Sunday, May 28, 2017

The Magical Belief In The Power Of Digital Health Seems To Be Unchallenged And All Pervasive.

We had a presentation from Tim Kelsey, CEO of the Australian Digital Health Authority to CeBIT a few days ago. Here is the blog reporting what was said.

How to make digital health a viable solution in Australia

Holistic and intergrated approaches to digital health

Tim Kelsey – CEO - ADHA
May 25, 2017
‘We’re all in this room because we share a common vision, putting to work digital enablement to help out patients. Yet there is still some work to be done - we’re not where we want to be yet.’
Tim Kelsey, Chief Executive Officer, Australian Digital Health Agency, kicked off his presentation by bluntly stating that digital health services in the country still have a way to go.
He stated at present, that 2 out of 3 hospital admissions there will be an error with medications, leading to more deaths from incorrect administering of medication than from traffic accidents.
To that end, he describes paper-based systems 'as ludicrous, but also dangerous’ and that ‘the solution ‘is so well established that we don’t have an excuse to ignore it.'
The response to this issue by state and federal governments has been ‘to draw a line in the sand and say, “we can no longer be dominated by the tyranny of the fax machine.”’ To ensure that Australia has a robust, agile and functioning digital health system, Kelsey said that two key priorities have been announced.
  1. Getting My Health Record on track
  2. The Development of the Digital Health Strategy

My Health Record

Simply put, My Health Record is the national infrastructure that allows patients to control their own medical information and to decide with whom that information is shared. Its potential is such that the President of the Australian Medical Association, Dr Michael Gannon has described it as ‘the future of medicine.’
Ultimately the national expansion program aims to give everyone a record by default - the exception being for those who choose to opt-out. Initial trials were run in rural Queensland and New South Wales. The outcome was ‘overwhelming support for a comprehensive shared record.’ The primary focus, Kelsey asserts, was ‘the quality of safety. The first thing you want to be assured of when you’ve been in an accident, for example, is that the clinician has access to your records. You want to see that your clinicians can prepare your care effectively.’ In fact the measure was so popular that only 1.9%-2% of those trialled opted out.
Kelsey also acknowledges that while there has been substantive support for the digital health platform, ‘there has been widespread and justified criticism.’ He said ‘While the principle is widely supported, the reality is that My Health Record isn’t where we want it to be yet.’
However, Kelsey is optimistic to the future of the project with a national expansion of the program, to be rolled out in 2018. Integral to its success is the ongoing collaboration with the community and with the tech industry. Kelsey also announced the creation of a developer engagement program called ‘Refresh’ which aimed to partner with healthcare, technology and research professionals who might be able to provide unique perspectives and industry knowledge.

The National Digital Health Strategy

The National Digital Health Strategy is the consensus on what the key priorities are for Australian digital healthcare. From the thousands of people consulted, 7 key priorities emerged, Kelsey describes them as ‘the core foundation that the community is telling us that they would like to see in a healthcare system that is safe, that is accurate and that works.’ The 7 key priorities are:
  1. My health information is available to me whenever and wherever it is needed
  2. My health information is secure and can be shared by me or my healthcare provider
  3. I, my carers, and my healthcare providers can use my healthcare information
  4. My prescriptions and medications are stored digitally and are used to improve my health
  5. I have more options and more choice for accessing my healthcare
  6. I feel confident using digital technologies to access and deliver healthcare
  7. It is faster and easier for me to develop and deliver health and care innovations

Journey to digital health 

While there is still work to be done Kelsey is optimistic about the direction of digital healthcare in Australia. ‘When established, these initiatives can ensure the safe care of those who are most vulnerable, who are most at risk.’
Here is the link:

http://blog.cebit.com.au/how-to-make-digital-health-a-viable-solution-in-australia

Other than pointing out that the ADHA has nothing to do with hospitals in any way that would affect medication errors within hospitals and to wonder just what the ADHA was doing to improve practice computer systems (Clinicians seem notably absent from their strategy thoughts) I will leave it to the readers to comment on this blog.

FWIW my take is that all this goes very little along the way to show real support of clinicians in delivering safer and better care for patients and offers very few solutions to the problems we face. Surely all this totally misunderstands to scale of the task and where the priorities should be.

Surely the faith in an evolving myHR must be pretty challenged by this morning's poll!

See here:

https://aushealthit.blogspot.com.au/2017/05/aushealthit-poll-number-372-results.html

What do others think? – and feel totally free to disagree!

David.

17 comments:

Anonymous said...

Having worked in the NHS a few years back this is history repeating itself. This will provide some insight as to what is coming - https://www.digitalhealth.net/2014/03/a-bad-week-in-the-bunker-for-care-data/

The infamous video is well worth watching

Anonymous said...

"Magical belief" says it all; but then what else would you expect from a magician?

Anonymous said...

Did no one with a background in Australian healthcare apply for the CEO job? This really is becoming an experience in waffle

Anonymous said...

What is this creepy fixation with the facsimile? Did he have a run in with one as a child? Where is the thinking and leadership around the emergence of internet of things and internet of health things, how does the architecture support and incorporate this massive influx of new data streams and where are the standards and specifications to allow interoperability to take place. I am not sure many devices have been design to support PDF, but I am sure designers could dumb them down so Tim can physically see an upload

Dr Ian Colclough said...

The aim of the national expansion program is to give everyone a record by default. “Initial trials were run in rural Queensland and New South Wales. The outcome was overwhelming support for a comprehensive shared record”.

The Siggins Miller “Evaluation of the My Health Record Participation Trials” at its most basic was a series of focus group studies which showed there was, as Mr Kelsey states, “overwhelming support for (the concept of) a comprehensive shared record.”

For the record let’s be clear. There was no evaluation of My Health Record in these ‘trials’. This is a far cry from overwhelming support for the My Health Record as it stands today.

In fact, it could reasonably be inferred that the claim of “overwhelming support” is a bastardised attempt to deceive and misrepresent the ‘trials’ as an evaluation of My Health Record which the participants overwhelmingly supported; which they didn’t.

There was no evaluation of My Health Record undertaken. There never has been! Why not?

Until the many improvements recommended by Siggins Miller [Recommendation 3] have been undertaken, completed, tested, proven and shown to be acceptable to doctors and their patients there can be no justification for extending the system outside the trial geographies, nor can there be any justification for incurring the huge costs involved in doing so’.

Dr Ian Colclough said...

“Kelsey is optimistic to the future of the project with a national expansion of the program to be rolled out in 2018”.

While the principle in concept may be widely supported there is substantial evidence that the current approach to the development of the platform is deeply flawed accounting for Mr Kelsey’s acknowledgement of the widespread and justified criticism.

The Government seems to be holding onto the misguided belief that it will all just happen if ‘someone’ keeps saying it will for long enough and loud enough.

Dr Ian Colclough said...

The National Digital Health Strategy is the consensus of 7 key priorities which Mr Kelsey describes as the “core foundations the community would like to see”. !!!

These are not foundations in any way, shape or form. They are aspirational fluffy thoughts along the lines of ‘wouldn’t it be nice’ (apologies to the Beach Boys).

These 7 ‘core foundations’ lack clarity, precision, substance and pragmatism, reflecting na├»ve rhetoric and a failure to understand what comprises a practicable common sense strategy that others can understand and will want to embrace.

Dr Ian Colclough said...

Integral to its success “is the ongoing collaboration with the community and with the tech industry”. This noble statement lacks substance and conviction. It gives one no confidence there is any clear understanding of what needs first to be done to bring that about.

Anonymous said...

‘REFRESH’ - a developer engagement program which aims to partner with healthcare, technology research professionals who might be able to provide …….. (whatever that might mean).

Excuse me haven’t we heard this sort of stuff ad infinitum over the last decade? We sure have and every time we end up in another dead end. Wake up Australia.

Anonymous said...

May 29, 2017 12:19 PM There you go Tim. Hey, here's a strategy - prove MyHR is working properly in the two trial sites, then get it evaluated objectively, honestly and transparently. 1 million consumers and their docs should be more than enough to make it work for you. Yes? No?

Bernard Robertson-Dunn said...

It's sad that the ADHA doesn't have as a priority, accurate and up-to-date health information.

On the other hand, if they did, they would rapidly reach the conclusion that MyHHR is fundamentally incapable of ever delivering such an objective.

MyHR/ADHA have all the characteristics of a conjuring trick. Deception, distraction and illusion.

Anonymous said...

They are a cargo cult. They want secure messaging so they can get more cargo, thinking that providing the appearance of an organisation that knows what its doing is enough. Once we have messaging the cargo will appear?

Bruce Farnell said...

If the 'strategy' leads them to the conclusion that the myHR is a solution then the strategy is fundamentally flawed and needs a lot more work.

The claim of overwhelming support for the myHR is a joke. Anecdotal comments from a few participants doesn't cut it. Also, the 1.9%-2.0% opt out rate does not equate to overwhelming support. All it tells us is that these people were sufficiently motivated to opt out. It tells us NOTHING about actual engagement or support for the program.

Base on actual usage I suspect that 95+% of the population are not engaged with the program in any meaningful way. How does this equate to overwhelming support?

Anonymous said...

I am surprised anyone hopes the Strategy will be anything more than the GovHR. Tim won't care he works for the highest bidder and has no alegence to Australia or our needs. If anything he is hell bent on proving the UK wrong, he will undoubtedly be picked up handsomely by organisation looking to profit from the data lake he is currently championing

Anonymous said...

What data lake? At some stage people will start to realise that MyHR doesn't and can't contain anything useful.

Anonymous said...

Sadly it is becoming apparent this has turned out to be a shame at great cost in money and people, I don't believe it was everyone's intent, however if we start see things like tenders for thought leadership pieces or expensive studies into data or interoperability that provide no clear guidance or actual investments in our standards communities, but rather support another year of yawning back slapping dribble the. We know it is another six years down the pan.

It is no wonder the ADHA is a poor partner in the new initiatives, I bet even the DTA has them on the 'if we have to meet them list'

Anonymous said...

What data lake? At some stage people will start to realise that MyHR doesn't and can't contain anything useful.

Unfortunately I see scant evidence from the CEO or EGM for Government and Industry and the EGM for Innovation and design have a strong enough background in health informatics or data architecture is grasp there is an issue, when listening to them at various events it is clear there intent is reasonable but clearly lacking any mental model of how this works, would not be surprised if IT is actually quite distasteful to them.

So in their innocence and sadly propped up by some parts of the community (for personal and commercial gain) they will naively continue to drive this beast forward with the promise it will be replatformed ( whatever that means).

Like children playing with matches.