Monday, July 25, 2016

Magical Thinking And The Search For Relevance - Ms Ley And The myHR.

This appeared today.

Malcolm Turnbull to meet key health bureaucrats

  • The Australian

Sean Parnell

Prime Minister Malcolm Turnbull will today meet with health department officials for the first time since the Coalition’s re-election bid for was almost derailed by Labor’s so-called ‘Mediscare’ campaign.
Ms Ley will also tell a Health Informatics Society conference almost four million Australians have an electronic My Health Record.
“In order to make our Health Care Homes work, we need innovative digital health ideas to help PHNs and primary health professionals to better co-ordinate and manage chronic disease,” Ms Ley will say.
“We need these ideas to link into the My Health Record and we need them to engage with the patient, so they can better self-care.”
The fate of the Medicare payments system — already holding back reform and compliance measures — is unclear, with Labor’s claim it would be privatised or sold prompting Mr Turnbull to rule out outsourcing in favour of an internal upgrade.
Lots more here:
So someone else needs to be very clever and innovative to sort out and make useful the hopeless myHR initiative!
Implication – we are out of ideas so please help us to not waste a fortune!
Great and true admission!
Just astonishing!


Anonymous said...

I've read the article David but I don't get it. What exactly is just so astonishing? What is the great and true admission you can see but I cannot? Where does it say we are out of ideas? Where does it say please help us to not waste a fortune? Maybe you're reading a different article!

Dr David More MB PhD FACHI said...

Ms Ley says:

“In order to make our Health Care Homes work, we need innovative digital health ideas to help PHNs and primary health professionals to better co-ordinate and manage chronic disease,” Ms Ley will say.
“We need these ideas to link into the My Health Record and we need them to engage with the patient, so they can better self-care.”

I would have thought it is the DoH/Minister's role to have ideas on how to make all this work...rather than spending $1B+ on the myHR and then asking for ideas on how to use it?

Surely if they knew they would be telling us?

This is a classic 'we have a hammer' so the whole IT for the trials needs looks like a nail!

Maybe might have been better to design the IT to support the trials? But that could have been a bit too sensible....


john scott said...

David, I agree very much with your assessment and analysis as far as it goes.

You will no doubt note that the Minister couched the challenge in the following terms:
1. Better co-ordinate and manage chronic disease
2. Help PHNs and primary health professionals
3. We need them to engage with the patient
4. We want the patient able to better self-care
All of these are laudable--as far as they go.

What is striking is the absence of any mention of: a) Specialists; and b) Hospitals and the State/Territory health care system; and c) the private health sector.

Better co-ordination of chronic disease (note not chronic condition) is a worthy goal to pursue. Unfortunately, a good deal of the chronic disease, as opposed to chronic condition, management rests with specialists both in the public and private sectors.

Patients and indeed carers are going to need their interests reflected through the prism of the real care team, not just one or two members. I and others with a chronic condition are forever crossing the existing boundaries and it is paramount that the challenge and indeed the opportunity be expressed in this reality. At the moment I have to keep them all informed and up-to-date and I am not alone in this obligation.

In this context, the missing strategic element is a focus on achieving a revolution in the quality of cooperation and collaboration to enable chronic disease / condition management to succeed.

The remainder both inclusions and exclusions demonstrate just how narrow and frankly unhelpful the Federal Health Department and Minister have been and this has been a long-standing problem, regardless of which party has been in power.

The KEY Question is whether the Health Minister and indeed the Prime Minister are prepared to put the assumptions and current strategy to one side and invite contributions of New Concepts and New Ideas and indeed New Evidence into the at present too narrow conversation?

If this were the case then I and presumably others would relish the opportunity to put forward such new concepts, innovations and evidence. Until then this should be seen as no more than widow dressing over the failed PCEHR.

Bernard Robertson-Dunn said...


"widow dressing over the failed PCEHR"

I hope that was a typo.

Apart from that, I agree totally with what you've said.

Anonymous said...

There is a growing resignation that ultimately it will the informed health consumer that will drive change - ie its our last hope. Acute system EMRs have dried up the funding. Lack of leadership/institutional inertia and actor self interest means its reached a point of a slow failed state/system. Consumer/citizen self management is the lowest cost option for government- one step removed from "you are on your own" but without the social collapse. This is where we are at. Have a look at dear old Queensland Health - re-co opting a previous co opted CIO back again!

Anonymous said...

The Minister reflects the bureaucrat's view. "Yes Minister, we have designed and built a very comprehensive highly functional system, at great cost (>$1.5 billion)to the taxpayer, based on expert advice and submissions we have received from a wide range of consultants, software developers, consumers, clinicians, professional bodies and consumer groups."

"And Minister, the system has been designed to deliver a health record for every Australian which will help better coordinate and manage chronic disease, and minimize adverse medication events thus helping to reduce the bulk of un-necessary hospital admissions."

"The system is being trialed as we speak Minister before it is rolled out nationwide, and that is where we are now at - Minister."

Bernard Robertson-Dunn said...

What would be really good would be to get a few questions asked at Senate Estimates:

How many MyHRs have Health Summaries?
How many MyHRs have been downloaded by someone other than the GP who put it up?
How many MyHRs have been used to deliver improved health care?
How much money has MyHR saved?
When will the MyHR system break even?

These would be nice to know

Anonymous said...

Does anyone know if the PHNs will be involved in the fiscal aspects of the "Health Care Homes" initiative? That is the direct handling of money via the PHN from the Government to General Practice?