Sunday, November 01, 2015
And I Used To Think The PCEHR Was An Absurd Thought Bubble. This Beats It By Miles!
We had a speech from the Health Minister at the Press Club last week.
Here is the link to the transcript.
Minister for Health Sussan Ley's address to the National Press Club on 28 October 2015.
These few paragraphs towards the end really caught my eye. The key ones I have italicised.
As we’ve seen this afternoon, we are a Government that continues to be focussed on ensuring Australian patients get affordable access to high-quality health care services.
However, like any industry, this should not be the limit when it comes to health policy.
The Prime Minister has made it clear we want to deliver a 21st Century Government that embraces the digital economy.
And health is no different.
We need to embrace digital health and innovation in the health sector if we are to deliver better integrated care.
Most importantly, we need to embrace the concept of personal choice – ways to empower patients to build a healthcare model that suits their individual needs.
When we talk about innovation, automatically our minds go straight to new technologies in the treatment of diseases, whether they are a diagnostic camera, a bionic arm or the latest breakthrough drug.
These are certainly essential to the future of health care in this country and we must continue to innovate.
This is why this Government set up our landmark Medical Research Future Fund to identify and co-ordinate national health priorities, as well as continued support for individual research projects through the NHMRC.
However, it’s time we reset the agenda when it comes to digital health and innovation and open our minds to the wider possibilities available.
As consumers, digital health has obvious benefits when it comes to the storage of our personal medical information that will vastly improve the way diseases and conditions are diagnosed and managed for Australian patients.
This concept is also designed to support doctors and other allied health professionals with accessing patient information at their fingertips, will help deliver better health outcomes for patients the first time and cut down on unnecessary risks and inefficiencies in the system currently frustrating doctors.
That’s why this Government has committed to revamping Labor’s mishandled Personally Controlled Electronic Health Record into a model that is easy to use and understand for patients and health professionals.
Admittedly, we could have walked away and put it in the too hard basket.
But as I said earlier, we are committed to delivering 21st Century Government for Australian patients.
One of the great criticisms of Labor’s model that was that it could not be used unless a patient signed up, rather than an all-inclusive system that simply gives those consumers who do not want their medical history made available the option to opt-out.
Therefore, in order to address this issue, I can announce today that all-inclusive trials of the Government’s new My Health Record will commence in early 2016 for around 1 million Australians.
The trials will be held in Far North Queensland and in the New South Wales Nepean Blue Mountains region.
But the great digital health revolution lies literally in the palms of consumers.
We now live in an age of smartphones, watches and wallets.
So, what if we, as government, got out the way and gave consumers full access to their own personalised health data and full control over how they choose to use it?
What if you, as a consumer, were able to take your personal Medicare and Pharmaceutical Benefit Scheme data to a health care service; to an app developer; to a dietician; to a retailer and say how can you deliver the best health services for my individual needs?
It’s a revolutionary concept in health – but it shouldn’t be – given it’s already happening with industries like finance across the globe.
Therefore it now really becomes a question of why not?
Why can’t we allow people to use their own personal health information in the same ways they would to access and customise a banking product?
Why can’t we allow people to create a health portfolio of products and services customised to their own needs simply by providing their data?
Why can’t we allow someone’s doctor to use an app developed on the free market to monitor their patient’s blood pressure at home following an operation, or keep a real time count on their insulin levels?
Why can’t we keep informed of our parents’ health well-being via digital connections so they can remain in their own homes, rather than prematurely entering residential aged-care?
The Answer is – we can and allowing consumers open-source access to their health data is the way to do it.
As I said earlier, this is what delivering 21st Government is all about and something I am keen to explore as health minister to better support the patients of this nation and give them greater control over their health and how they manage it.
----- End Extract.
So it seems the Minister is thinking about providing access for individuals to their MBS and PBS data (which is currently available view the PCEHR) on their smartphone or PC (and maybe other parts of the PCEHR as well). At present, of course, the smartphone apps and access mechanisms don’t exist but the Minister seems to believe the market will provide.
Right now - having checked a day or so ago - the PCEHR is about as clunky and mobile unfriendly system you can find. Each test or medication is located by date and time and has to be opened to find out what the record contains.
The questions that immediately come to mind include:
1. Is the PCEHR going to be updated to support mobile interaction (we can assume there will also need to be an access API that manages security, time-out etc.)?
2. Is the PCEHR to be expanded to hold all manner of consumer contributed data?
3. What information / data standards will govern the information held in the expanded system?
4. Or is the Minister actually talking about a new and different system to be delivered by the private sector?
5. How will clinician interaction with all the planned information be managed - and will they be required to review it?
6. How will the necessary updates and operational expenses be met? Will consumers be charged etc.?
7. Do any actual diagrams of information content, flow and functionality actually exist?
8. Has any work been done working out what information is useful for consumers and how does that match what is useful for clinicians?
9. Are there development funds to deliver what the Minister seems to be talking about?
10. Just what relevance does all this have to having clinicians being enabled to do a better job caring for patients?
Feel free to add your own! The more one thinks about all this the more the questions around just what is the system for, who is it meant to serve, what evidence is there for such a system and what actual analysis has been done to take the ‘thought bubble’ to any sort of reality.
Why do I have a nasty feeling that all this may have been designed on a companion napkin to the one that gave us the NBN - with a comparable amount of detail? Anyone who is able to allay my concerns I look forward to a comment from!
We have the precedent of the way the PCEHR was suddenly dropped, ill conceived, upon us. Surely the same thing won’t happen again? Why do I have this terrible feeling it just might?
Posted by Dr David More MB PhD FACHI at Sunday, November 01, 2015