Wednesday, October 14, 2015

This Speech Provided Some Alarming insights To The Governments Thinking On The PCEHR.

I almost missed this article last week.

Case study to watch: how to improve ehealth record take-up

by David Donaldson

06.10.2015
An opt-out system could arrest continued low engagement with the government’s My Health system. The deputy secretary in charge says having critical mass will help convince providers to engage too.
Australia’s progress towards a widely subscribed national ehealth system remains slow, with only around 10% of the population enrolled with the government’s opt-in My Health Record system and low uptake by health practitioners.
Due to low engagement rates following its creation as an opt-in system in 2012, the Health Department plans to recommend the government adopt an opt-out policy from 2017, Department of Health deputy secretary and strategic health systems and information management special adviser Paul Madden told a Committee for the Economic Development of Australia event last week.
Madden said that the government would be advised to go for a national opt-out system in line with prior recommendations subject to the results of regional trials to take place in 2016. Transferring to opt-out was recommended by a December 2013 review into the Personally Controlled Electronic Health Record (PCEHR) system.
PCEHR — which is being rebranded by the Coalition government as the My Health Record system — allows doctors, hospitals, and other healthcare providers to view and share an individual’s health information to assist in their care. This will facilitate access to records for patients no matter where they go to the doctor and should especially assist those who visit multiple providers for the same problem — potentially reaping significant benefits given the increasing chronic health challenges faced by the community.
…..
But progress remains slow. While the review recommended opt-out be introduced from the beginning of this year, legislation allowing for the regional trials and eventual national transition was only introduced to the parliament last month.
Nonetheless, although it “needs some tweaking” and usability changes, “the good news for our government is they’re not up for a really big system build,” said Madden. “The system exists, it’s been there for three years.”
And it’s been improved from where it began. Whereas the prospective customer needed to endure clicking through 17 screens to prove their identity when it was first created, the system is now down to two.
It is expected that putting records online could save the Commonwealth $2.5 billion per year within a decade by reducing inefficiencies, with an additional $1.6 billion in annual savings also delivered to the states, according to the government.
Four factors will help improve the health bottom line: increasing efficiency of access to information, enabling better coordination; moderating demand for services by giving patients information required to enable them to participate more actively in self-care; improving access to information and services to the vulnerable; and providing care providers with the tools and information required to make improved treatment decisions and to reduce the incidence of adverse events and unnecessary or duplicated services.
The full article is found here:
These three paragraphs say it all:
Nonetheless, although it “needs some tweaking” and usability changes, “the good news for our government is they’re not up for a really big system build,” said Madden. “The system exists, it’s been there for three years.”
And it’s been improved from where it began. Whereas the prospective customer needed to endure clicking through 17 screens to prove their identity when it was first created, the system is now down to two.
It is expected that putting records online could save the Commonwealth $2.5 billion per year within a decade by reducing inefficiencies, with an additional $1.6 billion in annual savings also delivered to the states, according to the government.
So the PCEHR needs just a tweak or two and billions will be saved. As they used to say when I was a nipper “Oh Yeeeeer”!
Can I have some of the happy medicine this Canberra bureaucrat is enjoying? I will leave it to the reader to assess the quality of the advice the Government is receiving!
Heavens above!
David.

7 comments:

Anonymous said...

These people have absolutely no idea on what is required to develop, test and implement a proof of concept pilot system with a small population of willing users (guinea pigs before any attempt is made to extend the system to a larger population.

Before extending to a larger population a completely independent assessment team is required to put this proof-of-concept pilot through its paces under the most rigorous of conditions.

Mr Madden should stop selling fairy floss and go back to primary school.

Anonymous said...

Ah, the madman again.

Simple people always have simple answers to complex questions. Unfortunately public servants love to be told that the answer is easy and straight forward. They deserve each other, the country deserves better.

Anonymous said...

Dear October 14, 2015 4:54 PM in my extensive experience in the domains of health and ICT you have succinctly told Mr Madden how he should go about doing his job. You clearly have an abundance of nous.

Terry Hannan said...

David, your posting on this is valuable. Just this morning I received this Chapter excerpt from Ross Koppel and it accurately summarises in a more formal manner because it is a book chapter the points you are making re; “it “needs some tweaking” and usability changes, “the good news for our government is they’re not up for a really big system build,” said Madden. “The system exists, it’s been there for three years.” The full chapter is a powerful read. Terry

Publ = Springer Health Informatics © 2015Healthcare Information Management Systems
Cases, Strategies, and Solutions Editors: Weaver, C.A., Ball, M.J., Kim, G.R., Kiel, J.M. (Eds.)
Comprehensive volume addressing the technical, organizational, and management issues confronted by healthcare professionals in the selection, implementation and management of healthcare information systems

Chapter 6
Great Promises of Healthcare Information Technology Deliver Less
Ross Koppel
Abstract Healthcare Information Technology (HIT) continues to hold immense promise for reducing medical errors, collecting instant and vast data from across medical providers, increasing efficiency, improving clinician and patient satisfaction, sharing data, guiding clinicians with up-to-date findings, and facilitating teamwork within and across professions. Yet, almost everywhere clinicians find this technology frustrating and falling short of its promised benefits. In this chapter I examine the reasons for this chasm between promises and reality. In doing so, I review the many benefits of healthcare Information Technology (IT), the origins of electronic health records in both academic and commercial settings, government policies intended to spur the economy and encourage implementation of healthcare IT, the forces influencing those policies, vendor contracts, in addition to the role of the Office of the National Coordinator of Healthcare IT and of other offices in the Bush and Obama administrations. I also explore the barriers to establishing data standards, interoperability, full and transparent evaluations of EHRs and similar technologies, sharing of problematic EHR screen shots, and rapid remediation of healthcare IT-linked difficulties. Healthcare IT, despite its problems, provides many and essential benefits, and will continue to improve. To that end, I offer suggestions for bringing the promise and reality closer together


Anonymous said...

Talking about Paul Madden, there is a rumour running about that he has already written the eHealth strategy that ACeH will be told to use going forward.

So much for independence and a new approach. Same old same old, just a new paint job.

Anonymous said...

So its coming up to 5 years of Mr Madden's service to e-health - http://www.theaustralian.com.au/business/technology/health-appoints-paul-madden-cio/story-fn4htb9o-1225958487120

Anonymous said...

When you use the word "service" are you using it in the sense of a stallion servicing a mare?