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.
Worst health policy No. 5 - My Health Record
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.
Worst health policy No. 2 — Real-time prescription monitoring
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?
David.
Not exactly a good look, as for the PCEHR/MYHR/GovHR it seems it's success resides in the fact the two dominant parties have both screwed it up so there is no political cheap shots to be gained.
ReplyDeleteAcross the spectrum form all thing digital to power generation Canberra's answer to life the universe and everything is 457.
Talking about accurate data, as of a few minutes ago, the MyHR statistics haven't been updated since 27 August - 17 days ago.
ReplyDeletehttps://myhealthrecord.gov.au/internet/mhr/publishing.nsf/Content/news-002
Not bad for weekly statistics. Maybe ADHA doesn't like what they show; i.e. a steady decline in the daily rate of both registrations and SHS uploads, with only the occasional kick from ePIP.
That's one thing we can count on with ADHA - ignore the evidence that doesn't fit with ideology and blind faith. Not that there's been much evidence of any beneficial use or increase in efficiencies to ignore.
Interestingly the ADHA website news feeds do not seem to have had anything posted since 1 September. What is going on? Have they run out of steam? This does not bode well, especially for an organisation that I hear has some 30-40 people in the communications and media section which is directly headed by the CEO.
ReplyDeleteMaybe it is time to remove the Board, obviously not in control.
6:50 AM, I am sure you will now see a scramble to put something up, perhaps a bedtime story from Tim or some pointless announcement. I see no advertising or any public communications regarding the Governments forced registration to theirHR. Very poor indeed.
ReplyDeleteMaybe the ADHA and MyHR have been closed? Who would know or notice?
ReplyDelete6:50 AM .... "an organisation that I hear has some 30-40 people in the communications and media section which is directly headed by the CEO."
ReplyDeleteThat is inconceivable. I have to assume you are reporting false news.
A maximum of 10 people is all that would be required for comms and media unless everyone is managing everyone else.
30-40 people!!!!!!!!!!!!!!!!! Surely not. ADHA, Tim Kelsey, Telstra Health and Shane Solomon have all been tarred with the same brush. Paul Madden seems to have extracted himself from any fallout. No doubt Mary Foley and Cynthia Whelan will be hoping to do the same at Telstra Health although one of them has to accept responsibility.
As for the ADHA Board Members and multiple subcommittee members - as they are all being paid generously they will all hang in there as long as they can.
In short - ADHA is another gov't IT stuff-up and cover-up.
Still no statistics. 18 days since the last weekly stats were published.
ReplyDeleteNow there's a coincidence. Statistics for 10 September are now available. That's the second time recently they've skipped a week.
ReplyDeleteThere's an interesting number of Consumer Health Summaries - 912,320 this report, up from 91,502 on 27 August.
An obvious typo, confirmed by looking at the .pdf version.
Maybe they were in a hurry?
The daily rate of Shared Health Summary uploads reported on 10 September is 2,337 compared with the two highest of 3,505 (30 April) and 3,024 (30 July) - which coincide with the end of ePIP reporting cycles.
@1:23 PM - As the Consumer Health Summaries are a DASHBOARD would it not be entirely reasonable to expect the Dashboard to be populated automatically from the statistical information within the MyHR database?
ReplyDeleteYou seem to be suggesting that one of the little people transcribes this information from one place to another (hence the obvious typo comment). If so it doesn't say much for their health information management capabilities.
On the other hand, if it is done automatically, then it must be a software glitch which doesn't say much for their information technology capabilities and their data checking capabilities.
HELP - if it was health information they were playing around with they could KILL people.
Maybe the IT guru running the show is having an off day. But what would a community of anti myhr terrorists know about information and technology.
ReplyDeleteAnonymous, 6:45PM,
ReplyDeleteYour comment is disrespectful and reflects ignorance of the long-standing contributions of many of the contributors to this blog for the purpose of achieving a high-performing health sector properly embracing digital pathways and technologies.
Please take your comments elsewhere if you are unprepared to be respectful and contributory.
I think the earlier poster was being ironic and self-depractory, rather than having a shot at the blog contributors. They were simply reflecting how the blog contributors "might" be seen in some parts of government.
ReplyDeleteAnonymous 10:43AM
ReplyDeleteCalling someone a 'terrorist' in these times is to say the least inflammatory and if there was any truth in your proposition would erode what little trust remains.
An apology, rather a call to irony, would be a more suitable response.
My earlier comment stands.
Bernard a great pickup, as you and 3:06 PM allude, there does seem to be a quality assurance issue here, is it an isolated instance? Or is it exposing a more systemic. It does look on the surface to have manual intervention and thus subject to interference. Hopefully it is something that is being worked through, it would be nice to know as analytics and business intelligence has a habit of scope creep.
ReplyDeleteJohn I fully agree with you position, but as 10:43 highlights although bad taste was not directed at the followers of this blog, it is taken from this article I believe, which if a true reflection is of great concern
https://aushealthit.blogspot.com.au/2017/08/do-you-think-this-is-credible-analysis.html?m=1