Tuesday, April 05, 2016

It Seems Clinicians Are Still Not All That Impressed With The myHR!

This appeared last week.

GP continue to shun MyHealth Record scheme

Paul Smith | 30 March, 2016 | 
Only 380 GPs appear to be actively using the billion-dollar MyHealth Record despite its recent Federal Government “reboot”.
According to Department of Health figures, 378 “providers” updated or uploaded a shared health summary (SHS) to the system in February.
Only 60 providers in Queensland posted the summaries — meant to be MyHealth Record’s information backbone — during the month.
In WA there were only 19 providers; in SA just 18 and in Victoria just 51.
From next month, the government will attempt to put more pressure on doctors to become involved by making it mandatory for GP clinics to upload a fixed number of summaries to receive ehealth Practice Incentive Program payments.
The summaries include a list of current medications, diagnoses, allergies and immunisation histories.
February 2016: documents uploaded/updated to MyHealth Record

Shared health summaries
Discharge summaries
Event summaries
Specialist letters
Diagnostic reports
While GP engagement with the MyHealth Record remains extremely patchy, hospitals in northern Sydney and north Brisbane have begun uploading patient discharge summaries en masse.
A total of 15,700 and 4600 were uploaded, respectively, during February.
More here:
What is interesting here is, with the absence of the NT (which uses a different system) is how few clinicians are actually uploading shared health summaries.
Approximately 6000 Shared Health Summaries a month - when you think of the number of GP consultations per month - just highlights how little the system is being used.
Pity the money being spent on this is not being spent to add some real value.
There is also a long and very well researched article in the Financial Review from last weekend which makes some interesting points:
  • Apr 2 2016 at 12:15 AM

'One size fits all' a recipe for ill health in endless medical records quest

How's this for a truly awful example of everything that's wrong with the health system:
Patient A is a 57-year-old customer of health insurer nib. She had 19 hospital admissions over a two-year period, costing nib in excess of $85,000, "due to her multiple chronic ailments, lack of care co-ordination of her healthcare needs and siloed communication across primary care, hospitals and specialists involved in her care," according to the insurer.
Mrs A, who had a history of pulmonary hypertension, diabetes, chronic back pain and numerous other chronic diseases, is the archetype of the high-care patient at the centre of the Turnbull government's big new plans for primary health care in this country.
Only on Thursday Prime Minister Malcolm Turnbull and Health Minister Sussan Ley said care for the chronically ill will be overhauled under a new system of Health Care Homes, in which electronic records will be a key component.
Australians with high-care needs see up to five different GPs a year. About 20 per cent of the population live with two or more chronic diseases, and half of all avoidable hospital admissions in 2013-14 were due to chronic conditions.
"There is still far too much evidence of overservicing, overcharging and avoidable treatment," nib managing director Mark Fitzgibbon says.
At the centre of this debate is a concern that the Federal governments much vaunted national My Health Record has failed to reach most Australians. Since it was launched in 2012, 2½ million people have signed up, vastly less than is needed to make the system a truly national record.
In frustration private health providers are creating their own systems. While this is helping lift the number of people with easily accessed data, there are risks that the process will ultimately lead to a fractured national record.

Good progress but much to be done

"I think [the private health insurance] industry is making good progress on this front, but there is much to be done. At nib we're especially interested in helping people make better decisions around their treatment options and choice of health-care provider through initiatives such as Trip Advisor style [website] Whitecoat," Fitzgibbon says.
New Medibank chief executive Craig Drummond said this week that the nation's soaring medical costs, which have pushed health insurance premiums up by 5 to 6 percentage points a year for the last decade, are unsustainable.
Leading up to Friday's Council of Australian Governments meeting, South Australian Premier Jay Weatherill dismissed $5 billion of extra federal funding for state hospitals as "a Band-Aid on a much bigger wound."
One of the most egregious shortcomings is the failure to share and collect patient information. This syndrome, with its endless anecdotes of repeat orders for unnecessary tests and scans, and wasted medicines, has become a symbol of the waste and inefficiency endemic in the health system.
"We can't co-ordinate before we're connected," Calvary Health Care chief executive Mark Doran says.
"Ambulances don't talk to New South Wales Health. In the ER [emergency room] they ring on the phone to tell you something is coming and they write it down on a piece of paper. It is crazy. Why wouldn't the ambulance be transmitting data to the hospital?"
Despite past failures, billions of taxpayer dollars are once more being thrown at e-health initiatives including a fresh $485 million injection into the federal My Health Record program.
Lots more here:
These few lines really say what most who read here know:
“The Grattan Institute's Dr Stephen Duckett says Australia's pursuit of e-health "has been a tragedy".
"We are way behind other countries, such as Denmark, and we have started off in so many of the wrong places to the extent that the then-Labor government conceptualised success not in terms of meaningful use, but in terms of how many people signed up," he says.
While governments tinker and try to push systems on to doctors and patients, healthcare providers are finding solutions based on the needs of patients and clinicians.”


Bernard Robertson-Dunn said...

Registration is not the same as health record creation

Health record creation is not the same as having a useful Health Summary in the record

Having or updating a Health Summary is not the same as using a Health Summary

"According to Department of Health figures, 378 “providers” updated or uploaded a shared health summary (SHS) to the system in February."

So how many people actually used a Health Summary as part of point of care?

I doubt they even track it, but it's the only meaningful measure.

Bernard Robertson-Dunn said...

On twitter, Michael Woodhead proudly tweeted that "PHN hires 23 staff to deliver MyHealth Record"


That's a lot of money to spend on populating a secondary health record system. My guess is at least $2m/year.

And I thought the MyHR was supposed to save money. Silly me.

Anonymous said...

Devolution of responsibility at its best A repeat of Wave 1 and Wave 2 fiascos. How on earth can 23 staff ever be justified - this is like the PCEHR Tiger Teams but worse.

Bernard - 5:22 PM - you have nailed it.

Anonymous said...

Regarding your latest poll, I am not convinced the money could be better spent, it is the same people putting the money elsewhere, and this is an example of waste as an industry

Anonymous said...

No at least the tiger teams were a joke, not as funny as clinically validated data. Wonder where that lot are now

Anonymous said...

Some Health Funds, State Health Departments and some private hospital groups like Ramsay Health Care are undertaking their own Health Record initiatives. Either they have no confidence in the Government's My Health Record or they have lost patience waiting for a meaningful, useful Health Record to evolve.

If these trends continue and there seems to be no way the Government can stop them emerging the whole concept of a national health record is likely to be undermined by some of these private sector initiatives, thus creating a fragmented market and confusing the consumer about which Health Record one should 'opt' to embrace (sounds like multiple opt-ins are evolving.

At the rate the Department's MyHR is evolving it is a fair bet that the private sector's health record solutions will become the defacto standard for most patients and their health professionals.

Anonymous said...

My Doctor gives me an updated health record every time I see him.

He asks for my health record USB, plugs it in to his system, drops my summarized personal health record on to the USB, secures it with a random security code which he writes down and gives to me. I can access the record when I want and download it onto my computer if I want. I can let my specialist upload it from my USB or read it on my laptop when I see him. I can also take it with me to hospital. On one occasion I printed it out showing the date it was last updated and the hospital inserted it into their hospital record. Next time I see my GP he will repeat the process, overwriting what's on the USB and provide me with my own updated personal health record. It's very convenient. I think it's probably the way of the future.

Bernard Robertson-Dunn said...

re: "Some Health Funds, State Health Departments and some private hospital groups like Ramsay Health Care are undertaking their own Health Record initiatives."

Are these health record systems for use at point of care?

The MyHR is being sold as a system that has a health summary and is not designed for point of care.

It's not surprising that proper health service providers are developing their own. The MyHR is just an expensive overhead.

Has anyone ever seen a report of someone downloading a health record from MyHR and using it in the delivery of health care?

I have never seen such a report. Which means that over $1.5billion has been spent on a system that's never been used for its intended purpose. It's rather like a write only database -- interesting technically but of no use whatsoever.

Anonymous said...

Re 3:42 PM "It's not surprising that proper health service providers are developing their own. The MyHR is just an expensive overhead."

My doctor agrees that's why he downloads my personal health record securely onto my USB for others to refer to if I permit them to. It's the most current information he has available about me which he updates whenever I see him with whatever other information he has received since my last appointment.

Anonymous said...

What's not to trust with DoH running the show, supported by NEHTA leadership - http://www.crikey.com.au/2016/04/06/sure-you-can-opt-out-of-giving-govt-your-info-by-giving-govt-your-info/