Sunday, November 27, 2016

The Signals As To Just Where The myHR Is Up To Are A Bit Confusing At Present. I Wonder What Is Really Going On?

A few days I noticed this from the AMA:

Maximising My Health Record.

22 Nov 2016
There is no doubt the evolution of the shared electronic medical record, or the My Health Record as it is now known, has been a costly exercise, with more than $1 billion spent to date. Many observers would argue that is a lot of buck for little or no bang.
Certainly, the My Health Record is not yet perfect. But a recent demonstration of its use to the AMA Council of General Practice (AMACGP) was promising, and GPs who had previously dismissed it might consider taking a second look.
We all want the My Health Record to work. It has the potential to support much better patient care, particularly when your patients see another doctor or health care provider.
By uploading key medical information via a Shared Health Summary, you are making sure other doctors who may be treating your patient in an emergency situation, or while they are away on holiday, have the information they need to appropriately care for your patient, thereby reducing the likelihood of your patient experiencing an adverse medical event or unnecessary testing.
Of course, this is a two-way street. The investment you make in providing accurate and up-to-date medical information about your patient for other doctors and health care providers will be repaid when you benefit from the information they upload to another patient’s My Health Record.
The vast majority of the Government’s investment so far in e-health has funded the building blocks of the e-health system, such as the physical and governance infrastructures, enabling frameworks and privacy protections. To the GP on the ground, this does not mean much for day-to-day patient care.
However, there has been a lot of working going on in the background to make the My Health Record more useful and easy to use. The AMA sat on the Clinical Usability Group of the National eHealth Transition Authority (now Australian Digital Health Agency) and we have driven significant changes. The demonstration provided to the AMACGP highlighted how easy it is to access a My Health Record, as well as to create and upload a Shared Health Summary.
For most practices, the process for Assisted Registration of patients is also much simpler. As long as the patient is known to the practice or have their driver’s licence with them, they can be easily registered for the My Health Record using the practice’s existing clinical software. Patients do not have to be registered with MyGov to be registered this way for the My Health Record.
The My Health Record is now at a point where we can begin to realise the benefits of a shared electronic medical record.
These benefits will only come ‘on scale’ when there is a critical mass of registrants. A welcome sign has been Government’s willingness to test ‘opt-out’ arrangements to increase uptake of the My Health Record. The current trials have seen very few patients opt out and, if this trend continues, they will prove the basis for the extension of those arrangements across the whole population.
Lots more here:
This is quite an interesting article which seems to be quite enthusiastic regarding a demonstration but then lists a collection of caveats on adoption, value, access and use.
Then we had this from Australian Doctor.

Can MyHealth Record be resuscitated?

| 23 November, 2016  
Five e-health experts tell Australian Doctor whether they think the MyHealth Record system will eventually work or if the restart button needs to be pressed on the whole project.
After four years and an estimated $2 billion dollars of taxpayers’ money, the MyHealth Record system remains largely unloved and unused by GPs.
It raises serious questions about whether the whole enterprise should be put out of its misery, and become another footnote in the list of IT disasters that were big on promises and small on delivery.
However, there is still hope among some that it can be salvaged.
Tim Kelsey, a colourful e-health evangelist, has been brought in from the UK to head up the Federal Government’s Australian Digital Health Agency.
The agency’s first step is yet another consultation — lasting six months — that aims to come up with a strategic direction for e-health in Australia.
A core part of the consultation will be to figure out what changes to the system are needed to provide genuine clinical value for GPs.
At present, more than 4.3 million people have a MyHealth Record, but the clinical documents that have been uploaded to the system are arguably few in number, and their relevance to many doctors on a day-to-day basis is limited.
Before the government created a financial compulsion for GPs to participate in the scheme by making it part of the e-health Practice Incentives Program payment, only 380 GPs were uploading shared health summaries to the system.
These summaries are supposed to be the information backbone of MyHealth Record.
Here, five leading e-health experts, including Mr Kelsey, tell Australian Doctor whether they think the system will eventually work, and offer benefit to patients and GPs, or whether the restart button needs to be pressed on the whole project.
There are then 5 commentaries here with the views rather split.
See here:
Additionally late last week there was this:

HIPS November 2016 Release

Created on Friday, 25 November 2016
The Australian Digital Health Agency is pleased to announce the release of HIPS v6.1. This version supersedes and combines the functionality of HIPS v5.0 and eHealth Integration Sample Code (eHISC) v6.0, and provides the basis for all future HIPS releases.
HIPS v6.1 also provides fixes for a number of high-priority issues, and support for three views introduced with recent releases of the My Health Record system.
New functionality
HIPS v6.1 supports the following views of the My Health Record system:
  • Pathology Report View;
  • Diagnostic Imaging Report View; and
  • Health Record Overview.
Resolved issues
The release resolves a number of high-priority issues, including:
  • Removal of memory leak associated with document uploads and ADT messages; and
  • Support for multiple active episodes for the same patient.
Inherited functionality
HIPS v6.1 includes functionality from:
  • HIPS v5.0:
    • Support for Secure Message Delivery (SMD)
    • Integration with national directory services (HPD, NHSD, NEPS)
  • eHISC v6.0:
    • Dynamic generation of pathology report and diagnostic imaging report CDA documents from HL7v2 ORU messages
    • Submission of HL7v2 messages via HL7’s MLLP low-level protocol.
Who does this affect?
  • Current HIPS or eHISC users who want to adopt the new features;
  • Current HIPS or eHISC users who want to address now resolved issues;
  • Healthcare provider organisations wanting to simplify their systems’ interactions with national digital health infrastructure;
  • Diagnostic service provider organisations wanting to integrate with My Health Record system;
  • System integrators contracted by healthcare provider or diagnostic service provider organisations; and
  • Software developers who want to incorporate HIPS into their product suite.
Link is here:
This left we rather wondering just why all this had not been done ages ago. The myHR project, has, after all, been going since June 30, 2012.
I thought I would hop on to my myHR and see how it was all looking.
What I found was a system consuming an enormous amount of screen white space that needed a huge number of clicks to get anywhere. Worse, once you get there, if you can figure out the menus, you have to access documents one at a time.
As far as I am concerned what we have now seems even harder to navigate and find information than the original manifestation from a year or so ago did! Maybe the version that is integrated into practice systems is much better? (let me know).
It is also important to note that ADHA is still not publishing any usage statistics for the system and it seems more and more likely with no real evaluation the program is simply going to be rolled out nationally if the rumours can be believed.
One has to be worried the public is rather being played for mugs with all this, given the pollies have no sense of what they are getting for the money being spent.
Let me know what you think about how all this is being done….
David.

1 comment:

Anonymous said...

My guess is the AMA is being politically astute. The have many fish to fry, no need to point out a sinking ship.

I do find some of the latest language from the head of ADHA a little odd and slightly desperate. Maybe it has dawned on him what he has been handed in both problem and people.