Sunday, January 31, 2016

Some More Details On The PCHER Opt-Out Trials Very Interesting Indeed. What A Shonk!

This well researched report appeared a few days ago:

Australia's first opt-out e-health site to start trials this week

More than 670,000 northern Queenslanders first in line.

By Allie Coyne
Jan 27 2016 6:46AM
One of the two Australian health networks nominated to be the first to trial the government's plans for opt-out medical records will start testing the approach this week.
The Northern Queensland Primary Health Network (NQPHN) was last year named as one of two sites, alongside the Nepean Blue Mountains PHN, to automatically sign locals up for a 'My Health Record'.
Combined, the two trial sites will see the new opt-out approach tested on around one million individuals at a cost of $51 million. Evaluation firm Siggins Miller has been given a $1.4 million contract to review the trials once they are complete.
Residents of the two locations will have My Health Record accounts set up for them by default using names, addresses and health identification numbers pulled out of the Medicare database.
On Wednesday and Thursday this week, Department of Health and NQPHN officials and staff from Siggins Miller will visit Cairns and the Tablelands to begin the first stage of public consultation on the implementation plan.
“These sessions with the Department of Health’s digital health division will be an opportunity for health industry experts and community members to share their valuable insight and feedback about our region’s needs and ways in which allied health can interact with My Health Record," NQPHN chairman Trent Twomey said in a statement.
“Their feedback will directly inform the implementation plan and delivery of My Health Record.
More here:
The report provoked me to do a little more research.
First the evaluation tender. Here is the summary.

Opt out trial program review and evaluation

CN ID                               CN3316597
Agency                            Department of Health
Publish Date                    21-Jan-2016
Category                          Information technology consultation services
Contract Period                24-Dec-2015 to 30-Nov-2016
Contract Value (AUD)       $1,429,230.25
Description                      Opt out trial program review and evaluation
Procurement Method      Open tender
SON ID                             SON2647271
Confidentiality - Contract No
Confidentiality - Outputs No
Consultancy                     No

Supplier Details

Postal Address 
Town/City        KENMORE
Postcode          4069
State/Territory QLD
Country            Australia
ABN                  56 076 986 500

Agency Details

Contact Name           BMU
Contact Phone          02 6289 1555
Division                    EHealth
Office Postcode        2606
Agency Reference ID 4500118987
Now the company that has been selected to evaluate the opt-out trial - Siggins Miller:
Here is the link:
The areas of expertise are listed on the home page as:
Consulting Service
The areas they have looked at in our domain are as follows (according to the site are)

Telehealth and e-health

Development of qualitative and quantitative evaluation methodologies for the assessment of the costs and benefits of multidisciplinary team meetings for cancer care which brought together rural and regional clinicians together with city based specialists, reducing professional isolation, providing secondary consultations on clinical matters and improving patient outcomes, convenience and continuity of care
Designed and managed consultations in rural and remote Australia for Health Workforce Australia to develop the National Rural and Remote Health Workforce Innovation and Reform Strategy and for the Department of Health and Ageing’s Rural and Remote Health Strategic Framework. In both these projects we gathered detailed information and developed a deep understanding  about the need for e-health solutions to:
·       address the tyranny of distance
·       assist with closing the gap in outcomes between rural and remote and Aboriginal and Torres Strait Islander and urban populations
·       improve the retention of health workers
·       support students on rural and remote placements
·       improve quality through increasing access to CPD, point of care resources and secondary consultations.
A long history of conducting system wide, multi layered evaluations of national capacity building efforts. We are used to working in complex field settings, managing multiple stakeholders and conducting large system wide consultations cost effectively. Our evaluations have included e-health related components, assessing the contribution of initiatives at the personnel, organisational and system level to overall outcomes and assessing the impact of the broader environment enablers and barriers on the achievement of hoped for outcomes
We are also skilled at working with those designing interventions or rolling out innovation to assess their readiness for implementation in a way that builds in evaluative thinking from the beginning, suggests monitoring and evaluation methods, and maximises chances of avoiding implementation failures by thinking things through in detail before launch.
Examples of our work in this area have included:
·         A 6 year longitudinal evaluation and support service to Cancer Australia between 2006 and 2012. This evaluation included evaluation of on line CPD and point of care resources, evaluation of multidisciplinary team meetings via telehealth, provision of secondary consultations and virtual teams including economic evaluation, on line directories of services and  the convening of national teleconferences and workshops to reduce duplication of effort, advise on change management and speed the uptake of innovation
·         A 3 year longitudinal evaluation of all aspects of Canteen and the DoHA YCNF to improve outcomes for adolescents and young adults with Cancer, including web based interventions, the use of social media and online resources for health professionals
·         Development of an evaluation framework for the Royal Australasian College of Physicians to monitor and evaluate its educational program including those elements based on lecture series based on video conference capacity
·         Design of an evaluation framework and implementation of the evaluation of telehealth mediated Aboriginal and Torres Strait Islander patient navigator program in Far North Queensland for Queensland Health
·         Development and implementation of an evaluation framework for an innovative pilot of a telehealth mediated Aboriginal and Torres Strait Islander Care Coordinator role in Far North Queensland
·         A two year evaluation of the National Drug Strategic Framework for the Department of Health and Ageing  including the evaluation of information systems to assist pharmacists to prevent illicit use of pharmaceuticals
·         Development of an evaluation framework and conduct of the first two years of an evaluation of AusAID funded capacity building in the health system in PNG which included building communication capacity in a developing country context.
----- End Extract.
In last week's blog we noted that there was planned to be consultation with all the professional groups and no consumer consultation. I assume that comes later.
See here:
So $1.4M for an evaluation that ends, apparently in less than a year, for a project that probably won’t even actually be live until June or so!
I look forward with breathless anticipation to the valuable evaluation that will flow after less than 6 months experience of opt-out and all its ramifications!
What a duplicitous farce on the part of DoH. A set up of the first water to me!


Anonymous said...

The trials will allow the Health department to test how it communicates the new approach, and removes those who choose to opt out, prior to a national rollout.

None of this has anything to do with whether the system does or does not work, is or is not acceptable. The trial assessment is purely to give the thumbs up for the national rollout. The assessment will state the opt out approach was a great success with over 80% community enrolled in the my health record and a small percentage asking to be deregistered out of the system.

The national rollout is a crash through fait accompli.You and your blogging companions can complain and bleat as much as you like it will make no difference. So suck it up boys and girls.

Dr David More MB PhD FACHI said...

If you believe that - you are wrong! There are powerful forces that will sink this and, at the end of the day, what I, and the readers are saying, will be justified.

Clearly you are a paid lackey of the 'dark side'. What will you do when your dishonest nonsense is exposed for what it is - dishonest nonsense?


Anonymous said...

Is this project yet another case of more 'jobs for mates'? Yes another wonderful 'ehealth' initiative!

Anonymous said...

"There are powerful forces that will sink this .... "

Those forces have been around for at least a decade but they don't seem to have had much luck in getting anyone to take notice. The juggernaut just keeps rolling along.

BTW I don't think January 31, 2016 5:33 PM is talking "arrant nonsense" - the prediction looks quite reasonable to me. I think he/she is right - we just have to suck it up because it doesn't look as though there is anything else one can do. One just has to watch the bureaucrats repeat their class act of making another mess of things and then coming up with another hair brained alternative to replace the one that failed. There doesn't seem to be anyone around capable of calling a halt. It's too much of a political hot potatoe.

Anonymous said...

Just because it may generate a heap of (empty) records does not mean it will be used in practice? However statistically I imagine it will look wonderful, as presented by the mates and their sponsors...

Bruce Farnell said...

It will be interesting to see what 'spin' is placed on the evaluation. The lack of engagement or relevance to the community at large will lead to a very low opt-out rate. It is unlikely that many people will be engaged sufficiently to bother opting-out.

My crystal ball predicts that the low opt-out rate will be promoted as a major success justifying a further rollout. Mark my words.

Anonymous said...

Bruce is correct. A low opt-out rate is no evidence of a successful MHR. Success will only be demonstrated when the record is fully populated with information received from the doctors and the records are used by the doctors.

This can be done in the two trial sites. Further roll out to the rest of Australia should not be permitted until the MHR has been proved in the two trial PHNs.

Anonymous said...

Interesting article, in the Medical Observer:

"E-health records have few fans, study confirms"

Anonymous said...

.... and the article concludes "“Without demonstrating to people the benefits of having a PCEHR, the potential for broad uptake and use of the system will be difficult to achieve,”. As February 01, 2016 8:26 PM says - prove it first in the two trial PHNs.

Anonymous said...

... and as soon as they demonstrate the uselessness and risks of the PCEHR, people, patients and GPs alike, will avoid it like the plague.