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#UNITEFORPARKINSONS

11 April 2017

200 years ago [in 1817] Dr James Parkinson wrote the classic An Essay on the Shaking Palsy – and Parkinson’s disease [PD] was recognised as a health condition.

Tuesday 11 April is World Parkinson’s Day.OD05200 Twibbon V1 NM

Both milestones are important and in honour, we are proud to show our support for #UniteForParkinsons – a global campaign aimed at raising awareness for PD, and uniting an active global Parkinson’s community.

PD is a complex, progressive and degenerative neurological disorder that causes loss of control over body movements. It impacts more than 70,000 Australians, with 32 Aussies diagnosed with the disease every day[i].

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A fellow supporter of #UniteForParkinsons is Peter Raymond, who has lived with PD for more 15 years. Tonight, he will share his experience with PD and deep brain stimulation with the US Consul General at an event celebrating the role of medical advancement in improving health outcomes. You can read Peter’s story here. 

For more information on the #UniteForParkinsons campaign visit uniteforparkinsons.com.au.

[i] https://shakeitup.org.au/understanding-parkinsons/.

Peter’s Story | Parkinson’s disease

10 April 2017

Peter Raymond wasn’t keeping up with the other members of his cricket team; he found himself dosing off at traffic lights in warm weather; and he’d bought an electric toothbrush because he didn’t have the strength to brush his teeth.

Tennis elbow; bad posture as a result of poor ergonomic desk design; arthritis; fatigue – Peter knew he didn’t have any of these, and he wasn’t suffering from ‘old age’ either. But the constant physio appointments he needed to make, coupled with the mountain of anti-inflammatory pills he was taking in an effort to curb his symptoms, signaled to Peter – a man who rarely fell ill – that something was up.

The physio and pills continued for 10 years. Then Peter  visited his GP who asked three seemingly simple questions:

  1. Could he squeeze the doctors hand – not with much pressure;
  2. How neat was his handwriting – it was indecipherable;
  3. Did he swing his arm when he walked? – no.

It took his GP five minutes to diagnose what had been bothering Peter for a decade. It was Parkinson’s disease.

For Peter the diagnosis was a relief – for Peter’s family it signalled a time of adjustment. According to Peter:

“When I told my family you could have heard a pin-drop. It was probably hardest on my son with whom I also played local cricket. It was the first acknowledgement that his dad wasn’t invincible. My wife simply said, ‘Dad is the same person he was before he was diagnosed with Parkinson’s disease.”

“It really came down to that – I was the same person, just a bit slower and my family needed to learn tolerance. I have stopped some things, but have also taken up new activities to replace these. For example, I’ve replaced my cricket and tennis, with indoor soccer and basketball. I became a civil celebrant so I could oversee my daughter’s wedding, and I joined community groups to become President of ‘Parkinson’s Victoria’ and sit on the Board of ‘Parkinson’s Australia’. I’m still active – just in different ways.”

When Peter told his team mates at the local cricket club of the diagnosis, they admitted they had thought something was up but had put it down to ageing. His team had noticed he carried his right arm when he ran and couldn’t take a high catch – two important aspects for Peter as a wicket keeper/batsman.

In the beginning, Peter considered himself in good health, largely unaffected by the symptoms of PD. He remained active, albeit on medication for more than a decade. Over time the medication increased from one pill per day to around14-15 and he experienced dyskinesia. It was at this point Peter raised the option of Deep Brain Stimulation (DBS) with his neurologist.

Peter was considered a ‘good candidate’ and so the journey towards DBS started. In all about two years passed between the time Peter first raised the potential for DBS and his surgery. A point Peter says reinforces his advice to people diagnosed with PD considering DBS; “Don’t wait. Years ago the thinking was to keep DBS up your sleeve, but it shouldn’t be a last resort. I didn’t want to get to 70 and then be told there was something that could have helped.

“For me it is a quality of life issue rather than a health issue. It’s about being able to spend quality time with my five grandsons. It’s about being active in the community and maintaining that sense of self-worth people attribute to giving back either at work, with their families, or through their community groups/clubs. I intend to be around for a long time to see my grand kids grow up.”

Peter is also keen for people to understand that every person’s DBS journey is unique. The key is embracing the journey and enjoying the people you get to know along the way. The decision to have DBS is a serious one, but it should not be feared.

“Right from the start I had a brilliant result. Almost immediately my medications reduced to just one pill a day; I had no dyskinesia; I was getting a good night’s sleep (when I hadn’t slept properly for years) and within four days I was out of hospital at the Parkinson’s Walk in the Park.  Life was good. Two years on – it still is.

CGM FUNDING IS HERE

1 April 2017

Prime Minister Malcolm Turnbull has fulfilled the Coalition’s pledge to spend $54 million subsidising continuous glucose monitoring [CGM] for eligible Australians with Type 1 diabetes. The promise, originally made on 15 May 2016, will be fulfilled from 1 April 2017 for Australians under the age of 21 who meet specific criteria.

This decision reflects years of effort by members of the diabetes community. We congratulate everyone involved.

Funding will apply to Medtronic CGM products used with a Medtronic Insulin Pump or standalone CGM with the new Guardian ™ Connect

This is a positive first step in improving diabetes management within our community. However, we realise that it does not provide CGM to everyone and that it should be a continued priority of our community to improve access to all who may benefit. For people who are not eligible, Medtronic will continue to offer CGM subscriptions packages.

The eligibility criteria for the ‘CGM Initiative’ announced is available here and listed below.

 

 

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ABOUT CGM TECHNOLOGY

CGM measures and indicates glucose levels continuously [24/7] to assist in monitoring. It can be used by type 1 and type 2 diabetes patients who would like better glucose control to improve the health and quality of their lives – and can help to take the guesswork out of glucose monitoring.

There are two ways patients can benefit from Medtronic CGM

  • With an insulin pump. With CGM and the Medtronic Veo or MiniMed 640G Insulin Pump, insulin delivery can be automatically stopped to reduce the occurrence or severity of hypoglycaemia1,2. Patients have the ability to set alerts to warn about highs or lows, and will see the full picture of glucose levels 24/7 on the device.
  • Without an insulin pump. Guardian™ Connect CGM delivers real-time glucose information direct to the user’s iOS device3. The user (and any care partners i.e. family members/carers or healthcare professionals) can be alerted if they’re heading towards hypoglycaemia or hyperglycaemia.

This is important because people who are hypo unaware are six times more likely to have severe hypoglycaemia leading to seizures, coma and even death.[i] Having hypos leads to more hypos and the increased risk of these severe events.

Medtronic have four products available through the CGM Initative; the Enlite™ Sensor, Guardian™ 2 Link, MiniLink transmitter, Guardian Connect™ CGM. CGM technology enables a user to monitor glucose levels 24 hours a day through a sensor.

The varieties of Medtronic CGM in Australia

CGM technology

[i] Prevalence of impaired awareness of hypoglycaemia in adults with Type 1 diabetes. Geddes J, Schopman JE, Zammitt NN, Frier BM. Diabet Med. 2008 Apr; 25(4):501-4

Apply Now: Medtronic Infection Control Scholarship 2017

29 March 2017

Encouraging collaboration amongst the Infection Control community, Supported by the ACIPC

Hospitals and Healthcare providers around the world continue to strive to reduce healthcare-associated infections. We care about helping to reduce infections and improve patient outcomes too.

With support from the Australian College of Infection Prevention and Control (ACIPC), the Medtronic 2017 Infection Control Scholarship has been designed to encourage Australian and New Zealand healthcare professionals with an interest in infection control, to share their successes and innovations in infection control and receive support for further work in this area. The scholarship is to support critical infection control projects to ultimately enhance patient safety and assist best practice procedures and work place outcomes.

The annual scholarship was established in 2006 and has awarded over $320,000 to projects in healthcare associated infection surveillance and management along with support areas including clinical governance, research, training, poster/paper presentations at conferences and post graduate education in the infection control space.

Funding will be awarded across three categories:

  • Major Research Project: Two grants for research project requiring funding up to $15,000 (Total Award = $30,000).
  • Minor Research Projects: Two grants for research projects requiring funding up to $5,000 will be awarded (Total Award = $10,000).
  • Educational Grant: $10,000 in grants to further educational requests related to Infection Control such as conference/oral presentations at either national or international conferences

More information on the scholarship and how to apply is here and on the ACIPC website.

The application form is available here.

Applications close Friday 31 March. If you have questions please contact: Aust.Infection.Control@Covidien.com

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What’s all the fuss about the PL?

23 March 2017

In recent weeks we’ve heard a lot about the Prostheses List [PL] through a Senate Inquiry titled “Price* Regulation Associated with the Prostheses List Framework”. So what is it and why is getting it right so important in determining how Australians benefit from medical innovation.

For almost 45 years, Medtronic has been part of the fabric of Australian healthcare and throughout this time we have remained entirely focused on getting medical devices to patients who will benefit.

We believe this Inquiry represents an important opportunity to ensure that we get the right product, to the right patient, at the right time, now and for generations to come. The PL delivers simultaneous surety to patients with Private Health Insurance [PHI] and choice for clinicians, but we need to do better – we need to bring the PL into the 21st Century.

To this end the Government has undertaken a number of measures including some targeted cuts to the PL. The impacts of these cuts are still being realised, but there will be consequences to services delivered. We strongly believe that before any further adjustments, a process using existing PL structures to address remaining issues should be established. This involves expansion to include high value, high tech items that do not meet the current criteria. Rash attempts to use a blunt instrument to address any real or perceived problems will jeopardise the value of PHI.

We know that reform must:

  • Improve value to patients;
  • Encourage innovation and process improvement;
  • Ground value for patients in agreed quality and outcome measures;
  • Manage chronic disease;
  • Align concurrent Government reviews of the health system; and,
  • Be transparent and consultative.

Medtronic is focused on delivering patient outcomes, through appropriate access to medical technology. We support the desire to improve the value of PHI on the premise that improved value translates to improved patient outcomes and a healthier Australia. It must not strip value from PHI members, by focusing on the bottom line of insurers. If the pursuit of health reform is masqueraded as ‘dollar capture’ no one wins.

We accept and support the need for thoughtful and consultative reform and to the credit of the Government this process is underway through the newly revised Prostheses List Advisory Committee and its workstreams. We also accept that the investment in medical devices is considerable – but they do deliver significant value back to the community. Medtronic believes that for every dollar spent, appropriate access to medical technology delivers back in terms of improved patient outcomes, savings to the health system, and the community wide benefits of people actively playing their part within the community, whether through return to work or otherwise. Globally, we invest approximately 1.8BN in research and development every year to continue to make these technologies even better.

Medical technology is getting smaller, smarter and less invasive, if the PL is not reflective of this, we risk compromising the high standards we all expect from the Australian healthcare system, and the standards we set for ourselves as leaders in our industry. We haven’t even touched yet on the need to expand the PL – watch out for another blog on this.

We know what we need to do to work towards reform, but this Inquiry is also about the value that private health insurers deliver. Medical device companies and private health insurers both have commercial interests to protect and enhance.  Our hope is that in the pursuit of perceived cost savings, the patient is not forgotten and that those Australians seeking certainty in delivery of healthcare are fully supported to live well.

PHI is confusing. Access to medical technology is not.  It is critical we have a viable and affordable PHI Industry in Australia in order to continue this delicate balancing act.  There is no system in the world that provides the breadth of cover, access and choice in healthcare as equitably across the population as Australia.  The PL is an important part of that balance.  We are committed to its appropriate reform.

* Note: The title of this Review includes reference to ‘Price Regulation’, but when we talk about the PL it isn’t actually a ‘price’, it is a benefit for PHI members when they go to a hospital to receive lifesaving and/or enhancing medical devices.

Wondering about the value of PHI?

22 March 2017

Between last week’s Senate Inquiry* and the current focus on renewing annual private health insurance [PHI] policies, the value of PHI is under the spotlight. So how is value really delivered?

We believe it comes down to ‘choice and access’. PHI provides consumers control and choice over the timing of treatment, clinician and services – compared with accessing healthcare through the public system. For HCPs, the PL arrangements provide a wide range of clinically effective medical technology with certainty of costs for all parties.

Only HCPs – in partnership with their patients – should have the right to choose the most appropriate medical technology or treatment option. In a Galaxy Research poll[1], it was almost universally acknowledged that implantable medical devices are important in promoting better health [99 per cent] and quality of life [100 per cent]. In Australia there is considerable confidence in the ability of doctors to choose a device suitable for the needs of the patient; as many as 82 per cent of respondents believe that the doctor should be responsible for the selection of the medical technology that is implanted.

Any significant restriction in the ability for clinicians to choose the best device for their patient diminishes the value of PHI for the consumer. So what happens when a medical device isn’t included on the PL because the PL in its current form has failed to keep up with medical evolution?

Health funds are not required to reimburse non-implantable medical technologies used in hospital procedures, which often leads to limited or no funding for these devices. Technologies that do not meet the criteria of the PL include:

  • Catheters used for ablation of Atrial Fibrillation [AF] [one of the most common reasons for emergency room visits in Australia],
  • Drug Coated Balloons for a range of vascular blockages [which can replace stents that remain in the body and are currently covered on the PL]; and,
  • Ablation Catheters to treat Barrett’s Oesophagus [which can lead to cancer, radical surgery to remove the oesophagus and death].

These are just three examples – there are more, with the potential to benefit large numbers of Australians. And it’s not just the patient numbers that are large. Consider AF – AF is a leading cause of stroke. Stroke costs the Australian community more than $5 billion each year. The total PL is significantly less than half of this… and that’s just one unfunded technology. Imagine the potential, the patients and their families we could help through reform of the PL and greater access to currently ‘unfunded’ technology.

The PL arrangements should be expanded to incorporate non-implantable technologies [including diagnostic and monitoring technology] that that provide improved health outcomes, cost savings and / or efficiency gains and are aligned with best clinical practice. This would support the use of medical technology based on the most appropriate treatment option rather than the availability of PHI coverage.

As part of the PL reform activities, there is now opportunity to address this anomaly to improve patient outcomes, reduce health system cost, and enhance value to privately insured patients. We hope this is achieved so that the right product gets to the right patient, at the right time.

In the meantime, if you take out PHI, it’s important to be assured you are covered for all appropriate treatment options and to discuss the best option with your doctor.

Note: *The title of the Inquiry is “Price Regulation Associated with the Prostheses List Framework” The title includes reference to ‘Price Regulation’, but when we talk about the PL it isn’t actually a ‘price’, it is a benefit for PHI members when they go to a hospital to receive lifesaving and/or enhancing medical devices.

[1] Galaxy Research. Medical Devices Study. Prepared for Medtronic Australasia. May 2015 eive lifesaving and/or enhancing medical devices.

 

VALUE IN HEALTH CARE

20 March 2017

Contribution by Ross Forbes, Director Corporate Accounts, Medtronic Australasia Pty Ltd

Value is one of those terms which seem hard to define. Is value objective or subjective, or a combination of the two? In who’s eyes is value being measured and by which standard metrics?

However, once value is viewed from a patient’s perspective, then clarity of value becomes more defined. Patients can see value as “being able to walk down stairs”, “being pain free “, “able to go back to work”, regaining feeling” “able to pick up the children,” “not be breathless playing golf”, there can be hundreds of examples of the outcomes patients value.

There is a momentum in healthcare, a transformation in relation to patient value, and the key is being able to understand what it is a patient values and moving toward delivering interventions which reflect that value. Value based care has as its centre, the outcomes patients care about, and understands the cost of those interventions required to deliver those outcomes.

All players in health care delivery have a responsibility to understand how they affect the outcomes patients care about, and be involved in understanding the costs to delivering those outcomes.

This will lead to a truly transformed health care system, with tangible value throughout the delivery of healthcare, with patients receiving outcomes which they value.

Medtronic is committed to ‘aligning value’, by collaborating across the health system to ensure patient care is efficient, connected, and coordinated.

Share your thoughts below. Remember to follow us on twitter @MedtronicANZ.