Digital Healthcare Today


Mobile phones are no longer just about making calls, they are about finding information and images, sharing insights and managing lifestyles. Mobile phone applications (apps) – whether for iPhone or Android are the latest tool to help the public access, aggregate and consolidate lifestyle related information.

Over a thousand people in Australia were interviewed in 2010 by The Mobile Industry Group and 41% said they had downloaded an application.[1] More than a third of those had downloaded at least one from the category of ‘health and fitness’.

Healthcare Apps







Example Health and Fitness Apps

Smartphone Apps and Pharmaceutical

The majority of medical apps worldwide are aimed at a broad market (such as lifestyle and health tools) but there is a growing number of apps that deliver direct support to those suffering from a particular condition and many of these are created by pharmaceutical companies for specific countries.

With apps, pharmaceutical companies in particular are creating a portfolio of services and support around their products that they can offer to patients and non-patients alike. The benefits for patients are clear – they can receive immediate information, which is personalized and shareable in order to better manage their condition. Patient apps can be broadly classified as:-

1) Dosage Calculators & Medicine Management: Includes personal medical record storage applications, tracking medicine history, appropriate compliance and encouraging patients to take medication correctly

2) Discovery Tools: Applications on symptom management: support group, healthcare professional and resource locators

3) Education Aggregators: General information on weight loss, specific diseases, or broad grouping of information about symptoms and conditions

Examples of benchmark applications to support patients include:-

1) iManage Migraine by Merck & Co. enables patients to learn about migraines, potential triggers and understand the treatment options. The patient can track information in an interactive migraine journal, which can be used to aid discussions between the patient and healthcare provider to help reach an effective action plan for managing migraines.

2) Novartis’ VaxTrack provides parents with one convenient place to store information about their family’s vaccination records. The built-in locater can source local pharmacies for flu jabs and record insurance information.

What Are The Benefits?

Much of the discussion around apps is around potential – they are not currently heavily downloaded and reviewed, but with the growth of tablets and more smartphones this is likely to change. Companies wishing to build deeper relationships with patients and healthcare professionals can add value to their product offering and deliver real support in disease and lifestyle management:-

1) Support specific outreach and healthcare campaigns – For instance to patients suffering from a specific clinical condition, those wanting to improve their health or increase their activity levels

2) Provide a practical support for patients and healthcare professionals – In gauging dose levels and tracking dose history (patient compliance)

3) Deliver insight and education for the broader community – Offering deep and relevant information or access to specialists

Applications – whether free or paid for will become a lasting engagement tool. They are useful, not heavily branded and empower the patient.


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Info on the move: Top medical podcasts


Recently, the British Medical Journal launched an iPad app – the first general medical journal to do so! This is truly a sign that the health world is embracing medical information ‘on the move’. The app ‘combines the weekly BMJ print journal selection of research, comment, and interactive education, along with live feeds of the latest news, blogs, podcasts, and videos’.

Useful health poscastsThe launch will be welcomed by doctors and nurses armed with tablets and smart phones, who are now more mobile than ever before – particularly those in remote and rural areas.

This mobile medical education, however, is about podcasting as much as it is about apps.

Mainstream sources of medical- and health-related podcasts include key international medical journals, such as the New England Journal of Medicine and the Lancet, as well as the World Health Organisation and the Cochrane Library.

Podcasts are also increasingly being used in medical schools, including for downloadable libraries of high resolution heart and respiratory sounds.

Interestingly, a recent survey of student nurses found podcasts allowed greater control over their learning, helping them gauge their individual learning needs and build their understanding of complex topics.

Here are five top audio resources specifically relevant to clinical practice in Australia (although there are surely many more worthwhile resources!):

1.       ABC’s The Health Report – Jargon-free, easy-to-understand information and analysis on health and medical matters, considered within social, scientific and political contexts – presented by Dr Norman Swan.

2.       ABC’s Health Minutes – 60 seconds of straight talk covering the latest in medical research.

3.       Australian Family Physician – Interviews with authors from the official peer-reviewed journal of the RACGP

4.       Australian Government National Health and Medical Research Council – Updates on Australia’s major health and medical research issues from the people who shape them.

The rise in popularity of audiovisual media in medical education will likely continue as society moves to using more audio and video and physicians strive to keep current in an era of evidence-based practice. Some futurists believe that we are entering a post-textual period of the Web and that there will be an even greater demand for audio and video content in the future.

Dean Giustini, UBC Biomedical Branch Library, Canada

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Nursing Australians back to health


This week marks a landmark moment in Australia’s healthcare system when a key item in the Government’s health reform plans is fully realised.  In a major change that will affect nurses – but also GPs, patients and the pharmaceutical industry – nurse practitioners and midwives will now have the power to access specific Medicare Benefits Schedule (MBS) items and prescribe certain medicines subsidised on the Pharmaceutical Benefits Scheme (PBS).

The change in legislation recognises the highly-skilled and capable Australian nursing and midwifery workforce, providing a new framework to enhance and expand their role in providing quality healthcare.

Nurse prescribing is common practice overseas. The UK has seen a significant shift in the last two decades in nurse prescribing – which started in the 1990s when community based nurses were able to prescribe independently from a limited formulary. Since May 2006 independent nurse prescribers have been given the ability to “prescribe any licensed medicine for any medical condition within their competence.”

With this local shift in prescribing power now happening in Australia’s healthcare system, divisions in opinion and the murmur of a ‘turf war’ were always going to be inevitable. Great effort has been made to ensure the change in legislation preserved the requirement for nurse practitioners and midwives to work in collaboration with medical practitioners to access the MBS and PBS – essentially ensuring GPs are ‘kept in the loop’.  The AMA has gone to considerable lengths to help GPs prepare for the changes asking them to ‘embrace the changes’ or risk the possibility of jeopardising the mandated collaborative arrangements.

Importantly everyday Aussies are reportedly supportive of the Government’s move. Research just released by the Australian Primary Health Care Research Institute (APHCRI) has shown Australians know the difference between being sick and needing a doctor and those “everyday health concerns” when a nurse practitioner would suffice.

Responses to the ongoing APHCRI survey has stated nurses are “good listeners” and could cater for “everyday health concerns, such as repeat prescriptions and minor illnesses, to free up GPs to manage more complex conditions.”  Shorter waiting times and better access to primary care has been identified as important advantages.

There is no doubt this represents a major milestone in Australia’s healthcare system. Ensuring this significant move enhances the delivery of best possible healthcare to Australians will be critical.  Time will tell whether or not we can indeed reach the levels of contribution nurse practitioners are making in the UK.

Big changes for Aussie nurses...

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It’s time we balanced the ledger


Let me introduce you to Gerald, a 12 year old living in the small outback NSW town of Bourke – population 1,800. Gerald loves fishing, Rugby League (he barracks for the Penrith Panthers) and lives with his Mum, Dad, Nan, brothers – Steven (14) and Adrian (5), and sisters – Becky (3), Isabel (1 ½) and Ruthie (two weeks old).

Gerald is an Indigenous Australian. As we are unfortunately aware, Australia continues to retain developing world standards when it comes to the health of Aboriginal and Torres Strait  Islander people. In fact, Aboriginal Australians rank 103rd on the United Nations Index of Human Development (which considers life expectancy, literacy, and standard of living) compared to all Australians, who come in 4th.

Gerald’s Dad, Shaun, is 45 years old and suffers from diabetes and kidney disease. Last week, Gerald travelled 300km to the ‘big metropolis’ of Cobar (population 5,200) for his first-ever visit to the dentist (two adult teeth were removed and three fillings added). Little Ruthie was born with a low birth weight and has an 80 percent chance of developing hearing problems before her 5th birthday. And Nan (60), who has been suffering dementia for six years, was admitted to the local hospital two weeks ago where she will spend the rest of her days.

It’s time we balanced the ledger when it comes to Aboriginal health

It’s time we balanced the ledger when it comes to Aboriginal health

Indigenous health is an issue high on the agenda of the Public Health Association of Australia’s annual conference, which kicked off last week in Adelaide.

According to the Australian Bureau of Statistics (ABS), the health of Indigenous Australians is inequitable when compared to the rest of the Australian population. The rate of suicide in the Indigenous population is more than three times the non-Indigenous population. The burden of disease and injury for Aboriginal people is 2.5 times the level for non-Indigenous Australians, and dementia rates for older Aboriginal people are five times more than that of non-Indigenous Australians.

What’s more, Indigenous children born in Australia are three times more likely to die before the age of five than non-Indigenous children – survival rates similar to that of Cambodia. Indigenous men and women can expect to live 11.5 years and 10 years respectively, less than their non-Indigenous neighbours.

A harsh outlook this may seem – but it is the reality for 562,681 Indigenous people living in Australia.  So how and when will we Close the Gap 

Last week, the previous Indigenous health minister – Warren Snowdon – was reinstated along with the Indigenous health portfolio as a result of public backlash.

One way to tackle the appalling statistics is to produce more Indigenous doctors. 150 Indigenous Australians are studying medicine in universities across the country – a move in the right direction. And 420km up the road from Bourke, the small rural town of Wilcannia has struck a pioneering agreement with the federal and NSW governments to set-up Indigenous-run small businesses, in addition to improving health services by establishing nurses in schools and setting up better healthcare for pregnant women. Gerald and his family have fingers and toes crossed that Bourke will soon follow suit.

We need to see proactive strategies based at ground level and focused on the premise of community education if we are to see any genuine improvements in the state of Australia’s Indigenous health.

When the health of some Australians is comparable to that of people living in third world countries we must commit to real change to close the gap and dissolve all inequities.

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Keeping it real


Certified_organicIf the saying is true, and ‘you are what you eat,’ is it a case of organic best, chuck out the rest?


Is the hype surrounding organic food just that- all hype?

Here at Cube, we’ve certainly dipped our toes in going au naturale. Sunflower seeds, carrots, liquorice (an office winner)…  the list goes on. In fact, you name it, we’ve tried it- the ‘certified organic’ sticker has been a star feature in the office for months. 


Yet when we got hold of a University of Sydney study that showed only a slight nutritional benefit in eating organic versus non-organic produce, we Cubans started to question our nutritional ways. If going organic is no healthier, yet considerably costlier, are we just suckers to the latest food craze? When an apple tastes like an apple, is it worth the extra $1 to go organic?

Not so fast….

The Biological Farmers of Australia (the experts should know best, right?) claim that eating organic may help us live longer. What’s more, the largest study into organic food, published in 2007, found that organic fruits and vegetables contain between 20 and 40 per cent more antioxidants than conventionally grown produce.

Presented with two sides of the coin, we decided to dig deeper.  

There’s lot of confusion about what constitutes organic. In Australia, there are currently 7 different organisations that certify (and label) organic products. What’s more, up until October last year, there wasn’t even a legal definition of the word ‘organic’- as long as a product wasn’t ‘certified,’ it could be labelled organic.

Thankfully, there is now a domestic Australian organic standard, which bans the use of fertilisers, pesticides and genetically-modified material. The only downfall is that the standard is voluntary, so it comes down to the Australian Competition and Consumer Commission (ACCC) to prosecute those who don’t comply. The Organic Federation of Australia (OFA) is pushing for one standard logo.

For the moment, as long as buyers pick products displaying one of the 7 logos, they can be sure their organic pickings are chemical-free- which can’t be a bad thing.

So, after a number of internal office debates, it seems we’ve come to a collective standpoint:

We like organic. In an age when everything is overly processed, there can’t possibly be any harm in ‘keeping it real.’

So, the organic stickers continue their domination in our home and office pantries, and it seems we’re not alone in our quest to go natural. Last weekend’s Organic Expo and Green Show  saw more than 8,000 visitors venture to the Sydney Convention and Exhibition Centre in Darling Harbour in search of all things chemical-free.

So, if you too are considering giving organic a go, here are a few suggestions:

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Tic tac toe. Who’s going to give Australia’s mental health a go?


THE ELECTION – it’s THE ‘hot topic’ dominating news headlines, coffee shop banter and online forums. Australia’s mental health has emerged as an issue with potential to derail the major parties. So are the parties bringing enough reform to the table to swing votes their way? 

 Mental health is Australia’s third largest health issue behind cancer and cardiovascular disease. Mental illness is the Is mental health a priority? leading cause of death for all Australians under 45, more than road trauma and binge drinking. It affects 1 in 5 Aussies and is predicted to be one of the world’s largest health problems by 2020. Such statistics can be overwhelming, however, let’s not dwell on why mental health has been relegated to the health backburner; let’s focus on escalating discussion, taking action and moving forward!

Currently, just 6 per cent of the health budget is devoted to mental health and only a third of those suffering will receive access to mental health care. Australian of the Year, Patrick McGorry has used his notoriety to give a voice to those shouting for change, particularly as 2,500 Australians die each year due to mental illness.

McGorry states that the best way to show the Australian community that mental health really is a priority for the Government is to invest in mental health reform and provide Australians with access to genuine 21st century mental health care. 

Recently the Western Australia state government appointed the first ever Mental Health Commissioner and Melbourne played host to the world’s inaugural International Youth Mental Health Conference – both small steps in the right direction.

An analysis of the major political parties’ election promises on mental health, conducted by national charity SANE Australia, has found that both policies lack vision and take a narrow and superficial view  of the complexities of mental health. SANE Australia has challenged the major parties to commit to ‘real action’ and ‘move forward’ promptly if elected.

Everyone who needs help for mental illness should get treatment and support as early as possible, for as long as needed, and in the community where they live.

In Australia, this is far from the reality of people with mental illness – says the Executive Director of SANE Australia, Barbara Hocking.

2010 is a pivotal year for mental health in Australia. Just last week, two dozen organisations have written to both main party leaders demanding for true leadership on mental health. The announcement of an election has propelled mental health out of the policy shadows and into the election spotlight. However, sustained effort and investment will be required to keep people with a mental illness living well in the community. Hopefully this August we will finally be able to give Australia’s mental health the help it deserves.

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Competition or the cause?


A story about a well-known Australian with media connections voicing a Community Service Announcement (CSA) caught the eye of the Cube team last week.

The Daily Telegraph reported on leading Sydney radio station 2GB’s decision not to run a CSA for little-known charity Retina Australia because it used the voice of the charity’s NSW patron, Don Burke. The reason? As it turns out, Burke has a weekend gardening show on rival station 2UE.

2UE's Don Burke

2GB went one step further and declared it would not air any rivals’ voices on its airwaves.

Unsurprisingly, this decision provoked an emotional response from Burke, who claimed the decision was ‘deeply hurtful’, especially as his name is not announced and it’s just his voice. The article also jolted the newspaper’s online readers into action, attracting in excess of 40 comments, most of which supported Burke and dismissed 2GB’s position.

This decision by 2GB raises an important, often unasked question – should competitive issues be set aside in the Australian media when the aim of the communication initiative is to raise vital funds for a charitable organisation? Or is it fair to put the needs of business before greater benefit?

Celebrities are engaged by companies and charities to help highlight a specific health cause more often than not – and their involvement is particularly crucial for organisations like Retina Australia who are inevitably deemed less ‘sexy’ (and therefore un-newsworthy) by the media.

The decision on who to use is often based on a combination of the celebrity’s personal connection to the cause and ability to attract the desired media attention – referred to in journalist circles as their ‘media currency’. If the chosen celebrity also has a regular column in a magazine, or fronts a television program, this is usually viewed as a positive by-product of the agreement.

Ironically, Retina Australia has received far more publicity from the decision taken not to air their CSA than would have been achieved through simply airing the CSA itself. But the situation does highlight celebrity affiliations to media won’t always lead to widespread coverage and that, in some instances, it can hinder – rather than help – the ability of communications professionals to spread a valid, important message far and wide.

This highlights how important it is to consider media outlet competition as well as cause connections and media currency when drawing up the shortlist of celebrities for a campaign.

Tell us what you think below!

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If the Coalition gets into office, what could Australia’s health system look like?


What could the health system look like if the Coalition was in power?

What could the health system look like if the Coalition was in power?

With an election pending, there has been a lot of noise from the Opposition about potential policies and reforms. In a parallel universe, what would the Australian health system look like if the Coalition was in power?

Recent proposals  from the Federal Opposition include cutting funding from current Labor health reforms including…

  • Medicare Locals
  • GP infrastructure to upgrade primary care facilities 
  • A national e-health system
  • 24 hour GP phone helpline grants

…and using this cash to roll out a $1.5 billion plan to improve mental health services, including:

  • 20 new early psychosis intervention and prevention centres 
  • 60 additional Headspace sites for young people with mental illness  
  • 800 early intervention beds
The Coalition also announced a $35 million grant towards the establishment of a Clinical Trials Network for diabetes. This supplements the $5 million that former PM Kevin Rudd announced back in March.

Whilst Tony Abbott claims Labor has been inactive in mental health reform, Nicola Roxon was quick to hit back against the proposals, saying national hospital and health reforms will be at risk if Labor is voted out of office

“It’s very important we do not neglect mental health and one of the disappointing aspects of the Government’s health reform proposals is that there’s been so little on mental health.”

Tony Abbott

 “The Coalition’s policy is undermined by the fact it is funded by cutting Labor’s health reforms, such as GP super clinics and e-health.”

Nicola Roxon

What are the stakeholders saying?

The AMA is currently sitting on the sidelines and waiting for further updates on what funding would be left for GPs, whilst the Mental Health Foundation of Australia expects the Federal Government to announce its own mental health reforms in the near future.

Australian of the Year, Professor Patrick McGorry, has called on the Federal Government bring physical and mental health together under a new mental health plan, whilst speaking at the National Press Club last week.  

The Coalition said last week they would unveil their primary care policy before the election, in response to concerns about how much (if any) funding would remain for primary care.

With a few months to go until an election, there is plenty of time for further announcements, proposed reforms and complete u-turns, so watch this space!

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Lab-grown organs – is the future closer than we think?


Australian Doctor reported on some pioneering research this week – researchers in the US have successfully transplanted lab-grown lung tissue into rats that works like the real thing. The pipe dream of organically grown organs has long been discussed in medical circles, but this breakthrough led us to consider whether the future might be closer than we think?

For years, transplant surgery has been the primary way of replacing severely damaged organs. Yet transplantation is one of the most challenging and complex areas of modern medicine – doctors must battle with organ rejections and transplant failure, as well as a major shortage of organs.

In June 2008, the world’s first whole tissue-engineered organ – the windpipe – was successfully transplanted into a 31 year old lady in Spain. 18 months on, she is leading a near-normal life without the need for immunosuppressants.

In cosmetics, ‘Reconstituted Human Epidermis’ (aka lab-grown skin) is already a reality – made from discarded skin during surgery, synthetic skin is being used to test the irritancy of chemicals as an alternative to animal and human testing. The technique has taken 30 years to perfect.

In the last few months, research teams have successfully created biologic blood vessels, corneal tissue and intervertebral discs. Next will be the development of a full-sized, functional organs. Moving one step further into the future, new research is investigating ways to use this technology to repair tissues and might one day prevent organ failure altogether.

However this area is surrounded by controversy. Whilst the development of lab-grown organs may benefit medicine, the use of stem cells continues to influence public opinion on whether or not research should continue. What do you think?

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Will Gillard get health?


Last week’s departure of former PM Kevin Rudd and Julia Gillard’s ascent into leadership broke Australian news site traffic records. And with every other media outlet in the country still running red hot with Gillard news, it would seem almost unfair not to mention our new PM’s impact on health policy.
As a start, Julia Gillard has proficient experience in the area, serving for three years as the Opposition health spokeswoman during Abbott’s tenure as Federal Health Minister. She has also been involved in Rudd’s own ‘health revolution’.
A recent Galaxy poll shows nearly a quarter of us want to see a fast-track of the health reforms as a first priority. But what do the various industry bodies have to say about whether or not health policy will be given the red light by the new leadership?
The doctors
The AMA says that a leadership change is not likely to change the track of health policy. The group is also of the belief that Rudd’s National Health and Hospitals Network will remain in place.
The nurses
The ANF believes Gillard has what it takes to win the election – ‘Australians want a hospital, aged care and primary health care system that works and Labor has demonstrated a keen understanding of this’. The group also welcomes the first female PM into the fold.

The e-health experts
…say Gillard gets it and they look forward to see how the e-health agenda progresses.

The mental health advocates
Mental health experts are hopeful that our new leader will put mental health higher on the agenda. A great deal of momentum developed in the lead up to the leadership shake up, with over 60 organisations delivering nearly 100,000 signatories calling for an urgent focus on mental health – but this was unfortunately delivered to the wrong PM.

Professor Patrick McGorry sees this momentum as an incredible opportunity for the Gillard Government to take action and score some ‘brownie points’ in the lead up to the election.

But watch out Julia – Tony Abbott just pledged $1.5b to improve front-line mental health services if the Coalition is elected.
Health got a mention in Julia Gillard’s acceptance speech (video below, in case you missed it). Will this enthusiasm translate into action?

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