Sunday, June 04, 2017

AusHealthIT Poll Number 373 – Results – 4th June, 2017.

Here are the results of the poll.

Are You Confident The Current National Digital Health Strategy, With The myHR As Its Core, Will Be Successful?

Yes 3% (7)

No 95% (192)

I Have No Idea 2% (4)

Total votes: 203

The numbers speak for themselves, almost no one, that reads here, thinks the strategy as presently known has much merit. Pretty sad I reckon.

A really great turnout of votes!

Again, many, many thanks to all those that voted!



Anonymous said...

To June 02 7:06 who opens with - All you negative fear mongering My Health Record sceptics need to take note that there is another view of the world
I post this in a new thread as the original thread focused on another important subject which is itself saddening me to witness.
While a GovHR formal the PCEHR can rightly claim to be an important part of addressing the current data fragmentation. If IMHO we are looking to the future then I believe that tapping into the complete, current and ‘fast flowing’ datasets of healthcare providers is an alternative model that delivers more comprehensive benefits to both consumers and the regulators and funders of health. With that it is not that people are against the vision that has been around for decades, it is that the GovHR was a useful step in this journey and served a technical aim of a period of time that has now passed. I find it interesting that some have become so fundamentally bound to the GovHR that they are unable or unwilling to engage in exploring next generation solutions. Is it that we have lost that capability at a national level to have these conversations? Or that no one dare speak of alternative for fear of reprisals? If everything thinks that way then no one will blink first and we loss a generational opportunity.

So are we fear mongrels? No more than than our ancestor who invented the wheel, no more than Florence Nightingale nor Henery Ford.

Anonymous said...

This is a good viewpoint that I believe many people are not considering. The PCEHR will have have some sort of successor, and that successor will need to address the greater issue of data interoperability so health care professionals (and others that need access to data) are able to access the data when they need it. We need to look at what's coming up on the horizon instead getting stuck on the current implementation.

Anonymous said...

A refreshing viewpoint indeed. I wonder Anon if you would accept $ 550,000 a year to lead the way? Anyway you hit a cord and below is my contribution.

While the notion of data may well be unexciting, without appropriate experts such as computer scientists and health informaticians at least have an equal role in design and implementation the current enthusiasm by well meaning but less qualified evangelicals of data could prove an expensive folly. There is no doubt the power of complete, quality data to dramatically improve the fortunes of all health market stakeholders, particularly consumers, is assured if done well. This will I believe have positive consequential benefits to health budgets and will become an important by-product, as intended by the current Secretary for Health.
The time for piecemeal data initiatives is long since passed as is the the ostracisation of these essential subject matter experts capable of partnering with vendors and healthcare providers. Some in the community have for to long have demonised these people as obstacles to achieving progress and it continues, even spreading to include many other professionals who have been in eHealth long enough to. Shin to wonder if there are better ways to do things and less interested in their own 15 minutes of fame.
We ( not I or me) as a community must embrace an initiative that is truly transformative, ( currently we have a snake that changes its skin, not a caterpillar able to undertake a transformation). This goal or vision I put forward, requires that as a collective we start from the perspective that data recorded at the point-of-service is the richest, most accurate and most current resource we have and that the new architecture should seek to capture once and use many times and work toward clinical or open interoperability as it's mantra. To satisfy important threats state-of-the-art techniques to assure security and privacy must be intrinsic to any solutions approach, we must look to gain layers of agreements between stakeholders in privacy and security viewpoints so as not to deflect, hamper and ultimately defeat the initiative as has happened too often in the past, for me this is a result of not listening because it is a difficult discussion for some.
To succeed, a community of purpose so to speak must be inclusive and representative of key stakeholders, with consumers, clinicians and other health services providers determining the health outcomes required (why) and policy makers, funders and researchers driving the what, when and how. It is imperative that government is a key stakeholder and free of unconflicted. This undertaking should be driven as much by non-government stakeholders, perhaps adopting a profile of the standards community with a meritocracy theme where practical. Any and all funding must be independent of electoral and government funding cycles. It must also be freed from the constant changes in stakeholder and management groups that are the characteristic of many national initiatives to date. We should adopt an iterative, lightly engineered approach but extremely well disciplined to ensure safe and changeable implementations.
It is well understood how complex the Australian health system is and the complex make up of governance, funding arrangements, professional bodies, actual and perceived federal, state and territorial policies and legislation add to the challenge and even just the. Umber of identifiers in use… I could go on but other are better placed to articulate these and the challenges facing even data interoperability.

Bernard Robertson-Dunn said...

I had a small rant at the PM&C briefing on the Productivity Commission's Data Availability and Use last Thursday.

As it happens I think what I said resonates very well with Anon 3:33 pm

"There is no doubt the power of complete, quality data to dramatically improve the fortunes of all health market stakeholders, particularly consumers, is assured if done well."

This is a summary of my rant:

In the section on health data, the Productivity Commission focused on availability and use of secondary data. The report looks as though it has been written by multiple people, none of whom properly understands health data. There are numerous places where they contradict and others where there are statements that are totally incorrect. E.g:

“unlike Australia, where each individual will have one eHealth record, in the US each healthcare provider maintains an electronic file about a patient.”

In Australia patients have multiple health records; there is no single eHealth record.

If they had looked at primary health data they would have realised that healthcare professionals need access to health data and that access needs to be protected from emergencies (eg loss of power and communications) and from overloads of centralised systems due to widespread health events or natural disasters.

This means that there should always be local systems and that secondary systems cannot be relied upon. In other words there can never be a single, national eHealth record which is to be used at the point of care.

If you believe the government’s website the MyHR is an optional, secondary, summary system which is incomplete and not to be relied upon.

MyHR is not a data set (the Productivity Commission wants to define National Interest Datasets – whatever they are) any more than a library is a data set. MyHR is a collection of documents and is virtually useless as a research tool. It most certainly is not a National Interest Data set.

What is needed is:

a) better organisation and management of data at the point of care to support clinical use and secondary research purposes.

b) minimal involvement of health professionals at the point of care in managing health data (as opposed to using it)

c) an indexing systems so that data can be identified

d) interoperability such that the data can be accessed as required, based upon a need to know.

Such an approach would allow health datasets to be created as required based upon the most accurate and complete data available at that time.

The section of the Productivity Commission’s report is fundamentally flawed and needs to be redone by people who understand the intricacies of health data. If the government develops policies based upon the Productivity Commission’s report, it is likely to get them seriously wrong.

Anonymous said...

d) interoperability such that the data can be accessed as required, based upon a need to know.

In healthcare this must ensure the semantics, context and meaning is very important

Anonymous said...

The question has to be ...are we being better served by ADHA rather than NEHTA? Is the process anymore transparent, timely or consultative? Has the tax payer being served by the change? Is the half million dollar man making any difference? Are standards being promulgated and delivered?