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Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Wednesday, August 30, 2017

Another Blogger Has Come Out With A Change Of Mind On The myHR. Not Sure I Am Convinced.

This appeared a few days ago:

A new hope for the My Health Record?

It looks like we’ve entered a new chapter in the Australian digital health story. After several rocky episodes it seems the force is with us and Australia’s digital health record system is on the road to recovery. At the same time there are challenges ahead.
When it comes to the national electronic My Health Record (formerly PCEHR) there is no shortage of scepticism among health professionals. Many have disengaged after unsuccessful encounters with earlier clunky versions of the system.
A lot of work has been done to make the interface easier to use. Accessing the system and uploading a shared health health summary has now become a fairly simple process – as it should be.

Towards opt-out in 2018

The My Health Record will get a massive boost in the middle of 2018 when the system will change to opt-out. Currently Australians have to actively sign up if they want a digital shared health record but from May next year every Australian will have a record – unless they opt out.
Earlier this month the Council of Australian Governments (COAG) approved Australia’s new digital strategy which carries the title ‘Safe, seamless and secure: evolving health and care to meet the needs of modern Australia‘.
The strategy outlines plans between now and 2022 for secure messaging between providers and with patients, telehealth, interconnectivity and interoperability, electronic prescribing and dispensing, test beds for new digital health technologies, development of health apps & tools and workforce training and upskilling.
…..

Challenges ahead

The strategy document acknowledges some of the issues doctors have with regards to security, safety and use of the data: “They [doctors] need assurance that the digital systems they use support them to meet their obligations to keep their patients’ health information secure and private, and that health data will be used safely and appropriately to improve patient outcomes.”
Doctors have also voiced concerns about the medicolegal risks that come with accessing a patient’s My Health Record, for example when diagnostic tests and images will be available that may not have been reviewed and actioned by the requesting clinician.
Clear guidance is required on how the reports are to be handled and who is responsible.
Most clinicians will not have an issue with de-identified data in the My Health Record being used for research or public health purposes, but transparency around secondary use of data will be welcomed and would encourage engagement with the system.
Uploading of shared health summaries is happening in general practice but concerns have been raised about the quality of some of the data. The current incentive payments seem to encourage volume. However, if the uploaded clinical content is not useful, others may not engage and upload data from their end. A classic case of the chicken and the egg.
It seems the Australian Digital Health Agency has sorted out its governance issues and is becoming a more transparent, engaging enterprise. An effective implementation strategy will genuinely address the barriers to engagement with the MyHealth Record and not just sprout benefits. I believe there is hope for Australia’s digital health record.
The full blog is found here:
While I am sure Edwin can speak for himself, I have to say that recalling his earlier posts a few years ago it seems that little has changed for the ‘better’ rather than the Government forcing us all to take a myHR, and some cosmetic changes to the management of .pdfs.
The medico-legal issues, the data quality issues and so on remain as they were!
This blog:
and this one were typical
and not much seems to have really got better – indeed some of his recommendations have just been ignored.
Needless to say I still believe the myHR is not a sensible solution for e-Health in Australia going forward.
A fundamental re-think is required!
David.

2 comments:

Anonymous said...

Is the good doctor Edwin Kruys using MyHR to great advantage? Has it helped him in the management of his patients? He should write a story to tell us of his experiences today. Sorry Edwin but it seems to me you have opted to simply kick the can down the road a few more years believing all will be well.

In doing so you seem to have forgotten, overlooked, turned a blind eye to what many, many people have been saying for a long time about the underlying architecture/design underpinning the system and many other major deficiencies.

Bernard Robertson-Dunn said...

What I find really amazing is that even informed people like Dr Kruys conflate being registered for a MyHR and having a meaningful/useful health record, or, in the case of MyHR, a medical/treatment record.

All the opt-out out process is going to do is register people. Medicare data (i.e. when you last saw a GP, specialist or had a test) will get dumped into your MyHR database but the medical information in such data is minimal at best and useless at worse.

Similarly, your medication data covers what you have been prescribed for that the PBS system covers. There are plenty of medications that this won't include.

If you don't see your GP and give them permission to upload your Sheared Health Summary, you won't have one.

The "massive boost" Dr Kruys is looking forward to may make bureaucrats happy, but it won't improve its utility. It will increase its attractiveness to hackers though; they'll be interested in the personal identifying information.