Tuesday, March 21, 2017

We Really Have To Move Slowly And Carefully With Health Record Apps. It Is Not All That Easy!

This appeared a few days ago.
16 March, 2017

Now you need to take the MyHR and EMR apps seriously

Posted by Jeremy Knibbs
We’re great ones for predictions at The Medical Republic so here goes a couple of big ones regarding personal electronic health records and GPs.
The My Health Record system (MyHR) is finally going to do some good, but patients carrying around their personal electronic medical records (EMR) isn’t going to look anything like government agencies or doctor groups have been saying it will for a while. That’s probably a relief because no one could quite work out how the MyHR was ever really going to work if neither doctors nor patients had particularly bought into uploading and maintaining the data.
Two things are happening about the MyHR project that should be far more interesting to GPs:
  • The Australian Digital Health Agency (ADHA) (formerly the NEHTA) is starting to cut through the murky world of pathology, radiology, pharmacy and hospital reporting to offer centralised data on the MyHR which doesn’t consist of just messily cobbled together health summaries from GPs who aren’t being paid well enough to stop and do this job properly.
  • The private sector is starting to move rapidly on the mobile opportunity of personal health records and some, such as MediTracker, have cracked the problem of talking to the major patient management systems in a live, and reasonably seamless, manner.
GPs are now faced with the very real prospect of having technology which allows them, their patients, and allied network, to share a mobile patient record that is live and useful, and, most importantly, is not difficult for you or your patient to maintain.
Such technology can now serve a very immediate and practical purpose, such as help GPs provide chronic illnesses much better. And it isn’t going to get in the way of you and your patient, such as loading health summaries tend to do now.
Today, only one mobile app actually talks to the MyHR, and that is Chamonix’s offering, called Healthi.
Unfortunately, Healthi is currently next to useless because it doesn’t talk to your patient management system, such as Best Practice. Plus, Healthi doesn’t appear to understand the ecosystem of GPs and allied health professionals, where the most impact from a mobile personal EMR can be achieved.
To even get the Healthi app to work you have to set up a myGov account, and if you’ve ever tried to do that, you know that it’s going to be painful to get it all going.
MediTracker, which TMR reported on in our last edition, does talk to the major patient management systems and has a cloud network that talks to allied health, specialists and hospitals. But it isn’t talking to the MyHR yet. This apparently is going to change in the very near future.
When this occurs, GPs will have a lot of what they need for the personal mobile EMR to be very useful for them and their patients and GPs should start thinking about embracing it.
Undoubtedly the people from Chamonix are thinking of talking to the major medical software systems as well. And according to Tim Kelsey, CEO of ADHA, no fewer than 30 software and mobile developers are currently working on talking to the MyHR application program interface (API). So the race to produce a useful personal mobile EMR has well and truly started.
There is a great deal more here:
So it seems there is a bit of a ‘gold rush’ on to get access to the myHR and make it available to the patient and other carers.
On the surface this all seems to be a splendid idea. As I was just digesting this, I had this little article appear!

Data breach fear for 26m GP records

Nadeem Badshah
March 18 2017, 12:01am, The Times
An investigation has been launched into the security of a computer system that holds 26 million patients’ records.
The Information Commissioner is looking into a potential breach involving 2,700 GP surgeries. It centres on SystmOne, which is used by family doctors. When GPs switch on “enhanced data sharing” so that records can be seen by a hospital, they also can be accessed by thousands of staff even if there is no medical reason to do so.
Paul Cundy, of the BMA’s IT committee, has written to GPs who use the system, which is owned by TPP, calling on them to take “urgent action”. He warned doctors that they had breached data protection laws. “This is a serious issue with potentially huge implications for patients, GPs and TPP. At the moment GPs are at risk of complaints being made against them,” he said.
More here:
My reaction was that there must rather have been a loud “oops!” coming from the developers. Clearly the design of the enhanced data sharing needs a little more work.
At the same time this appeared from the US.

GAO details weaknesses in federal push to share patient data

By Joseph Conn  | March 16, 2017
A federal watchdog group said HHS isn't doing enough to measure how much patients are using their medical records. The Government Accountability Office also found patients aren't accessing their medical records because they can't aggregate all of their information into one medical record, underscoring the need to streamline and standardize systems.
Patients often have to go through different portals for each provider, the GAO said, adding that patients generally have to manage separate login information for each provider-specific portal.
Personal health record technology is available to collect the records, but these systems “are not widely used,” a 55-page GAO report stated.
That is despite the federal government having spent more than $36 billion to incentivize hospitals to buy the technology to make it easier for patients to access and use their medical information. The federal government has long promoted the idea that informed patients are healthier and could potentially drive down costs.
Congress asked the GAO to look at interoperability of health IT systems from the patient's perspective. It was tasked with describing the extent and type of information available to patients, their views about access and what actions providers are taking to encourage access. Congress also asked the GAO to evaluate efforts by the HHS to boost patient access.
The agency looked at data from 3,318 hospitals and 194,200 physicians.
They found that hospitals participating in the EHR incentive payment program offered 88% of their patients electronic access to their medical records, but only 15% of those patients electronically accessed their information. For physicians and other eligible professionals in the incentive program, the numbers were 87% and 30%, respectively.
Lots more here:
So, as always, care in handling patient information is vital! Additionally patients are apparently rather less interested in their health information than many imagine so it is important to have engaging and useful systems.
I hope all the relevant information controls and access controls are being mandated by the ADHA and that sensible pilots to confirm attractiveness and utility are also being conducted. I hope so!


Anonymous said...

This also is a good reminder how we can learn from others costly mistakes - https://www.theregister.co.uk/2015/10/13/nhs_apps_library_shelved/

I am sure the ADHA can market a good picture of a utopian future, however I question their collective understanding of reality, or discipline when it comes to chasing numbers as a success criteria.

Anonymous said...

I have the MediTracker app and connected to my GP. It is fine and does what they say, however if it goes anywhere near the pcehr I will remove it and my subscription, I sadly don't trust anything from government interconnecting with my devices, they are to high a security risk to be a backdoor.

I am also not surprised with the stats from the US, having access to this information is a nice to have but not really up there with banking, super, etc and it is certainly not riveting fun for the whole family.

What we also need to be careful of, is that we do not divert attention and resources away from properly supporting the healthcare workforce, they are the real value to me as a consumer not some app stuffed in a folder with a bunch of other iPhone health stuff.