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."

Sunday, May 29, 2016

AusHealthIT Poll Number 322 – Results – 29th May, 2016.

Here are the results of the poll.

Is The myHR An Ideal And Practical Solution For Co-ordination Of Care In Complex Patients As Claimed By DoH?

Yes 0% (0)

No 96% (107)

I Have No Idea 4% (4)

Total votes: 111

This was the clearest vote ever! The myHR is not seen as fit for this use definitively.

Good turnout of votes as well!

Again, many, many thanks to all those that voted!



Andrew McIntyre said...

Your current question raises an interesting point. I certainly have a conflict of interest with Telstra winning the Cancer registry project although did not tender for it.

I do however think that the problem is being "solved" at the wrong end, which seems to be the modus operandi for the bureaucracy. While a cancer registry is important it is dealing with issues after the horse has bolted. The long term studies like the Framingham study and the womens health study have provided very useful information suggesting that eg Saturated Fat is not bad and polyunsaturated fat increases the risk of heart disease. Recent information from trials suggests that calcium supplementation is useless for fracture prevention and may cause cardiovascular complications.

The point is that the real gem that eHealth offers is that good data collection done at the time of clinical review ie prospective as part of routine care potentially offers a wealth of useful data to assess the value or harm of treatments/lifestyle factors. The analysis is in the future but we need to be collecting atomic data now to enable this population wide analysis in the future. What we have is extremely poor data collection that is text bases, non atomic and non shareable. If it was done in a standards based fashion and stored for future use it would be a treasure trove of information (Big data if you like to use buzz words)

What we have is $200 million going to a single organization to manage data that does not yet exist and a very narrow area of interest. If that $200m was spent on improving the quality and shareability of basic patient data like medication, weight, blood pressure and lab results by all health care providers (as well as colonoscopy reports, cytology reports and the resulting pathology) then the job of managing that data would be a whole lot easier, cheaper and more powerful and people would flock to do it for no cost as the data would be valuable. Like the PCEHR the bureaucracy wants to build castles in the air with no consideration given to the foundations of eHealth. Its ill considered and will not advance care, but might be good for shareholders.

Terry Hannan said...

Andrew, "you have taken the words right out of my mouth". I could not have put the problems better. The following text is complimentary to your posting.

• Lack of a robust measurement program
• No nationally agreed-on methods for systematically identifying, tracking, and reporting adverse events.
• A shortage of good patient-safety metrics
• Poor quality measures are plentiful.
Current patient-safety indicators, which use billing data
Poor sensitivity and specificity- their utility varies with hospitals’ billing practices.[Case-Mix, DRGs, ABF]
“To improve care you have to measure it”
• Data collected in a post hoc fashion-NOT at the time of care
• Fail to engage clinicians at the time of care delivery
• Data unavailable for review until years after the care is delivered.
Getting Moving on Patient Safety — Harnessing ElectronicData for Safer Care Ashish K. Jha, M.D., M.P.H., and David C. Classen, M.D.NEJM 365;19 NEJM.org 1756 November 10, 2011

Dr Ian Colclough said...

David, notwithstanding Andrew McIntyre's excellent comments re your current poll question, I have some difficulty coming to terms with the way you have phrased your question. The inference in your question suggests that if there are valid reasons for concern with For-Profit-Entities then surely the only alternative is to embrace Government E-Health Projects!

Both have a role to play. Neither can be excluded from the equation.

There are just as many valid concerns with Government-E-Health Projects as there are with For-Profit-Entities projects. Paramount to realising an appropriate balance, with one or the other or both, requires at the bare minimum - good governance, transparency and trust, solid project management and competent informed leadership.

Dr David G More MB PhD said...

Ian, my point was, implicitly, to see if the for-profit sector should be involved in managing health information. Clearly a majority seem to think so, so far with 60 votes or so in.

The question made no assumptions on the role of the public sector.

For more detailed views see the blog being posted later today. In summary I think most of the concerns are overblown and hysterical, and seem to be based on biases against business in general rather than understanding specifics. Both the private and government sector can stuff up the management of health information - and both have in the past!


Anonymous said...

Re your current poll on who should take the blame for the failure of dr shopping nationally - state or federal governments or both.

It's not that simple. Firstly there was a failure of leadership by the Federal Government. Secondly there was a failure by state and federal governments to deeply understand the problem to be solved. Thirdly there was a failure to thoroughly evaluate the Tasmanian DORA system before rushing in with $5M to acquire a national licence only then to dump a fait accompli responsibility on the states - "Now that we've bought the national licence you, the states, must modify the system at your expense however you want to meet your needs and then deploy it at your expense. Fourthly the peak bodies have made a lot of noise about the urgency to address the dr shopping issue then ducked for cover and done nothing. SNAFU.

Anonymous said...

"Now that we've bought the national licence you, the states, must modify the system at your expense, however you want, to meet your needs and then deploy it at your expense."

Sounds like Department of Health rides to the rescue:- "Hi there - we're from the government and we're here to help."