Tuesday, June 27, 2017

The ADHA National Digital Health Strategy Is Due Very Soon. What Do We Need To Learn?

In a blog published about 4 months ago I showed the Dec 2016 plans for release of the National Digital Health Strategy.
Here is the link:
The part that now matters is this part of the blog:
-----

Timetable.

First draft:

National Digital Health Strategy core document

 + Framework for Action - No CBA - End March 2017

AHMAC draft:

National Digital Health Strategy core document
+
Final draft of Framework for Action
+
Cost Benefit Analysis - Mid May 2017

Final CHC draft:

National Digital Health Strategy core document
+
Final draft of Framework for Action
+
Final Cost Benefit Analysis - End June 2017

Public Release:

National Digital Health Strategy core document
+
Framework for Action
+
Interactive web experience - July 2017

Technology Roadmap:

(post Strategy release) - End 2017

----- End Timetable.
Sadly the last meeting of the COAG Health Council was held on March 24, 2017 and looking at previous meeting timing – about six monthly – the next one won’t be till Oct/Nov 2017
Here is the link to the meeting communique’s.
The relevant sub-committee is as follows:

National Health Information and Performance Principal Committee (NHIPPC)

Role: To advise AHMAC on eHealth, information management and performance reporting development, governance and strategies, and to facilitate collaboration between the Commonwealth, states and territories and other key national stakeholders in relation to these areas.
Secretariat:
 NHIPPC.secretariat@dhhs.vic.gov.au 
Contact Number: 03 9096 7301
It seems likely that it is this committee who will be assessing and releasing the new digital health strategy.
To me we need to see this document pretty soon and it needs to address the various areas outlined in the timetable.
My views on what is needed are found here:
and here:
I wonder how many answers we will see actually emerge and be useful to clinicians and the industry.
The Cost-Benefit Analyses will be of especial interest.
Time will tell.
David.

15 comments:

Anonymous said...

I believe we saw the crux of the strategy a few days ago on your blog David, basically the states and territories have probably told Tim as interesting as he may find himself there is always the My Health Record he can tinker with. I do wonder based on an earlier posting today if the old Kelsey boss will take up the interoperability thing armed with the misconception that banging heads is all that is needed.

Bernard Robertson-Dunn said...

A logical analysis of how MyHR got to where it is today; why it got there and what needs to be fixed. All this should be based upon the myriad inputs/submissions from many knowledgeable and interested parties over the past decade, including and since the Concept of Operations,

A cause and effect explanation based on evidence and experience that the strategy will work and deliver value.

A proper identification and assessment of costs and risks.

Hyperbole, hope and wishful thinking are not enough.

Anonymous said...

So where are these drafts? We are due a final in two days but have yet to see any drafts, it may just be me but I was under the impression there would be material made available to the public for comment, all I have seen so far is some light weight videos. I did not notice previously but the dates above do not mention the audience, that may well be seen as clever but for me anyway leaves a bad taste and a feeling that we will be mislead and taken for a ride like never before.

I guess you have to be on the right side of the divide

Anonymous said...

Lets be clear. ADHA works for the government. MyHR exists to gather personal data on as many Australians as possible so that data can be used by the government, for the government either as is or by linking with other government data. It has no medical use at all. The strategy will be all about achieving the governments aims, not patient health. ADHA wont be able to say this so the strategy will just be a bunch of motherhood statements and a list of tasks with no link with healthcare.

Anonymous said...

@10.44 AM "It has no medical use at all. The strategy will be all about achieving the governments aims, not patient health."

If that is the case then why is the AMA, RACGP, PGA and people like Steve Hambleton promoting it?

Anonymous said...

@1.05pm Read the fine print of the MyHR. From the start, they have had to. Doctors et al are paid to use it and penalised if they don't - simple as that.

Bernard Robertson-Dunn said...

re : "If that is the case then why is the AMA, RACGP, PGA and people like Steve Hambleton promoting it? "

Vested interest and with nothing to lose?

Individual GPs and specialist - they may well object to a reduction in productivity (i.e. end up doing unpaid data entry work with no direct benefits to them) along with an increase in risk if they or their staff fall foul of the privacy laws.

Dr Ian Colclough said...

The recently published 4 April 2017 CHARTER for The Clinical and Technical Advisory Committee very clearly states the Purpose of the Committee will (among other things) be to provide advice to the Board on changes to digital health system design to improve clinical useability and usefulness.

This is central to the success or failure of the MyHR, irrespective of comments such as 1:05 PM and 2:42 PM.

To my mind, for whatever reason, one hugely important step in the overall design of the MyHR (in my view the most fundamental and most important of all system design steps)has been neglected right from the outset. Consequently, everything that has followed has eventuated without having the all the benefits of the missing step available to build upon.

Anonymous said...

It is only Advise given, not action taken. We have seen this before Ian. I hope I am wrong but I feel in a blind lust for data headed by people with a track recorded of openly willing to pass citizen data on to commercial entities without consent I feel you are being used.

Other than that the MyHR concept is as dated as the fax machine, the latter having actually had a purpose and is still in use.

Bernard Robertson-Dunn said...

re "Doctors et al are paid to use it and penalised if they don't - simple as that."

According to ADHA:
http://digitalhealth.gov.au/using-the-my-health-record-system/how-to-use-the-my-health-record-system

"Viewing a My Health Record
Medical practitioners who decide to use the My Health Record system are free to apply their clinical judgement to determine when and how they will use the system."

And expanding that section it includes the comment:

"A provider is under no legal obligation to use the My Health Record system"

If the rules have changed, ADHA need to update its website.

Bernard Robertson-Dunn said...

According to Pulse+IT "Australian Digital Health Agency figures show that on average, 10,300 consumers are viewing their record each week"

Lets put that in perspective.

Based upon figures published by the Department of Health for the week up to 25 June:

There are 4,949,545 individual registrations

Of those registered, 0.209% looked at their MyHR in that week.

There were 21,193 new registrations. So even if that number were all the new registrations and nobody with a MyHR before that week looked at their record, less than half were interested enough to log on, look at their health record or see who had accessed it.

There were 17,244 Shared Health Summaries uploaded.

There were 15,659 Discharge Summaries uploaded.

505 Consumer Health Summaries were uploaded.

As we have been saying, there is far more interest in uploading data than looking at it and/or using it.

And I still haven't seen any data on the number of times a MyHR has been used for healthcare and/or that has saved anyone any money.

If this trend continues, MyHR will get emptier and emptier with new registrations far outstripping shared or any other summary and/or any other upload.

And one final observation.

At the beginning of July 2016 there were 2507 Shared Health Summaries uploaded per day.
For the week ending 25 June 2017 there were 2,463 Shared Health Summaries uploaded per day.

Before the opt-out trials, GPs claimed that if more people had a MyHR they would probably use it. The evidence doesn't seem to support that prediction.

Looking at the SHS upload data, the only thing that seems to impact it is the ePIP cycle. GPs are uploading SHSs to qualify for the money.

Anonymous said...

@3.21 PM ... giving the ADHA the benefit of the doubt perhaps you will find they ask you why or how "the most fundamental and most important of all system design steps" has been overlooked and what should be done to rectify the situation. It's fair to say they have a lot to learn and its reasonable to expect that they would be keen to know why you said what you have. If the ADHA is receptive to two way communications and interested enough in what you think you will probably get a call from one of their smarter operatives who monitor David's blog - and quite a few do. If not don't be too down heartened quite a few of us have been there before.

Anonymous said...

Not sure about benefit, I do though having increasing doubt.

Question: Does the Agency have a reference or draft model already defined for the "component parts of an interoperable health ecosystem"? Or does this need to be produced anew and validated within the engagement period?

Answer: No, the Agency does not have such a draft or reference model, this is considered core to the delivery. It is considered the successful tender will reference their experience in having delivered this type of framework previously.

Are these people serious? They do not even have a reference model of healthcare in Australia. I am wondering if this Agency is equiped to manage such complex problems and oversee emergent systems. Maybe we should just leave it to the States to work out.

Anonymous said...

Amateurs Dabbling in Healthcare Architecture. It's a bit disconcerting watching this Interoperability embarrassment of Tim's making. Perhaps it's best it is not mentioned again in public. I am sure once they are old enough to use crayons we can revisit it, by then the Internet of health things will have been embedded and something new will be on the table to replace it.

Anonymous said...

Give the man some credit, takes a bit to attempt to step out of ones comfort zone. I do like your spin on ADHA very apt.