Author: Team
Medical Device Commercialisation Training Program
Public Hospital Admissions Rising Fast
[vc_row][vc_column][vc_column_text]Admissions to public hospitals are growing faster than admissions to private hospitals, according to a new report from the Australian Institute of Health and Welfare (AIHW). The report, shows that of the 11 million admissions to hospitals in 2016–17, 6.6 million were in public hospitals and 4.4 million were in private hospitals.
“Admissions rose by 4.3% on average each year for public hospitals and 3.6% for private hospitals between 2012– 13 and 2016–17, and these were greater than the average growth in population of 1.6% over the same period” said AIHW spokesperson Jenny Hargreaves.
In 2016–17, the majority of admissions to public hospitals (83% or 5.5 million) were for public patients – however, about 1 in 7 (14% or 912,000 admissions) were for patients who used private health insurance to fund all or part of their admission.
There were 2.2 million admissions involving elective surgery in total. In terms of the safety and quality of care delivered, the report shows that in 2016-17 there were more than 186,000 hospital-acquired complications or 2.2% of 8.6 million in-scope admissions. Overall, the average length of stay in 2016-17 was 3.2 days in public hospitals and 2.2 days in private hospitals.
Australian Private Hospitals Association (APHA) CEO Mr Michael Roff said the report reveals public hospitals have not shied away from taking privately insured patients, while forcing those on public waiting lists to wait longer for treatment.
“The latest data shows privately insured patients continue to jump the queue in public hospitals. The median wait time for elective surgery for a public patient is 42 days. That’s twice as long as the privately insured who wait a median of 21 days,” Mr Roff said.
“The AIHW data show one in seven public admissions were for privately insured patients – that’s 14 percent of all admissions to public hospitals,” he said.
Meanwhile the peak body for the Private Health Insurance industry said: “The harvesting of patients from public emergency departments and pressuring them to go private, risks undermining Medicare and the Australian health system,” Dr Rachel David, CEO of Private Healthcare Australia.
“As a result of this cash grab, public patients are waiting longer for their surgery in public hospitals and the practice adds more than $1 billion to the cost of health fund premiums per year.
CEO of the Medical Technology Association of Australia (MTAA), Ian Burgess, said under MTAA’s Agreement with the Government to reform the Prostheses List, the MedTech industry is incurring revenue cuts of $1.1 billion which goes directly to the private health insurance companies to improve the affordability of private health insurance.
“We’re the major reason this year’s average private health insurance premium increase was the lowest in 17 years,”
“MTAA strongly supports the need for a healthy and viable private health insurance sector in Australia, however private insurance needs to provide consumers value and that value needs to be better communicated. This includes the choice of medical technology that a patient’s treating doctor considers to be the most clinically appropriate, generally with no gap payment applying to that technology,” Mr Burgess said.
And don’t miss ABC 4 Corners this Monday as it looks at what’s driving up your out of pocket costs. This will air just before Senate Estimates providing another opportunity to put healthcare costs front and centre. PulseLine will continue to look at the fierce debate and asked the question, is Private Health Insurance worth it? [/vc_column_text][/vc_column][/vc_row]
DISRUPTION IN HEALTHCARE: WHERE ARE THE PROMISED CHANGES?
[vc_row][vc_column][vc_column_text]Disruption is the ‘it’ word associated with companies like Uber, Amazon, eBay, SpaceX and Airbnb. These companies have disrupted the taxi industry, hotel sector, brick-and-mortar stores and even government space programs.
In many of these examples companies have used a consumer focussed service model and purported to return power to traditional consumers, who can now earn money from renting out a spare bedroom, selling second-hand possessions or through ridesharing.
The healthcare sector is a large and slow-moving beast which accounts for over 10% of Australia’s GDP. Some critics believe it to be inefficient with poor patient outcomes despite increasing government spending. Although these factors suggest that healthcare is a sector primed for disruption, to date there has been limited adoption of new technologies with no major changes to the healthcare delivery model.
Regulation has been acknowledged as an impediment to disruption. It slows down innovators and increases the cost of bringing new products to market. The healthcare sector in particular is extensively regulated, a ‘necessary’ measure given the high cost of mistakes. As lives are on the line, regulations often require lengthy and expensive clinical trials to determine whether a product is safe.
In addition, separate regulations around privacy and data storage requirements increase the complexity of the system for tech developers. This increases the costs faced by innovators, which in turn limits the number of newer start-ups and benefits larger already existing companies. As disruption has traditionally come from outside the industry, this concentration of development into larger companies in turn slows the speed of innovation.
The healthcare sector is known for its strong bias towards specialist knowledge. Doctors can train for up to ten years, at great expense. This centralisation of specialised knowledge means that innovators must convince key hospital staff to adopt their product for it to be successful. Given the length of their studies doctors have been trained to prefer particular methods for detection and treatment of certain illnesses.
Additionally, the strict licensing requirements and the risks posed by doctors if they go too far outside the realm of ‘accepted thinking’ mean that doctors are relatively set in their ways and are less likely to favour innovative solutions, especially where those solutions would cut doctors out the equation.
This concentration of knowledge also means that innovation is slowed by the current fee-for-service model. Under this model doctors and hospitals are rewarded for the time spent treating patients, not the time they saved through, for example, adopting an internet-based consultation system.
This means there is no incentive for doctors or hospitals to adopt technology that would reduce the time they spend with patients. It is this logic that led Goldman Sachs to suggest that developing cures could be bad for business. This means that uptake of any technology that would actually ‘disrupt’ the industry is slow, even where that disruption could be better for patients’ and government’s bottom lines.
Despite these factors, there are signs that innovation is starting to accelerate. The Australian Government is taking steps to accelerate this process, moving Australians’ health data onto a digital platform and providing additional funding for start-ups through programs like MTPConnect or the recently announced National Health and Medical Industry Growth Plan.
In the next article in this series we will address why disruption is a good thing and how organisations are working to bring change to the healthcare sector.
Health Horizon is a start-up that empowers health consumers by allowing them to find and track health innovations that interest or affect them so that they can gain control over their health future.
Read the original article here.[/vc_column_text][/vc_column][/vc_row]
BEHIND THE SCENES, AMERICA’S MEDICAL TECHNOLOGY COMPANIES ARE FIGHTING THE CYBERSECURITY BATTLE
[vc_row][vc_column][vc_column_text]Globally healthcare regulators have identified cyber security as a key issue for medical devices such as infusion pumps, implantable pacemakers, cardiac defibrillators and telemetry heart monitors. Experts and regulators worldwide are focused on reducing device vulnerability and mitigating risks of hacking and malware attacks.
AdvaMed has recently praised the U.S. FDA for its proactive leadership and for working collaboratively with the MedTech industry and the broader healthcare community in the cybersecurity space.
Ensuring medical devices are shielded from cybersecurity threats is, in the words of the U.S. Food and Drug Administration, a “shared responsibility” among all stakeholders.
Medical technology companies, hospitals, physicians, IT professionals, providers, regulators and patients all need to work together so that the safety and integrity of interconnected medical devices – everything from pacemakers and ICDs to monitors and infusion pumps – is not compromised due to cyber threats.
No one takes this responsibility more seriously than America’s medical technology companies, for whom patient safety is the #1 priority. Unfortunately, little is known or understood about the extensive work medical technology manufacturers have done and are doing to address this potential threat.
Medtech companies continuously assess the security of their devices in a world where the risks continuously evolve. They address cybersecurity throughout the product lifecycle, including during the design, development, production, distribution, deployment, maintenance and disposal of the device and associated data.
Similarly, manufacturers implement proactive measures to manage medical device cybersecurity, including but not limited to routine device cyber maintenance, assessing post-market information, employing risk-based approaches to characterizing vulnerabilities, and timely implementation of necessary actions. These requirements are a matter of law, as FDA has in place comprehensive regulations prescribing these risk management programs, and manufacturers face severe penalties for failing to follow the rules.
But addressing this issue goes beyond an individual company’s merely meeting current regulations. Cybersecurity is ever-evolving, and the medical technology industry recognizes that it must constantly evolve to meet potential threats. That’s why we collectively developed our own set of medical device cybersecurity principles. These principles ensure device manufacturers build a cybersecurity program based on the best available information, such as FDA guidance, NIST publications, and consensus-based standards.
Our industry also recognizes that cybersecurity threats require the cooperation and collaboration of multiple stakeholders in the health care ecosystem. And that’s why we have committed to working with regulatory agencies, industry partners, health care providers and others to address this challenge to ensure that everyone takes this threat as seriously as we do.
FDA is to be commended for the proactive leadership it has taken in recent years when it comes to cybersecurity. The Agency has worked collaboratively with our industry and the broader health care community to ensure medical device cybersecurity is considered and addressed throughout all stages of product design and use. While manufacturers have long included cybersecurity considerations in premarket development and postmarket surveillance, the Agency’s detailed guidance on these issues has provided important instruction and clarification for medtech companies. FDA should also be commended for their work engaging with other Federal agencies in their area, including DOJ, FBI, DHS and NIST.
Open communications is a key strategy in combatting cybersecurity threats. To that end, the medical technology industry has worked closely with public-private organizations – with the encouragement of FDA – to establish a medical device information sharing and analysis organization. Similar to systems successfully used in the energy and finance sectors, this program provides a streamlined mechanism for companies to submit and share information concerning cybersecurity-related issues.
However, despite manufacturers’ best efforts, many cybersecurity threats remain outside their control. Most connected devices are linked to third-party networks, such as a hospital’s IT system or a patient’s home-based Wi-Fi network. A chain is only as strong as its weakest link, so if these systems or networks are vulnerable the medical devices they are connected to are vulnerable as well.
The confluence of medical technology and communications are transforming health care, providing physicians with real-time information and the ability to remotely monitor and treat patients. Our industry is committed to doing our part to ensure this progress continues by rigorously addressing cybersecurity threats pre- and post-market. We will continue to work with FDA, health care providers, the academic community, security experts and other stakeholders to ensure the continued security, safety and effectiveness of medical devices.
Closer to home, the TGA is taking the lead in developing a strategy for cyber security of medical devices in collaboration with CSIRO and Standards Australia. The aim is to address risks associated with implantable and non-implantable devices connected to the web in an increasingly complex and interconnected healthcare system.
PulseLine understands the TGA is developing a strategy to increase stakeholder awareness of expectations regarding cyber security of medical devices across the industry. PulseLine will be asking the TGA to provide some further insights in the weeks to come.[/vc_column_text][/vc_column][/vc_row]
A Conversation With Dr Neil Soderlund
Digital Health Needs To Be Safe, Seamless And Secure
[vc_row][vc_column][vc_column_text]Australian Digital Health Agency CEO Tim Kelsey delivered his Your Health in Your Hands – the Digital Evolution of Health and Care in Australia speech at the National Press Club today and outlined the collaboration needed between governments, consumers, clinicians, and entrepreneurs to make data and technology work better for modern health.
“Australia has one of the best systems in the world – by any measure. We are at the forefront of medical research, we have world-class facilities, and the people that provide care are among the most highly skilled and committed professionals anywhere.
“But the hum and whirr of the fax machine in the background of our care services reminds us that there is more to do: paper based healthcare means that clinicians do not always have the right information at the right time to make the best decision,” Mr Kelsey said.
Mr Kelsey said that Australia’s National Digital Health Strategy – Safe, Seamless, and Secure underpins the country’s vision for digital health. My Healthy Record is the strategy’s top priority because it puts consumers at the centre of their health care and provides choice, control, and transparency.
More than 5.7 million Australians currently have a My Health Record. By the end of 2018 Australia will be the first country of its size in the world to provide mobile records to every person, unless they choose to opt out. By 2019, every registered clinician will have a secure means of communicating digitally, without resort to paper or a fax machine.
Damien Taylor is one of many parents who has experienced firsthand the benefits of My Health Record. His young daughter Maggie underwent open‐heart surgery for a congenital heart defect at seven months old.
“Maggie’s medicines, conditions, and hospital stay information were captured in My Health Record so we won’t need to keep hard copy records and try and remember everything at each medical appointment in the future,” Mr Taylor said.
Dr Elizabeth Jackson also believes digital health is the way forward for Australia’s healthcare system. The Cairns-based obstetrician and gynaecologist uses My Health Record to provide her expectant patients with peace of mind throughout their pregnancies.
“My Health Record is an incredibly valuable tool. It allows 24/7 access to patient records and allows us to work together as a team to deliver high-quality and cost-effective medical outcomes,” Dr Jackson said.
A national communications strategy will be implemented to inform all Australians of the benefits of digital health, and to explain the opt out process. During the opt out period individuals who do not want a record will be able to opt out by visiting the My Health Record website or by calling 1800 723 471 for phone based assistance.
Engagement at a local level in community and in trusted healthcare provider settings is a central pillar of the communication strategy with research confirming that 89% of people will expect to receive information about My Health Record from their health care provider.
“The benefits of My Health Record must be accessible to all Australians. There has been a particular focus in our communications research on developing appropriate support for people with limited digital literacy or access, and other groups including people from culturally and linguistically diverse (CALD) backgrounds, Aboriginal and Torres Strait Islanders, and people living in rural and remote communities,” Mr Kelsey said.
The Agency is also working with more than 100 partner organisations, including the Primary Health Networks, the Australian Health Practitioner Regulation Agency, and Australia Post to inform the Australian public about My Health Record, its security controls, benefits, and their rights to opt out.
Information will also be made available in over 15,000 health care locations including general practices, pharmacies, public and private hospitals, and via Aboriginal Medical Services and National Aboriginal Community Controlled Health Organisations.
Australia Post Chief Executive Christine Holgate said the company is pleased to announce that it will be working closely with the Agency to support the national expansion of My Health Record with 3600 Australia Post outlets reaching up to two million Australians over the three month opt out period.
“Australia Post recognises the critical benefits of My Health Record for improved health sector outcomes. We will support the expansion program through traditional postal and parcel services, and promotion through our extensive post office network,” Ms Holgate said.[/vc_column_text][/vc_column][/vc_row]
My Health Record Data for ´Research and Public Health Purposes´
[vc_row][vc_column][vc_column_text]The Medical Technology Association of Australia (MTAA) welcomes the release of the framework to guide the secondary use of My Health Record system data. The guiding principles within the framework align with MTAA´s position to allow third parties access the data for public health and research purposes.
To inform on how data on the My Health Record system can be used for research and public health purposes while preserving privacy and security of data in the system, the Australian government developed the framework in consultation with key stakeholders.
Minister for Health, Greg Hunt, said My Health Records “provides many benefits to patients, including reduced duplication of tests, better co-ordination of care for people with chronic and complex conditions, and better-informed treatment decisions”.
“I would encourage each and every Australian to use their My Health Record and to speak with their healthcare providers regarding these benefits,” he said.
The Australian Medical Association President, Dr Michael Gannon, said the current system meant many patient records were incomplete especially if the patient has seen another specialist or has been discharged from a hospital.
“The My Health Record now provides patient medications, referrals, shared health summaries, pathology and diagnostic imaging reports and, increasingly, hospital discharge summaries”, Dr Gannon said.
Consumer Health Forum CEO Leanne Wells welcomed the government´s announcement.
“The clinical benefits of My Health Record for patients are significant and compelling: hospital admissions avoided, fewer adverse drug events, and better-informed treatment decisions. For too long, healthcare has lagged behind in exploiting the clear benefits of information technology,” Ms Wells said.
However, issues and concerns would remain to be addressed, especially enforcing law protecting security and privacy.
Australian Digital Health Agency CEO Tim Kelsey says, “Strict privacy control, set by an individual, is a central feature of My Health Record. Each person can control the information in his or her My Health Record, and the healthcare provider organisations that can have access.”
Ultimately, patients will be the biggest beneficiaries of this framework development.
Now under the framework, My Health Record system data may be linked to other datasets, such as the Pharmaceutical Benefits Scheme (PBS) or the Medicare Benefits Scheme (MBS). This is a great opportunity for the medical device sector.
Ian Burgess, CEO of MTAA said: “The development of My Health Record will provide a tremendous opportunity to improve data collection across the whole health system and across the patient journey. We believe the government should prioritise consideration of the inclusion of medical device data in the My Health Record,”
“This would allow for improved post-market surveillance. While registries can be invaluable they’re complex and expensive. Ultimately, My Health Record should be the main data infrastructure system, rather than maintaining separate data collection systems,” Mr Burgess said.[/vc_column_text][/vc_column][/vc_row]
PRIVATE HEALTH INSURERS NEED TO FOCUS ON VALUE
[vc_row][vc_column][vc_column_text]As Sydney Morning Herald reporter, Esther Han said earlier this week “it appears the federal government’s private health insurance reforms – including cutting the cost of devices on the prostheses list and allowing insurers to offer discounts to young adults – have done little to stem the flow of members heading to the exits.”
CEO of the Medical Technology Association of Australia (MTAA), Ian Burgess, said under MTAA’s Agreement with the Government to reform the Prostheses List, the MedTech industry is incurring revenue cuts of $1.1 billion which goes directly to the private health insurance companies to improve the affordability of private health insurance.
“APRA quarterly figures show that private health insurance benefits paid for prostheses decreased by 13%, saving the private health insurance industry $72 million in the March quarter alone.
“We’re the major reason this year’s average private health insurance premium increase was the lowest in 17 years,”
“MTAA strongly supports the need for a healthy and viable private health insurance sector in Australia, however private insurance needs to provide consumers value and that value needs to be better communicated. This value currently includes the choice of medical technology that a patient’s treating doctor considers to be the most clinically appropriate, generally with no gap payment applying to that technology,” Mr Burgess said.
The latest APRA data shows that in the 12 months ending March 2018, private health insurers increased premium revenue by 4% and retained more of that revenue, with total benefit payments increasing by just 3%. As a result, gross margin increased from 13.6% to 14.41% and profit before tax increased by 3.9% to $1.8 billion.
Private health insurers have managed to consistently increase margins and profit levels, compared to three years ago profit before tax has increased by 20%.
Referring to Roy Morgan research that in the year to March 2018, an estimated 256,000 people decided not to renew their private health insurance, Norman Morris, Industry Communications Director, Roy Morgan said “there is major doubt among many members regarding the current value to them of retaining their private health insurance. It is up to the health funds to communicate the value of having private health insurance”.
“Our research on member satisfaction with private health funds has shown major differences in satisfaction across funds and as a result the poorer performers could learn from the top ones and so improve their chances of member retention,” Mr Morris said.
While the latest APRA data for the year to March shows a decline of 36,742 in the number of people with hospital insurance and an increase of 52,977 in those with general insurance (extras), these represent net movements (exits and new). The Roy Morgan data represents an exit rate in the order of 1.9%, which is broadly in line with industry modelling published by the Department of Health.
The APRA figures show the number of people with hospital cover as a proportion of the population is continuing to decline – down another 0.1 per cent in just three months to 45.5%.
Private Healthcare Australia CEO Dr Rachel David said: “In fact more Australians than ever currently hold PHI. What people say they might do and what they actually do can be quite different and our research has repeatedly shown than 80% of people with PHI value it and want to keep it.
“Of course, members are concerned about rising premiums and out-of-pocket medical costs but they also understand that premiums are rising because the funds are paying for more healthcare,” said Dr David.
“We are working with the government and stakeholders to improve affordability by addressing issues such as cost-shifting from the public sector, low-value and wasteful care, fraud and compliance issues with the MBS”, Dr David said .
Meanwhile the Australian Private Hospital Association (APHA) pointed out the statistics released this week showed a 4% increase in privately insured patients treated in public hospitals this quarter.
CEO of APHA Michael Roff said this means more than 800,000 public hospital episodes of care were funded through private health insurance in the past 12 months, resulting in health insurers unnecessarily paying out $1.1 billion to public hospitals and forcing premiums up.
The increase of private patients in public hospitals is costing the private health system $1 billion, further evidence of real “fat in the system”.
“It means more people without the ability to pay for private health care will be left waiting for their surgery. We know that public hospitals let private patients jump the queue, with public patients waiting twice as long for treatment compared to insured patients. So the more private patients they treat, the longer public patients have to wait,” Mr Roff said.
Earlier in the week PulseLine was present when Shadow Minister Catherine King MP delivered her Post-Budget Briefing speech at the Australian Institute of Policy Studies to a full room in Sydney. She made it clear that for Labor the priorities are threefold – Medicare, public hospitals and private health insurance.
Labor has already announced our policy to task the Productivity Commission with an inquiry into the private health system, and to cap premium increases at 2% for two years.
“This policy was driven by two messages that we heard over and over in recent years.
“The first was from consumers, who told us that private health insurance premiums have become unaffordable. And they’re right – premiums have increased by 27 per cent since 2014 – costing families an average $1,000 more. Health insurance is now a leading cost-of-living concern – right up there with energy bills. Hospital cover has dropped to its lowest level since 2011. This is a worrying portent for the future viability of this industry. But private health insurance is still a product that Australians want – and rightly so.
“The second message we heard loud and clear was from the private health insurance industry itself. It told us that governments and regulators needed to step in urgently to turn the tide. We agree. And so while Labor’s policy prescription is different than the insurers’, we have the same aim: to maintain private health insurance coverage and the unique balance between our public and private systems, said Ms King.
Ms King pointed out that it has been 20 years since the Productivity Commission has reviewed the private health system in and despite recent reviews, reforms and Senate inquiries it has barely scratched the surface of the complex private health system.
The APRA publications provide industry aggregate summaries of key financial and membership statistics for the private health insurance industry. Key performance statistics for the private health insurance industry in the year ended 31 March 2018:[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image=”1989″ img_size=”full”][vc_column_text]Reform in healthcare is clearly a hot issue and will continue to be as we hurtle towards the next Federal election.[/vc_column_text][/vc_column][/vc_row]
