclipse concurrent users.

This provides Peter Mac with an increasingly comprehensive set of patient data from which its clinicians may draw insights to uniquely devise the preferred treatment strategy for an individual patient as well as continually evolving the best practices for managing patient cohorts of similar conditions.

Chris Cowley, Managing Director of Varian said, “In treatment planning, the radiation dose calculation has historically taken significant time. With Eclipse, the system can use graphical processing units (GPUs) that result in very fast dose calculation – resulting in significant time efficiency for Peter Mac as their GPUs reside in the cloud.”

Collaboration with Microsoft during deployment of the new cloud-based system provides the quality and security features of the Azure cloud.

Dr Nic Woods, Health Industry Executive for Microsoft Australia stated, “We’re delighted to have been working in partnership with such an innovative team at Varian. Seeing the cutting-edge treatment solutions that they are bringing to improve the delivery of care of patients around Australia is exactly the kind of partnership that Microsoft wants to build.”

“The combination of Varian’s expertise in radiation oncology and the Microsoft Azure cloud’s resilience, performance, security and scale are a winning combination for Peter Mac,” Chris Cowley added. “Because this is a cloud-based solution, it will grow with Peter Mac and they will gain quick access to important innovative updates.”[/vc_column_text][/vc_column][/vc_row]

If privacy is increasing for My Health Record data, it should apply to all medical records?

Posted on | by Team

[vc_row][vc_column][vc_column_text]The laws underpinning the My Health Record as well as records kept by GPs and private hospitals currently allow those records to be shared with the police, Centrelink, the Tax Office and other government departments if it’s “reasonably necessary” for a criminal investigation or to protect tax revenue.

If passed, the policy of the Digital Health Agency (which runs the My Health Record) not to release information without a court order will become law. This would mean the My Health Record has greater privacy protections in this respect than other medical records, which doesn’t make much sense.

Changing the law to increase privacy

Under the proposed new bill, state and federal government departments and agencies would have to apply for a court order to obtain information stored in the My Health Record.

The court would need to be satisfied that sharing the information is “reasonably necessary”, and that there is no other effective way for the person requesting it to access the information. The court would also need to weigh up whether the disclosure would “unreasonably interfere” with the person’s privacy.

If granted, a court order to release the information would require the Digital Health Agency to provide information from a person’s My Health Record without the person’s consent, and even if they objected.

If a warrant is issued for a person’s health records, the police can sift through them as they look for relevant information. They could uncover personally sensitive material that is not relevant to the current proceedings. Since the My Health Record allows the collection of information across health providers, there could be an increased risk of non-relevant information being disclosed.

But what about our other medical records?

Although we share all sorts of personal information online, we like to think of our medical records as sacrosanct. But the law underpinning My Health Record came from the wording of the Commonwealth Privacy Act 1988, which applies to all medical records held by GPs, specialists and private hospitals.

Under the Act, doctors don’t need to see a warrant before they’re allowed to share health information with enforcement agencies. The Privacy Act principles mean doctors only need a “reasonable belief” that sharing the information is “reasonably necessary” for the enforcement activity.

Although public hospital records do not fall under the Privacy Act, they are covered by state laws that have similar provisions. In Victoria, for instance, the Health Records Act 2001 permits disclosure if the record holder “reasonably believes” that the disclosure is “reasonably necessary” for a law enforcement function and it would not be a breach of confidence.

In practice, health care providers are trained on the utmost importance of protecting the patient’s privacy. Their systems of registration and accreditation mean they must follow a professional code of ethical conduct that includes observing confidentiality and privacy.

Although the law doesn’t require it, it is considered good practice for health professionals to insist on seeing a warrant before disclosing a patient’s health records.

In a 2014 case, the federal court considered whether a psychiatrist had breached the privacy of his patient. The psychiatrist had given some of his patient’s records to Queensland police in response to a warrant. The court said the existence of a warrant was evidence the doctor had acted appropriately.

In a 2015 case, it was decided a doctor had interfered with a patient’s privacy when disclosing the patient’s health information to police. In this case, there no was warrant and no formal criminal investigation.

Unfortunately, there are recent examples of medical records being shared with government departments in worrying ways. In Australia, it has been alleged the immigration department tried, for political reasons, to obtain access to the medical records of people held in immigration detention.

In the UK, thousands of patient records were shared with the Home Office to trace immigration offenders. As a result, it was feared some people would become too frightened to seek medical care for themselves and children.

We can’t change the fact different laws at state and federal level apply to our paper and electronic medical records stored in different locations. But we can try to change these laws to be consistent in protecting our privacy.

If it’s so important to change the My Health Records Act to ensure our records can only be “unlocked” by a court order, the same should apply to the Privacy Act as well as state-based laws. Doing so might help to address public concerns about privacy and the My Health Record, and further inform decisions about opting out or staying in the system.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_zigzag][vc_column_text]

Authors

[/vc_column_text][vc_row_inner][vc_column_inner width=”1/2″][vc_column_text]
Research Fellow in Law, University of Melbourne

Professor of Speech Pathology, University of Technology Sydney[/vc_column_text][/vc_column_inner][vc_column_inner width=”1/2″][vc_column_text]
Associate professor, University of Melbourne

Director, University of Newcastle Legal Centre, University of Newcastle[/vc_column_text][/vc_column_inner][/vc_row_inner][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

This article originally appeared on theconversation.com.

[/vc_column_text][vc_row_inner][vc_column_inner width=”1/4″][vc_single_image image=”2387″ img_size=”full”][/vc_column_inner][vc_column_inner width=”3/4″][/vc_column_inner][/vc_row_inner][/vc_column][/vc_row][vc_row][vc_column][vc_raw_html]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[/vc_raw_html][/vc_column][/vc_row]

Fully Funded MRI Licences

Posted on | by Team

[vc_row][vc_column][vc_column_text]The Government and the Opposition in recent times have been making a series of announcements regarding where new MRI licences would be made available.

The Opposition got the ball rolling when in May it announced that in government it would provide for 20 new licences, 10 for public hospitals and 10 for private hospitals.

Last weekend, the Government upped the ante by announcing they would fund an additional 30 MRI licences with Minister for Health, Greg Hunt, naming the first ten localities to receive them from November this year.  This also follows on from the review Minister Hunt ordered into how MRI licences are allocated.

Up until recently, there had been a total of 5 new MRI licences since 2013, and 2 of them were announced during the election campaign.

The flurry of activity by both the Opposition and the Government can be traced back to the Senate inquiry into diagnostic imaging that reported in February of this year.

By putting the issue of MRI licences in the political and public spotlight, it was only a matter of time before both major parties started making the commitments they have.

It is also testament to the power and influence that a Senate inquiry can have in that in 5 years only 5 new licences were made available, but in the space of 5 months since the inquiry, access to 50 new licences have been announced.

The other telling point is that health remains and will be a front and centre political issue between now and the federal election.

Both sides are competing for votes and know health can be a deciding factor in how many people decide to vote.  Access to MRIs has shown itself to be the latest battleground in the ongoing health debate.

While Labor and the Government seek to outdo each other on announcing new MRI licences, the big winner is patients.

Magnetic Resonance Imaging is amazing medical device technology, and the more people that can have access to it when needed, can only be good for the community as a whole.[/vc_column_text][vc_zigzag][/vc_column][/vc_row][vc_row][vc_column width=”1/4″][vc_single_image image=”1915″][/vc_column][vc_column width=”3/4″][vc_column_text]

ABOUT THE AUTHOR

Jody Fassina is the Managing Director of Insight Strategy and has been an strategic adviser to MedTech and pharmaceutical stakeholders.[/vc_column_text][/vc_column][/vc_row]