Sunday, March 26, 2017

Is It Possible To Really Believe Anything We Hear From Government Regarding The myHR? Are They Really Ignoring Their Own Legislation?

Towards the end of 2015 modified update legislation relating to the then PCHER was passed through the Commonwealth Parliament.
This legislation was triggered in response to the earlier Royle Review of the PCEHR commissioned by Minister Dutton when the Abbott Government was elected.
Here is a link that covers the outcome of that review from late 2014 – including a link to the actual report.
The summary of the 2015 legislative outcome is as follows.

Re-booting ehealth

Australia November 16 2015

In brief

  • The uptake of eHealth records has been low, with only 10% of Australians having registered, an insufficient population for an effective national system.
  • The ‘re-booting’ of eHealth, announced by Minister Ley in May 2015, has progressed with the passing of the Health Legislation Amendment (eHealth) Bill 2015 (Cth) by both houses of Parliament.
  • The most dramatic reform is a shift from an ‘opt-in’ to an ‘opt-out’ approach to enrolment, which is likely to give the system the necessary ubiquity to drive utilisation and innovation.
  • The regulation of the use of health identifiers and health information has been strengthened as a corollary of the adoption of an ‘opt out’ model.
  • Further reform is expected, with the expansion of the role of the National eHealth Transition Authority under a new structure, to be called the Australian Commission for eHealth.
Most interesting are the comment on the recently approved opt-out approach to the myHR.
Here it is as part of a much fuller review.

“Adoption of an ‘opt out’ enrolment model

The most substantive change introduce by the Bill is an amendment to the MHR Act to allow the creation of a ‘My Health Record’ for an individual unless they opt out.
The Bill requires that a trial of the ‘opt out’ model must first be undertaken to determine whether the change in model leads to participation in the system at a level that ‘provides value to users of the system’ before the model can be adopted throughout Australia.
The requirement for a trial is an unusual approach; it suggests a degree of uncertainty as to whether the poor take up of the PCEHR is explained by personal choice or apathy. It is also unclear whether anything short of an overwhelming level of ‘opt out’ in the trial would influence the Commonwealth to abandon the rollout, given the clear imperative to establish a functioning eHealth record system in Australia.
Here is the link to the legislative review:
This was the state of play till Friday when this was sprung on the unsuspecting public.

COAG Health Council Communique - 24 March 2017

The Federal and state and territory Health Ministers met in Melbourne at the COAG Health Council to discuss a range of national health issues. The meeting was chaired by the Victorian Minister for Health, Jill Hennessy.
Page last updated: 24 March 2017
24 March 2017
The Federal and state and territory Health Ministers met in Melbourne today at the COAG Health Council to discuss a range of national health issues. The meeting was chaired by the Victorian Minister for Health, the Hon Jill Hennessy.
Health Ministers welcomed the Hon Dr Jonathan Coleman, the New Zealand Health Minister, the Australian Capital Territory Health Minister, Meegan Fitzharris MLA, the New South Wales Health Minister, the Hon Brad Hazzard, the Commonwealth Health Minister, the Hon Greg Hunt and the Hon Roger Cook, the new Health Minister from Western Australia, to their first COAG Health Council meeting.
Major items discussed by Health Ministers today included:

Health Practitioner Regulation National Law Amendment Law 2017

Advancing the clinical trial environment

Expiring National Partnership Agreements (NPAs)

Update on medical research at Commonwealth and state level

Pre-exposure prophylaxis for the prevention of HIV

Meningococcal W

Ear disease and hearing loss in Aboriginal and Torres Strait Islander children

Other items

Ministers considered a number of other important national health matters, noting ongoing cooperation and work on issues including long term health reform, digital health, childhood obesity, the implementation of the Health Care Homes program, end of life care and the medicinal cannabis.
Ministers agreed that the Fifth National Mental Health Plan will re-emphasise its objective of Suicide Prevention and will therefore become the Fifth National Mental Health and Suicide Prevention Plan.
Ministers agreed to a national opt out model for long term participation arrangements in the My Health Record system.
Here is the link to the full communique with the comments on all the earlier matters included.
Note the bold text in the last 2 lines – seemingly meant not to be noticed or commented upon! This rather reminds us all of a Department getting out the controversial / bad news late on a Friday afternoon in the hope it is not noticed!
So we are left with 2 choices – either there is a secret evaluation report of opt-out but we have not been shown it or a decision has been taken ignoring the legislated requirement of a trial and presumably a report on said trial(s).
Either way it looks to me the Health Department and the ADHA would appear to be trying to reduce our confidence in the transparency and proactivity of their communication.
We really need to see better than this for the sake of both the e-Health community and the public. Observing co-design in actuality as well as in announcements  would be really good as no-one wins if things are done like has just been done here!


Anonymous said...

That is Gold David, if there is one thing you expect bureaucracy to adhere to it is legislation.

Anonymous said...

David some interesting insights in the Australian today under the heading - Medicare ID check on the cards as new payment management system introduced.

Anonymous said...

They had better get this right, The success of Health Care Homes relies on a MyHR and my mum really needs to be part of that. I will be a very unhappy son of a farmer if this results in anything less than it promises. The government has done much harm across the board.

Anonymous said...

Being inclusive is not achieved through power point statements anymore than defining a culture creates that culture, quite the opposite, to foster cultural change and become inclusive is led through action and honesty which leads to respect and trust earned. Sadly the direction seemingly being taken is more akin to totalitarianism. It is not isolated to ADHA but rather a collective across governments.

ADHA wants to be inclusive but has now been stained and may be in a worst light than its predecessors if things do not change quickly

Anonymous said...

ADHA folks love stories of Digital Health, these stories are why I worry about the MyHR -

Looking at governments latest treatment of citizens based on government computers telling them inderviduals were ripping us off. I know consumer and privacy advocacy groups work hard for my interests but government has become so arogant that there is little these groups can achieve. I watch the French elections with dimming hope, we can I'll afford a repeat of the early 20th century.