Wednesday, January 18, 2017

This Rather Strikes Me As Being A Bit Economical With The Truth.

This appeared a couple of weeks ago:

Phone access makes health care easier

Chloerissa Eadie
Tuesday, January 03, 2017 12:25PM
BECAUSE Bunbury woman Sandra Motteram could access her daughter Eliza’s health records on a phone, the four-year-old went through with a scheduled vaccination instead of having to make another appointment.
Ms Motteram visited the Bunbury Community Health Centre to find that the computer system was down, which meant medical staff could not access Eliza’s health records, requiring the pair to come back at a later date.
However, because Ms Motteram was registered for My Health Record she pulled up her daughter’s records on her phone, allowing her to receive the vaccination on the spot.
“It was really convenient at that time and everyone pretty much has a phone on them these days,” she said.
Community health nurse manager Marie O’Donoghue said it was “a particular glitch” which prevented the centre from accessing the records.
“It saved a lot of time, because children are often apprehensive when they come in for an immunisation at that age and Sandra had prepared her well, so it was important that we followed through on that,” she said.
More here:
The ADHA also cited this case:

Child Immunisation and Digital Health

Monday, 09 January 2017
The week before Christmas 2016, with temperatures peaking at 43 degrees, I travelled with our CEO, Tim Kelsey and Chief Medical Adviser, Clinical Professor Meredith Makeham to Perth, Bunbury and Busselton in Western Australia.
The trip was part of our national conversation with the Australian people about digital health; how we can best shape it around Australia's needs, wants and aspirations. This conversation is part of a larger consultation activity as we work towards co-producing a National Digital Health Strategy for the Australian Government.
All up, we talked to around 100 people across the WA health sector. Many subjects were raised and discussed, including the important subject of child immunisation.
Dianne Ritson, Regional Manager, and Jo Moore, Director Population Health, both from Country WA Primary Health Network, introduced us to Sandra who had a fantastic story about how the My Health Record helped her as a busy parent. Sandra took her 4-year-old daughter, Eliza, to the Bunbury Community Health Centre for a vaccination. But on the day of the visit, the health centre's IT system was down. Fortunately, Sandra had set up a My Health Record for Eliza, and she was able to access her daughter's immunisation* information on her phone and Eliza could receive the correct vaccination immediately without issue.
Without the My Health Record, Sandra would have had to come back to the centre another day and prime Eliza for her vaccination all over again. "It was really important that we did it that day," Sandra said, echoing the sentiment of parents everywhere.
More here:
However it is the little (*) that matters:
* Immunisation data accessed via the My Health Record is sourced from the Australian Immunisation Register, a national register that records vaccinations given to people of all ages in Australia.
We all need to remember the Immunisation Register was set up to ensure children were vaccinated and additionally, now, to permit compulsory enforcement for No Jab, No Pay! This of course means people on various benefits have a financial incentive to keep the records up to date!
It is a totally different animal to the myHR and is updated and maintained even if a myHR did not exist.
Additionally a vaccination  provider can access the register directly on-line.
See here:
I will leave it to you assess the quality or reporting and the ADHA Blog (I note the author does not seem to be named). Of course having multiple routes to access the register did assist in this unlikely combination of events - but is hardly a justification for the myHR!
David.

7 comments:

Anonymous said...

Chequebook journalism? It does appear to be a story rehashed, would not be surprise if Tim wrote it originally and it has been rehashed to appear to be a third person and then passed to the WA paper

How do we know this was MYHR app and not the Medicare or even a local app?

Anonymous said...

Let's not let the truth stand in the way of a good story David.

Anonymous said...

It is the same language and same tactics used by Tim in the U.K. He has no idea and has learned nothing, there is no listening to learn just listening to sell.

Minister want a taste of what's to come:

https://storify.com/mellenoweth/handling-of-nhs-patient-data-inquiry

https://storify.com/bengoldacre/discussing-the-care-data-mess-with-tim-kelsey-who

At least expense claims will be overshadowed.

Bernard Robertson-Dunn said...

Here's an example of technology being used to assist in better medical decision making:. IMHO it has somewhat more value than helping a parent who can't remember (or write down) her child's immunisation history or provide a workaround for Community Health Centres who don't treat their IT seriously.

AI can predict when patients will die from heart failure 'with 80% accuracy'

The researchers' programme assessed the outlook of 250 patients based on blood test results and MRI scans of their hearts. It then used the data to create a virtual 3D heart of each patient which, combined with the health records of "hundreds" of previous patients, allowed it to learn which characteristics indicated fatal heart failure within five years.

The computer was able to analyse patients "in seconds", promising to dramatically reduce the time it takes doctors to identify the most at-risk individuals and ensure they "give the right treatment to the right patients, at the right time".

Dr Declan O'Regan, one the lead researchers from LMS, said: "This is the first time computers have interpreted heart scans to accurately predict how long patients will live. It could transform the way doctors treat heart patients.

"A doctor equipped with this new cardiac imaging approach would therefore be able to make more informed judgements about outcome than if they were relying only on current ways to investigate patient data."

http://www.ibtimes.co.uk/ai-can-predict-when-patients-will-die-heart-failure-80-accuracy-1601517

Apart from a bit of hype (IMHO it's not AI it's data analysis and data matching) it does suggest a scenario for a combination of precision and personal medicine involving both big data and big models.

The approach uses data from multiple sources to a) learn about the disease and b) learn about a patient.

It does raise some interesting questions:

1. Could the patient data that might be stored in MyHR be easily used by such technology, for either learning or diagnosis?

2. Could the patient data that might be stored in a GP's eMR be easily used by such technology, for either learning or diagnosis?

3. Does it reduce costs as well as improve an individual's health care?

Bernard Robertson-Dunn said...

I think this is a fantastic article.
http://www.newyorker.com/magazine/2017/01/23/the-heroism-of-incremental-care

In the context of Health IT it says (formatted for clarity):

“Our ability to use information to understand and reshape the future is accelerating in multiple ways.

We have at least four kinds of information that matter to your health and well-being over time:

1. information about the state of your internal systems (from your imaging and lab-test results, your genome sequencing);

2. the state of your living conditions (your housing, community, economic, and environmental circumstances);

3. the state of the care you receive (what your practitioners have done and how well they did it, what medications and other treatments they have provided); and

4. the state of your behaviors (your patterns of sleep, exercise, stress, eating, sexual activity, adherence to treatments).

The potential of this information is so enormous it is almost scary.”

Does any ehealth record system store these "four kinds of information that matter to your health and well-being over time"?

Anonymous said...

Bernard might we also ask:

Is the way the data curated and the form it is stored lend itself to to being harvested for this purpose and what meaning is lost along the way. Clinical information is not as simply as financial information or information on who I am and where I live.

Bernard Robertson-Dunn said...

Yes.

IMHO, the data is only the starting point. How it is used and interpreted will change according to many factors, not the least being a) the acquisition of more data and b) the perspective of the health care professional.

And to re-enforce your statement that "Clinical information is not as simple as financial information or information on who I am and where I live.", clinical information ages much faster than most other types. You may change your address but not that often. Your blood pressure, blood tests etc today may be completely different from last week, last month and last year. Especially if you have just had an accident or acquired a virus.

As the article illustrates, much of diagnosis and treatment is trial and error, sorry, feedback and discovery.

And different medical disciplines have different perspectives. Ask a cardiologist about calcium in the arteries and they will have a totally different perspective about calcium from that of a rheumatologist (bone doctor).

There is a lot of talk abut big data. What are more important are big models. i.e. models that use big data.

An earlier comment of mine "AI can predict when patients will die from heart failure 'with 80% accuracy'" was about big models combined with personal models.

All these models use data, some big and some small/personal. Unfortunately just collecting data requires some form of model. The skill is in acquiring data and storing/managing it in such a way that it facilitates the use of that data in new models.

Where MyHR falls down is that the model it uses for data collection is the document.

As Andrew McIntyre has pointed out many a time in this blog, what he needs, as a health care professional, is atomic data. He will apply his models and his understanding of healthcare to that data. The last thing he needs is pre-digestsed data stored in ways that make no sense from his perspective.

I agree with that, and would add that a health record system needs both atomic data and interpreted data.