Sunday, March 06, 2016

We Are Not Exactly Being Told The Truth Regarding The New PCEHR. Lots Of Spin And Evidence Free Assertions.

This press release appeared on Friday.

My Health Record gets one million more reasons to sign up

The number of Australians with a digital health record will jump by more than a million, as part of the Australian Government’s commitment to improving health outcomes and saving lives through digital innovation and information sharing.
Page last updated: 04 March 2016
4 March 2016
The number of Australians with a digital health record will jump by more than a million – or 40 per cent – as part of the Turnbull Government’s commitment to improving health outcomes and saving lives through digital innovation and information sharing.
Minister for Health Sussan Ley today officially launched the Turnbull Government’s new My Health Record, which will give both patients and health professionals immediate access to all of their necessary health information on-line to improve co-ordinated care outcomes, reduce duplication and provide vital information in emergency situations.
This will include trialling the automatic creation of electronic health records for more-than one million residents in Western Sydney and North Queensland, to improve coverage rates after the previous Labor Government’s preference to allow patients to opt-in, rather than opt-out, led to less-than one-in-10 Australians signing up.
Ms Ley said the Turnbull Government had particularly focussed on protecting patient privacy as part of the new My Health Record, passing supporting legislation mandating fines of up to half a million dollars and even jail sentences for anyone who tries to deliberately misuse or access information in the health record.
“It’s important Australians are able to have access to their medical records and safely and securely share them with health professionals no matter where they are in the country if we are to truly improve clinical outcomes and efficiency,” Ms Ley said.
“Our new My Health Record means people will not have to remember the names of the medications prescribed, details of diagnosis and treatments, allergies, medical procedures and there will be no need to repeat the same information when they see another doctor or go to hospital.
“I consider this a landmark turning point in improving our health system and bringing it into the 21st century.”
The Turnbull Government’s new My Health Record is part of a $485 million Budget rescue package to salvage Labor’s failed attempts to develop a national electronic health records system in Government, with the decision to transform the system from opt-in to opt-out a key recommendation of an independent review of Labor’s scheme.
Under the trial, patients will be able to share vital health information securely online, at any time, with authorised healthcare providers, such as doctors, pharmacists, specialists, hospitals or allied health professionals.
However, Ms Ley said patients would have ultimate control over who accessed their information, including adding additional password protections.
“Doctors have indicated they’re much more likely to use the system if all their patients have a record,” Ms Ley said.
“We also need full national coverage if we’re to cut down on inefficiencies created by not having one seamless records system, such as double ups with testing, prescriptions and other procedures.
“The Turnbull Government takes privacy very seriously and we have put in place the necessary protections to ensure the information in your My Health Record is as safe and secure as possible. Trialling the implementation of the new opt-out system is about reassuring the public they can have confidence in our new My Health Record.”
Ms Ley said a life-saving “break-glass option” was included in the new My Health Record, allowing patients to have maximum security protections whilst also not having to worry about blocking access to their vital information in medical emergencies such as anaphylaxis, heart attacks, stroke or accidents where a patient is unconscious.
Residents in the Northern Queensland Primary Health Network and Nepean Blue Mountains Primary Health Network will shortly be receiving a letter informing them of the trial and telling them how they can opt out if they choose. By mid-June 2016 residents participating will be able to change their access controls to the record, ahead of their doctor accessing the My Health Record in mid-July 2016.
Key Facts and Features:
    • $485 million over three years – the first time a Government has committed multiple years of funding to assist the roll out of this important system.
    • 2.6 million Australians already have a record
    • This will instantly increase to 3.6 million, as a result of these trials – a 40 per cent increase.
    • The additional one million users co-opted into the system include about:
      • 360,000 residents in the Nepean region of Western Sydney (Nepean Blue Mountains PHN).
      • 700,000 residents in North Queensland (North Queensland PHN – covering Mackay up to Cape York/Torres Strait)
    • Nearly 8,000 healthcare providers are registered to use it
    • The new My Health Record seamlessly connects with GP and hospital systems
    • Redesigned user interface - easier to navigate online platform
    • New GP training and incentives
    • Stronger privacy controls for YOUR My Health Record:
      • Password protection
      • Lock down access to specific GPs or hospitals
      • View every person who has opened the record
      • Delete files that are unwanted
      • New criminal penalties for deliberate misuse
      • Fines up to half a million dollars per breach for deliberate misuse or access
    • If all Australians are signed up to a functioning My Health Record, it is estimated that it could save 5,000 lives per year and could help avoid:
      • 2 million primary care and outpatient visits
      • 500,000 emergency department visits
      • 310,000 hospital admissions
    • Potentially, $7.6 billion annual savings and improved value and efficiency in healthcare expenditures by 2020 could also be achieved by reducing medical duplication and adverse events. For example:
      • Around 10.4% of patients every year treated by a GP will have an adverse drug event
      • As many as 18,000 Australians die each year as a result of adverse drug events
      • With My Health Record patients receive better care, and therefore forecast to save $2.8 billion annually through reduction of medical errors
To point out a few bits of nonsense.
1. You can’t delete your information.
If you try you get this:

Effectively Remove a Document From View

You are about to effectively remove a document from view of this digital health record. If you continue, healthcare professionals will be unable to open and view this document.
Note: If you believe a document contains inaccurate information, you should raise this with your healthcare professional before removing the document. The contact details for the healthcare professional can be found in the top right hand corner of the document. If you proceed, you must indicate the reason for removing the document.
The My Health Record System Operator will retain a copy of all documents for legal purposes.
2. “Redesigned user interface - easier to navigate online platform” - Not unless it has been updated since yesterday - still clumsy and awful.
3. “Seamless Connection to GPs and Hospitals “ - just waffle - what does it mean?
4. All the data on impact are pure guesses - lacking any sources or evidence.
5. The potential savings are pure imagination as are most of the figures quoted which again are not sourced.
6. The system does not track individual providers - just organisations or practices - so who knows who actually accessed the record - the receptionist?
My view is that thy have thus far provided about a million reasons not to sign up.
Really these people could not lie straight in bed and I would not trust them with my heath information.


Bernard Robertson-Dunn said...

The government is being remarkably economical with the truth.

For a start, in spite of the headlines, the trial participants won’t get a health record – help with registration is not a health record.

Under the opt-in process, you are required to get a myGov account, register, get a Personal Access Code, appoint a “Nominated Representative” and then your doctor could add a health summary document and other information. In other words creating a health record was more than just registration.

All the government is doing in the trials is making the registration part of the process a bit easier. It most certainly is not creating a Health Record.

All it will have in it is some personal identifying data, your Medicare data, PBS data and if you have registered as an organ donor. You still need to go through the rest of the opt-in processes and get your doctor to add a minimum amount of health data. Then it might be called a Health Record, even if it shouldn't be relied on for health care purposes (the government's words)

By claiming you have a health record, the government runs the risk of misleading many people into thinking they need do nothing else. Not everyone is familiar with computers, the internet, and can understand the subtle difference between registering for a health record and actually having one.

It won’t address the concerns of many GPs. In the review of the system many health professionals claimed that one of the reasons they were not using the system was because not many patients had a health record. Increasing the number of registrations will not increase the number of health records.

In other words, the government is spending millions of dollars trying to address one of the stated concerns of health professionals (others being the shear uselessness of the system and having to spend time spent managing it) without actually succeeding.

I wonder if Sussan Ley realises what she is being asked to say by her advisers and
the political risks she is taking.

Greg Twyford said...

Isn't it about time that the AMA, and other doctor organisations, such as the RACGP, strongly advised their members to boycott this whole sham. Most GPs that I know from my long acquaintance in GP IT support don't understand this stuff, don't care about it, and largely think it's a waste of their time and our money. And I agree wholeheartedly.

The incentives to GPs involves swallowing this thing whole. They and the pathology industry are the only real sources of data for this monster. Most hospitals I know of still do discharge summaries by hard copy. Most specialists are oblivious to it all.

Why can't the bureaucrats let go of this monster, apart from their lust for more data for the inevitable data-matching? I don't trust them to keep it secure, nor to keep their hands of it for as yet unstated purposes. Nor does anyone in health IT who's not part of the gravy-train.

George Orwell would be turning in his grave.

Anonymous said...

The problem with Greg's eminently sensible suggestion is that the AMA and RACGP avoid making any recommendations like Greg suggests to their members for fear of upsetting the Government. These peak bodies do not know the meaning of leadership, they spend their time hedging their bets and sitting on the fence. Basically, they lack the courage to do the right thing, stand up and be counted.

Bernard Robertson-Dunn said...

Doctors will upload data and get paid for it.

What they won't do is use it for any meaningful purpose. They have no need of the system.

Unfortunately, the government only measures registrations, not well formulated health summaries and most definitely not beneficial health outcomes.

Anonymous said...

We have a situation that is well described by the term "Cognitive dissonance".

They have spent so much money that failure is enormously embarrassing so they harden up and become even more voracious in pushing it, even trying to compel it to work using PIP payments and shutting down Standards Australia so there is no other alternative.

It won't work and the minister is obviously protected from getting other differing opinions, or else you you would have to conclude she is not up to the job. The hardest thing to do when you go the wrong way is to stop.

The quality of the system will certainly be tested when they start getting a pdf for every lab result generated in Australia. That is an enormous load which would scare anyone with any IT experience. Perhaps that will be the crisis that puts an end to this nonsensical waste of public money. This is especially so when when we don't actually have the money to waste!

Greg Twyford said...

Anonymous of 06/03 9.09pm has focussed on one of the key issues in our health system. The government 'owns' general practice through bulk-billing, the PIP, and other 'incentives'.

The specialist groups and the AMA are perfectly happy for this to continue, so long as the government leaves them alone. The government intermittently talks about specialist and pathology over-servicing, but this doesn't constitute as big threat, so all is OK at this level.

Meanwhile, the RACGP has a history of initiating change in the nineties to adopt IT for efficiency and clinical outcome objectives. Great idea. Quickly the government took ownership of this development and increasingly moulded it to their own purposes. The RACGP, accepted this in exchange for the hope general practice would become more powerful, at the centre of things.

This process has continued for the best part of 15 years now, with GPs being presented with increasing amounts of work from new initiatives, the crowning glory of which was the PCEHR 'preparations'. The neoplastic transformation of this naive idea into a bureacratic plaything has become increasingly malignant, despite the well-qualified opposition to the direction it has taken.

So, yes, anonymous of 06/03 9.09pm, general practice, the taxpayer, and the security of our health data are all at peril, thanks to this murky scenario.