Tuesday, June 06, 2017
Somehow Jeremy Knibbs Seems To Think He Has A Plan To Fix The myHR. My View, He’s Dreamin’
This appeared late last week:
2 June 2017
The RACGP and AMA compacts with the federal government aren’t seen by most GPs as meaningful, which isn’t surprising. At just 55c extra per consult this coming year, a drawn-out path to a full lift of the freeze over the following two years, and not much else, these contracts were always at risk of being seen as limp. The agreements might in fact be locking in a position of no progress, or worse, ongoing regression. After all, we’ve now firmly agreed to snail’s pace changes to MBS rebates, which essentially keep GPs well under any sort of indexed pay rise for the next few years. And that’s the tangible part of this compact.
As much as the RACGP has led with its chin by making such a compact, blaming the College is probably a little simplistic. They are, after all, mainly a training organisation. Plus, they’ve grown into an organisation that is large and struggling to undersand what it is. As such it is a little unwieldy in terms of governance and leadership in matters like these. Which is a long way of saying, the College at this point really isn’t set up for this sort of stuff.
The AMA is largely an employment and lobbying organisation, so perhaps we could blame them a little more, but as with the RACGP, navigating the politics of such big organisations tends to dilute the ability to lead change.
So is there any hope of transformative change for general practice in the near future?
There might be. But from the most unlikely of places. Perhaps from a place that has been moribund for so long it has entered mythology as one of greatest government screw-ups of all time. From the agency that brings us – I’m almost reluctant to mention the name here lest you stop reading or fall asleep in your chair – the My Health Record. Yes, the Australian Digital Health Agency, previously NEHTA.
Before you click away, or flip the page, bear with me for just a second. The federal government didn’t get into the game of digital transformation just to make us all laugh, or cry, at how much they could screw things up so thoroughly. They had good intent. They just didn’t have a clue after that. Which doesn’t exactly excuse spending nearly $1.5 billion on trying to establish a nationwide digital health record for all Australians and four years on, having very little to show for it.
But just say you could make some form of the My Health Record meet some of its intended specifications sooner rather than later. Say you could make substantial progress towards this goal within the next nine months. What might that look for GPs and their patients?
Do not click away chuckling.
I’m suggesting it because the Australian Digital Health Agency (ADHA), the organisation now responsible for the MyHR, could, more or less, enter into a compact with the GP profession and the public right now – a compact that could deliver tangible and substantive progress within nine months. That’s not that long to wait, given what we’ve gone through so far.
Under this plan, if the ADHA didn’t deliver within the timeframe, they would have broken the compact, and we could all return to our exhausted and cynical corners, having wasted at least another $200m or so. And presumably, those in charge would fall on their respective swords.
Currently, I don’t agree with how much the ADHA and thus, the MyHR, is spending, and on what. But if the basics of this compact were realised, we would all see tangible progress towards potentially transformative change. Change that would effectively benefit patients and doctors, and even lead to increased GP incomes, well above what would be delivered under the RACGP and AMA compacts.
So here it is. The MyHR ADHA 10-point compact between the Australian healthcare sector and the Australian people, authored by me but with input from various sources, whether they know it or not.
Read the 10 point compact here:
Right at the end of the article we read the following:
“These are exciting times. I hope everyone sees this compact for what it is and gives it all their support and constructive criticism. And we should all endeavour to keep the players honest to their compact initiatives as specified.
If we give it our all, and we don’t play politics, commercial tic tac toe, or my brilliant career games, and it still doesn’t work? We will have at least put this thing properly to bed. So we can move on.”
I am happy to wait but sadly I believe the outcome will be as I have consistently predicted – a useless and wasteful system. All the ideas are wonderful, as far as they go but sadly they really are just the proverbial lipstick on a horrible looking pig.
Until the myHR is fundamentally re-organised to ensure there is only one copy of the patient record, that this is held by the patient’s GP, and is made accessible to others who need it with the patient’s consent and agreement the whole thing is junk. A large database off asynchronous inaccessible .pdfs held by the Government is no-one’s idea of useful clinical system.
Please remember we are talking about a national health records system that is neither fish nor fowl or even koala since it does not properly meet the needs of the patient, the doctor or the Government. A triple fail!
We need to start again with a much better base architecture and concept. It really is as simple as that.
Posted by Dr David G More MB PhD at Tuesday, June 06, 2017