This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Quote Of The Year
Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"
H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."
Monday, June 07, 2010
What Should We Think About This Portal Idea? Worthwhile or Not?
The following article appeared a few days ago – expanding nicely on my notes from the Senate Estimates hearing last Thursday (June 3, 2010)
THE Rudd government's much-vaunted "personally-controlled" e-health records system will be delivered via a "portal", but with health bureaucrats still "mapping out the build" the option for outsourcing to platforms like Microsoft's HealthVault or Google Health remains on the table.
Queensland Liberal Senator Sue Boyce pushed hard for an explanation of the proposed personal e-health record system at a Senate estimates hearing yesterday, but little detail was forthcoming.
In last month's federal budget, Treasurer Wayne Swan and Health Minister Nicola Roxon announced an allocation of $467 million over two years to fund the creation of a personally-controlled e-health records system.
Health spokeswoman Raelene Thompson said the intention was for patients and doctors to access personal records through a web portal, from any location including a home PC.
"The concept is for a voluntary system, and only those people who wish to use an e-health record will have one, and what goes into that record and who is allowed to access it will be within their control," Ms Thompson said.
"So, if you have chosen to be part of the system, you will authorise your health providers to have access."
Senator Boyce referred to a post-budget opinion piece in The Australian that queried whether the private sector, Medicare or some other government body would run a national e-health system, and asked Ms Thompson to confirm whether Medicare would develop the system.
The Rudd government's personally-operated e-healthrecords system will be released with the help of a "portal".
Queensland Liberal Senator Sue Boyce called for a detailed report on the proposed personal e-health record system at a Senate estimates hearing held yesterday, however, he only got a little detail.
In last month's federal budget, Treasurer Wayne Swan and Health Minister Nicola Roxon posted to extend $467 million over two years in a bid to financially back the development of a personally-controlled e-health records system.
PEOPLE trying to reduce stress and anxiety and improve their health are becoming "self-trackers" – using modern technology to tally every aspect of their lives.
They plot minute data including working hours, sleep, exercise, sex, diet, productivity and weight.
Sometimes called "personal informatics", adherents use heart-rate monitors, websites that record their alcohol use, calorie intake, mood or sexual encounters and mobile phone applications that tally sleep patterns.
Typically, self-trackers then share the information through social media, with The New York Times recently calling the trend "constructing a quantified self".
Self-trackers usually start with a goal, but then can't stop recording. One man kept an archive of his ideas for more than 25 years, now numbering more than 1 million.
Emmy Kerrigan, 35, sees her life as a stack of numbers assembled in to a manageable whole. She runs a website development company in Cairns and tracks her working day in six-minute increments, including coffee and meal breaks, and time spent on Facebook.
The bottom line is that what DoHA seems to be talking about is having themselves provide what the rest of the world describes as a Personal Health Record (PHR) provided by Government for those who want it.
The National Health and Hospitals Reform Commission (NHHRC) came up with the idea of the Personally Controlled EHR (PCEHR) in its final report which just preceded the Rudd / Roxon consultation tours all around the country during last year and earlier this year and led to the trickle fed National Health Reform agenda announcements earlier this year.
(Here we get evidence baby boomers are not all that convinced about PHRs and the effort required to maintain them.)
The bottom line here is really very simple.
First, if provider systems capabilities, deployment and connectivity are not addressed first there will not be a great deal of useful information to populate the portal.
Second, doing a PHR is something you do after you have all your basic infrastructure, applications and communications largely in place.
Third, the evidence just creating a PHR portal for the 1/3 of patients who might use is very unlikely to make any great difference to the health system without the prior steps. (we know from Kaiser’s experience only about a third of their population even activate the PHR).
So what is happening here is a cynical ploy to be appearing to do e-Health by doing something very easy, by outsourcing a PHR portal to Microsoft, Google, IBM or whoever, while the hard work – which will genuinely take years is quietly put on the backburner until after the election (or the one after that).
If there is something more useful, that might make a real difference to people’s lives, in the planning then it is time the public was let into the secret.
The bottom line is that you fix IT support for healthcare providers and then make the information available for their patients. Not the other way around!
This is the ultimate ‘cart before the horse’ initiative if ever there was one!