Sunday, April 10, 2016

Maybe, Just Maybe, There Is Some Reality On The myHR Emerging. Not Before Time But They Are Still Not Really Accepting The Scale Of The Mess!

As part of the recently released draft Commonwealth Digital Health Strategy we read the following:

9.1 My Health Record

The national My Health Record system was launched on 1 July 2012, as the Personally Controlled Electronic Health Record (PCEHR). The My Health Record system is a secure online summary of an individual’s health information.  The individual is able to control what goes into their My Health Record, and who is allowed to access it.  An individual’s My Health Record allows an individual and their healthcare providers to view and share the individual’s health information to provide the best possible care.
In order for the My Health Record system to be successful the following need to be addressed in the next three years:
·         A critical mass of consumers registered;
·         Active participation by healthcare providers, to both contribute clinical content and to use the information to inform clinical care;
·          Sufficient clinical information available to make accessing the content worthwhile;
·         Clinical information included of sufficient quality for healthcare providers to be able to confidently use the information for clinical care; and
·         The use of the My Health Record needs to be embedded within the clinical practice and workflow of healthcare providers.
Strategies to address these goals have been reflected within strategic initiatives throughout this document.
Following a recent architectural review of the My Health Record system, it has been recognised that changes are needed to the design of the underlying My Health Record system technical infrastructure in order to meet emerging and future clinical requirements.  These changes will be considered within this current planning period.
----- End Extract. (p39)
At the end of the same section we also read:
National Strategic Initiatives
S8.1 Design and implement changes to the My Health Record system technical infrastructure in order to meet emerging and future consumer and clinical requirements.

S8.2 Develop and make available a My Health Record system release and development roadmap.

S8.3 Implement changes to the authentication services for connectivity to digital health solutions, focusing on improving registration and renewal processes for healthcare providers and organisations and to rationalise the number of authentication certificates required.

S8.4 Establish better alignment of the roadmaps for the National Health Services Directory, including the National Endpoint Proxy Service, with the other strategic initiatives detailed within this strategy. 

(p40)
All this is just amazing. What we have is the Government out there compelling a million or so citizens to be allocated a myHR, while admitting, explicitly,  the present myHR product is simply not up to scratch.
Just what rationale can there be for not undertaking the re-design and re-implementation work - as well as, of course, addressing all the known issues (security, privacy, access controls, usability etc.) -before conducting the ‘opt-out trials’?
How on earth can the impact of opt-out be evaluated when the present mess is being trialled rather than a system that might actually be useful and clinically acceptable - assuming that the present myHR is reparable - which I very much doubt. No matter what is going on - the trials should not proceed until the myHR is shown to be fixable and then fixed and tested!
Seems someone is very keen to spend our money in a heck of a hurry for no good reason!
It is worth noting that points S8.3 and 4 highlight there is still a lot more work needed in the basic e-Health infrastructure as well.
David.
Note: For more information or to download the draft plan go here:
D.

1 comment:

Anonymous said...

As you say David, this is an amazing, extraordinary, inexplicable revelation! How can this be?

It leads one to ask, that if "it has now been recognized that changes are needed to the design of the underlying My Health Record System technical infrastructure", why on earth are they persisting with the two opt-out trials?

Equally incredible is the statement that "these changes will be considered within the current planning period." This suggests very strongly that they have not yet defined what changes are required and whether it is feasible to make them to the technical infrastructure as it exists today.

Were these revealing statements intended to be made (public) or were they simply an oversight and not picked up and removed from the DRAFT document?

Thinking about this I would suggest that the statements were an oversight and had they been noticed, by the 'editor or editorial group' approving the DRAFT for publication, they would have most certainly been removed from public scrutiny.

There is no other way to account for the inclusion of these statements for they do nothing other than undermine the PCEHR (My Health Record) project vindicating what you and your readers have been saying on this blogspot for a very long time.