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.
Sunday, October 23, 2016
I Think It Is Time For The ADHA To Start Lifting Its Game. We Have Seen A Few Rather False Starts I Believe.
A little while ago the Australian Digital Health Authority (ADHA) announced it had established a blog to provide expert comment on e-Health.
We have had two posts in the last month, both of which have rather reflected a detachment from reality and the e-Health environment.
First we had this (written by Tim Kelsey):
How to harness the power of the modern information revolution: reflections from Perth
Wednesday, 12 October 2016
Nine years ago, Fiona’s husband Peter was diagnosed with a brain tumour. It was benign and they were told that it wouldn’t kill him, but would be ‘a bit of a nuisance’. Peter, who worked as a business consultant in Western Australia, went into hospital for surgery – and then their world was shattered. There was a complication after his second operation and Peter, vulnerable to infection, contracted meningitis. He suffered brain damage and has required around-the-clock care ever since. What initially seemed like something Peter and Fiona could live with, now consumes their whole lives.
Fiona is one of a group of carers and patients who have kindly given up their morning to share insights with me on how health services can be improved with better access to patient information. We are in the community training room of the Health Consumers’ Council in Perth, on the campus of the Royal Perth Hospital. Outside it is bright and blustery; inside everyone is silent and focussed as Fiona describes, with extraordinary dignity, the journey she, Peter (now 49) and their two-year-old daughter have travelled since.
Peter routinely requires hospital treatment. Fiona collects the paper forms from his care facility, which are passed on to the ambulance paramedics, and then to the triage nurses in the Emergency Department (ED), and then they wait – often for hours – for him to be admitted to a ward. Although his information travels with him, Fiona says that it is not always obvious to the treating team what the priority health concerns are. Peter’s medical needs are complex and there are quite a few critical health issues that Fiona has asked to be kept on his file at the hospital as she isn’t always available to attend ED. ‘We are not medical people’, she says. ‘We don’t know how to find our way around the health system. I can show you the letters to the hospital I’ve written asking them to improve their process. I’ve seen my husband go through so much. Even when we pre-agree an admission with his specialist, I still have to go through the ED. I just find it remarkable – ridiculous.’
Fiona wants her husband’s history to be available electronically to his entire treating team, and she would like this to happen without having to repeat herself or intervene. On one occasion, because his record is not shared digitally, his specialist wasn’t made aware of a drug that a hospital doctor had prescribed – and that could have been dangerous for him. ‘It just fell through the cracks’, she says.
“Western Australia has a distinguished record of technology innovation in healthcare. The University of Western Australia is a field leader in proton magnetic resonance research and has spun off a business – Resonance Health – that provides specialised diagnostic imaging services to hospitals across the world including London, Philadelphia, Morocco and Vietnam.”
Sadly the truth is that WA has a long track record of making a really substantial mess – over the last few year with its acquisition and implementation of e-health in the public hospital sector.
Jul 22, 2015 - A LONG list of problems at Perth’s new Fiona Stanley Hospital, including urgent patient cases not being given priority over routine surgery, have been detailed in an independent report. ... The report also detailed problems relating to service provider Serco, including its porters ...
Feb 22, 2016 - WA govt admits to "systemic" IT issues at Health department ... to serious problems with the IT systems and infrastructure at Fiona Stanley Hospital ... "It not as though the information and communications technology risk was a ...
I guess this just reflects being a newcomer. All that is really needed is the local patient GP who can print out the patient’s detailed summary for the patient which the wife can carry to present to all those involved as needed – until of course WA has made some progress with its systems.
What’s the collective noun for a group of healthcare providers? A horde? A congregation? Certainly not a gaggle. I think it should be an orchestra – just as an orchestra is made up of distinctive yet harmonious sections, so too is the healthcare industry.
Recently, at the Sydney North PHN workshop, an orchestra of healthcare providers watched expectantly, waiting for me to pick up my baton, set the tempo and begin:
“The vast majority of people in this room did not get into the healthcare industry to work with computers. Your priority is your patient. Am I right?”
The pharmacists nod their heads, the general practitioners give a bit of a chuckle, and the practice nurses smile. Good, we’re in agreement.
I’ve been a privacy advisor for digital health for five years, and no presentation I make is ever the same. Yet, there is one consistent element with every audience: privacy is a priority. I see that as one of the reasons why some providers have not dived head first into adopting digital health. Those providers want to be absolutely sure that the trust their patients already have in them to uphold privacy is not eroded.
Rather the some rather time worn anecdotes and cute comments, maybe, the approach the ADHA recommends to manage health information privacy – or a link or two etc. - would have been of rather more use. I think those reading the ADHA blog need to be reassured that the ADHA experts really know their stuff in depth. This really does not show that.
There are a lot of people hoping for a new start with the ADHA and much greater understanding and depth from ADHA. Thus far the omens are a little worrying…I hope this changes – and soon!
In passing - I wonder where the new National E-Health Strategy is up to and when we will all get to comment on it.