Tuesday, September 12, 2017
Australian Doctor Reveals The Five Major Health Policy Failures Of The Last Few Years.
After careful consideration Australian Doctor has called out the five programs they feel have been the worst as far a waste of money and failure to make a positive differnence
At No 5 we have one of our favourites.
4 September, 2017 Antony Scholefield
One of the tougher questions to ask yourself is the name of the one big Federal Government health reform of the past 20 years that has actually worked.
We’ve had a string of taskforces, special commissions and expert advisory groups, whose seemingly endless consultations were going to draft the government blueprint to fix things.
Yet look at the results and you see little more than the expensive wreckage of botched ideas and failed promises.
This week Australian Doctor offers its countdown of the standout failures, which act as a reminder of why politicians are never paid for performance.
We start with number five, the digital health disaster currently going by the name of the My Health Record.
Two years after the PCEHR system was launched, with typical political bluff and bombast, there were a few statistics that seemed to capture in miniature the monumental size of the white elephant it had become.
An investigation by the Consumers e-Health Alliance found that the system contained a grand total of seven specialist letters and six e-referrals.
Yes, some 288,000 clinical documents had been uploaded, but only 71,100 were considered by the alliance review to be “potentially useful in a clinical sense”.
And the cost for every shared health summary stored on the system — the list of a patient’s medications, diagnoses, immunisation history and allergies — worked out at around $40,000 a pop.
As Australian Doctor wrote at the time, a lung transplant would have been cheaper.
The IT industry has an unrivalled talent when it comes to overpromising and under-delivering at significant cost to others but given the system was meant to be saving thousands of lives a year from things like medication errors, this seemed a special type of policy bungle.
What went wrong? Well, in the rush to sell the idea to patients, the then Labor Government and the army of expensive IT consultants it recruited seemed to forget the obvious — first and foremost the system was supposed to be a clinical tool to help health professionals do their job.
That meant that the clinical information it held had to be up-to-date, accurate, relevant, concise and easy to find. Anything less was a waste of time.
Bizarrely, even though the system has now undergone more relaunches than John Farnham’s singing career, including a name change to the My Health Record, it still has no comprehensive list of medications actually dispensed to the patient.
Nor does the system, aimed at reducing the duplication of tests, include, on any large-scale level, imaging or pathology test results.
And although GPs are tasked with uploading shared health summaries, it is still not clear how many of these are regularly updated and curated to ensure they remain relevant to the patient’s other treating practitioners.
It is for these reasons - the apparent lack of meaningful use - that people remain sceptical about the system's value even though some 5.1 million Australians are registered and 10,250 health practitioners are signed up. The numbers look impressive but they are not the policy's hard endpoint.
Health IT blogger Dr David More describes the My Health Record as “a technically flawed, privacy invasive, insecure, expensive and largely clinically irrelevant lemon”.
Lots more here with a table of scores:
For number four they nominated GP Super Clinics
For number three they nominated the various GP Copay systems.
For number two we have another failed Digital Health initiative – to date.
Paul Smith | 7 September, 2017 |
This week, Australian Doctor is publishing its top five worst Federal Government health reforms of the last 20 years.
So far we've had the My Health Record, GP Super clinics and Peter Dutton’s GP copay fiasco.
At number two is the long-running failure to introduce a real-time prescription monitoring system at a time when the lives of thousands of Australians are being torn apart by widespread medication misuse.
Milica Minchev’s death in 2013 made the newspapers but what happened to her was not in any way remarkable.
And that is where the tragedy lies. The 48-year-old was found dead, lying face down on the floor of her uncle’s home in Thomastown, Melbourne.
The coroner’s report described the mother of two sons as likeable and outgoing, but heavily dependent on a range of prescription drugs.
She spent the last 12 months of her life doctor-shopping, before finally overdosing on a lethal cocktail of diazepam, amitriptyline and alprazolam.
Every coroner in every state in the past 20 years has carried out similar inquests into similar deaths and made similar recommendations for governments to introduce a real-time prescription and dispensing monitoring system.
Three years ago, Victorian coroner Audrey Jamieson said the state’s death toll from prescription drugs was higher than the numbers killed on the state’s roads.
But while political lip service has been paid, commitments made, pledges uttered and money promised, it has been tough to awaken governments from their slumbers.
Currently, the only state where the idea has been made reality is Tasmania.
Practices have access to DORA (Drugs and Poisons Information System Online Remote Access), which tracks prescriptions for opioids and alprazolam.
We are 18 months away from a national real-time monitoring system on GP software — at least that is what Federal Minister for Health Greg Hunt was promising last month.
Federal governments have made similar promises before, the last one dating back to 2012. It went nowhere.
It is also worth pointing out that on the same day as Mr Hunt fronted the cameras, Victorian Minister for Health Jill Hennessy revealed plans for a separate $30 million system in Victoria.
Lots more here:
For number one they listed the disastrous NT Intervention:
You can read about this fiasco here:
While you can dispute the order the fact that 2 of the five are e-health initiatives says it all. We really are presently just not doing Digital Health all that well!
What do you think of the list and the order?
Posted by Dr David G More MB PhD at Tuesday, September 12, 2017