This very long and very informative article appeared last week.
4 May 2017
Unfinished business – the Frank Pyefinch story
Dr Frank Pyefinch, the founder of both MedicalDirector and Best Practice, is the closest thing we have to a founder of Australian digital GP medicine. His story and ideas tell us a lot about how we should be embracing a rapidly unfolding digitally connected world in Australian medicine.
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Fast forward until today and Frank believes that Best Practice is the strong and growing market leader. It has Sonic Healthcare as a 30% strategic stakeholder, and is, in the background, building its next two big iterations – a fully functional cloud and mobile version of its product, and a multi-functional patient app that talks directly to the system.
When asked about all the noise around the rise of digital medicine, the capital-letter consulting firm advice to big health corporates on strategy, the venture-capital funding starting to flow, and of course, all the hype, Frank’s mind seems almost to be wandering.
It’s not that he isn’t focussed. It’s just that he has a plan. His own plan. And a lot of experience and a track record that says he might just get to the end of that plan. He’s genuinely not that interested when I talk to him about things such as the MediRecords cloud-based system, MediTracker, medical artificial intelligence robots, and the like.
On the MyHR, he is a little animated. His best guess is that technology may have already bypassed the project. He says that things such as the upcoming Best Practice mobile app for patients, and the recently released MediTracker patient mobile app, may make a lot of the MyHR the project redundant in the not too distant future.
MediTraker is downloadable through Best Practice, and both it, and the new patient app (not out yet), talk directly between a patient and the Best Practice patient management system, so patients already can have a form of their medical record with them at all times. Eventually, they will be able to most of the things they need as a patient, says Frank, such as bookings on the fly, and, eventually, telehealth.
As with his competitors, Frank doesn’t follow the MyHR project that closely. He first got involved when NEHTA, the predecessor to the Australian Digital Health Agency (ADHA), approached him, and other vendors with a request that he write a link to the PCEHR (predecessor to the MyHR). In Frank’s typically laconic style, his first response to the Department of Health at the time was, “no thanks”, as he saw very little utility in the project for either his doctors or his patients.
That he was disinterested in the project should have rung alarm bells for NEHTA. It didn’t. The original argument was that it was for the public good. Frank didn’t think so. And he does consider the public good, because the public are the patients on his system.
Eventually NEHTA caved in and paid all the major patient management system software vendors to write links to the MyHR. Frank is still a little annoyed he had to do it, as he thinks it was a lot of work for not much progress.
It looks likely that the ADHA may have to pay the major pathology providers to do the same thing to get them to talk to the MyHR.
What is intriguing is that no one senior from the ADHA has contacted Frank and attempted to sit down with him and ask him why he is so disinterested. After all, he is at the epicentre of medical data and communications in the country. That is, if you believe that GPs are that major hub – the fulcrum where prevention keeps people away from the expensive tertiary system, and gets them out of there much quicker when they are unlucky enough to have to visit it.
But for some reason, still no one is interested. Maybe they don’t want to hear the bad news?
Although he has been known to be cantankerous from time to time, Frank is perfectly open and pleasant during this interview. He is on his own timetable and he seems pretty confident on all his settings. He’s not focussing on competitors. He’s focussing on his patients and facilitating the GP-patient relationship to make it even more efficient.
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Disclaimer: The author owns 0.8% of MediRecords (for what that is worth). Best Practice has never paid The Medical Republic any money for advertising, and certainly not for this article.
The bottom line here is that if the biggest provider of practice management systems in the country has already gone past what is offered in the myHR, why are we still investing in it.
It must be that the Government wants to hoover up your personal data for its own purposes. It is nothing to really do with clinical care!
Thanks Frank for making that clear!
David.
I use the apps discussed and my GP is part of IPN. I am hoping this excludes me from Opt-out as I already have access to the benefits, so many I could not accomodate any more benefit, perhaps the Government could redirect those benefits to some where else.
ReplyDeleteDavid, If you'd just stop looking for logic and/or evidence, and/or a rational argument from this government, you'll feel less stressed and a whole lot better. They are like naughty children, they will eventually learn or suffer the consequences, but they can't be told.
ReplyDeleteGreat insights, thanks for posting David. I am noticing a lot of key people well versed in eHealth have been left out of the conversations. Is it that some cannot or are afraid to engage in meaningful debates with subject matter experts and leaders who have earned those titles?
ReplyDeleteI am not sure this is exactly what the ADHA board intended, well I hope it is not.
There's a potential win-win for everyone except the poor old taxpayer and those the government might wish to surveil.
ReplyDelete* Everyone is "given" a MyHR
* Proper, real and useful eHealth systems have the capability of uploading documents into MyHR with little or no effort by healthcare professionals and are incorporated int standard workflow. e.g. the GP who has just seen a patient closes the record on the local system and a new SHS (probably exactly the same as the previous one) is uploaded.
* The healthcare industry and the vendors who support it pay lip service to the government, but in reality just get on with the real business of improving healthcare. As Frank has pointed out, the government lives in its own bubble and believes what it wants to believe - at least, that's my interpretation of the article.
* No healthcare provider ever downloads anything from MyHR, so there's no problem with data inaccuracies, inconsistecies, difficulties in making sense of all the pdfs, as well as MBS and PBS payment data.
* The government claims great success - there's lots of registrations, lots of data being uploaded, Senate Committees are well impressed by the stats.
* Nobody would be able to identify if it was actually saving money or doing any good, but some tame consultant could write a report claiming it did.
* The government can link to MyHR looking for potential fraud conducted by patients and/or healthcare providers (under section 70 of the legislation - "protection of public revenue"
It would be rather like having a stuffed pet in the corner of your living room. Looks good, no mess, very little upkeep costs (the occasional dusting) and it gives the impression of a pet without actually being one.
No healthcare provider ever downloads anything from MyHR, so there's no problem with data inaccuracies, inconsistecies, difficulties in making sense of all the pdfs, as well as MBS and PBS payment data.
ReplyDeleteReminds me of my days within the entity whereby software success. Was measured by lines of code, no one new if if was necessary code or quality code, just lots of code. Still like clinical workflows they rarely new what code actually was.