Tuesday, January 23, 2018

Excitable Overreach In A Paid Puff Piece Regarding The myHR As The Options For ‘Replatforming’ Are Considered By The ADHA.

This appeared in Forbes last week:
Jan 17, 2018 @ 05:00 AM 4,529

Australia's Electronic Health Record Program Already Showing Benefits

OracleVoice Simplify IT, Drive Innovation
In what may be the most comprehensive national effort of its kind, the Australian government has created more than 5.4 million electronic medical records and plans to offer EMRs to the country’s 24 million citizens by the end of 2018.
The records contain information about each individual’s serious illnesses, surgeries, prescribed medications, and family medical histories—information that can be critical to making correct diagnoses.
ADHA CEO Tim Kelsey says that the ability to share a patient’s health information with doctors already has improved care in Australia.
The ultimate objective of Australia’s “My Health Record” program, begun in 2015 and run by the Australian Digital Health Agency (ADHA), is to speed life-saving treatment to citizens anytime and anywhere they need it.
In a unique move designed to give citizens control of their own health records, each individual can choose which doctors, hospitals, and other healthcare providers can access his or her records. Approved healthcare professionals can then access those records anywhere with an internet connection using computers or smartphones.
 “Australia will be one of the first countries in the world to provide a mobile health record to its entire population,” says ADHA CEO Tim Kelsey. “The project is being followed very closely by many other countries.”
Care Improvements 
To accelerate the initiative, the Australian government announced in May 2017 that it was moving the program from voluntary opt-in to voluntary opt-out. By the end of 2018, a My Health Record will be created for every Australian, unless an individual chooses not to have one.
Kelsey noted that the ability to share a patient’s comprehensive health information with doctors and other medical care providers already has improved care in Australia. He offered several examples:
  • In an emergency, paramedics and other responders have immediate access to information about a person’s blood type, history of heart attacks and strokes, allergies to medication, and other factors that can mean the difference between life and death.
  • In a country where an estimated 2% to 3% of hospital admissions are due to a medication error, having a patient’s record of medications has helped doctors avoid dangerous interactions.
  • People with serious, long-term illnesses requiring care from different physicians can be sure that each doctor has the results of the latest diagnostic tests. That coordination of care eliminates the need to repeat tests from doctor to doctor.
  • Electronic records eliminate the need for patients to fill out those annoying paper forms over and over again. General practitioners in Australia spend about 10% of their time searching for paper records and faxing and emailing them to other medical facilities, Kelsey says.
Another unexpected benefit of the project: Once individuals gain control of their own electronic health record, they tend to take better care of themselves.
“They improve their compliance with their doctors’ advice and take their medications on schedule,” Kelsey says. “We don’t see that same level of empowerment in countries where their digital systems are not accessible to patients.”
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Linda Currey Post covers science and technology advances as a senior writer at Oracle.
More here:
Handily the article also provides links to the Oracle products on which much of the myHR is based as I understand it.
Clearly this is just an advertisement for the myHR and the Oracle Products which are making such a great success.
The claim that the myHR has already improved care is more a ‘feeling in water’ than research-based evidence I would contend.
As some commenters have already pointed out there is something not quite kosher about the ADHA CEO spruiking the myHR based on the technology that the article publisher sells and, with opt-out, is probably hoping to sell more of, to the ADHA or the Government.
Anyway the article really does not really add much to the store of human knowledge!
David.

18 comments:

Anonymous said...

Quite agree David, trust get eroded day by day, this blatant product endorsement by the ADHA CEO is highly questionable and is not expected behaviour of someone in the public service. Not sure it sets up future conversations very well, the ADHA has presented the Governements position on standards and innovation, if it does not support Oracle then it’s not on the agenda for discussion. They will be forcing us contribute through paying a license fee soon.

Then again it is becoming expected behaviourof late, bully staff, forced subscription, half truths and questionable ethics all round.

Anonymous said...

Either Tim is lying or he doesn't know he's lying. Either is very bad.

Dr Ian Colclough said...

@7:18 PM It is not appropriate to suggest he is lying. His background is marketing and limited practical experience at the grass roots of the health system. I do not expect him to know much about the way the health system operates other than a superficial understanding. To a large degree he is a pawn helplessly entwined as a newcomer in the complex politics of Australia's health system.

One cannot expect him to know what he does not know because he doesn't know what he doesn't know. That's why Oracle holds the power.

As for replatforming a system for which the 'problem to be solved' has not been analysed and defined ....... that is another matter altogether.

Anonymous said...

I would agree with 10:19PM, the job of ADOHA is to implement policy not set it. As for Oracle well they build a solution and it was procured to solve a believed problem, I am certain the benefits are real enough to them and those benefits are about to become 5 fold.

A bigger concern for the Governemnt May reside in a recent study commissioned by GlaxoSmithKline (GSK)

https://www.thesenior.com.au/health/personal-information-concerns/

However, I think the strategy will be to weather the backlash for a month knowing something else will pop up and people will forget and move on forgetting the MyHR even exists.

Anonymous said...

I am sure the ADHA lawyers have issued a letter to Forbes to have the article removed. We know they are quick to react to incorrect reporting. A SES level public service employee would never endorse a product or commercial brand.

Anonymous said...

@10:19 PM - so he doesn't know he's lying?

He's a historian with journalism experience. A strange combination with which to run a technology/health oriented agency.

Bernard Robertson-Dunn said...

re the GSK study:

"Despite the reluctance to sign up to online health records, the survey also found that 57 per cent of respondents wished their healthcare records could be more effectively shared across health providers - something that electronic health systems aim to deliver by better connecting national health systems."

Sharing health data among health care professionals directly involved in delivering your health care is a good idea, although even then there are issues regarding data management and usefulness.

However, why the need to also give it to the government?

This is a question that will be asked of the government many times before, during and after the move to opt-out.

tygrus said...

Can anyone find the published peer-reviewed research that Mr Kelsey is quoting from?

I live in a trial opt-out area. I have faced 2 of the 4 situations listed by Mr Kelsey as being improved by using the My Health Record (MyHR). Unfortunately, the MyHR failed to be a benefit in my situations. Without a Health Summary in my record and the other failings it would not be of benefit in the other 2 situations listed by him. My personal impression is 0/4.

Dr Ian Colclough said...

@ 10:26 AM Mr Kelsey well knows that quoting from "peer-reviewed" research without providing the reference source discredits whatever claims and arguments are being posited. That's an oversight which no doubt he will correct if asked to.

Anonymous said...

AnonymousJanuary 24, 2018 9:09 AM. Having done a stint at ADHA, that is no surprise. The recruitment is very odd. I never once got asked to demonstrate my claimed skills, it was all behavioural questions. Once onboard I soon learned the hypocrisy of the behavioural angle. The organisation is dragged to some cultural alter by bullies and friends of that bully. Sooner the mining industry picks up the sooner health will benefit and these people can go back to looking after robots and spreadsheets

Bernard Robertson-Dunn said...

Yet another health data solution that doesn't involve a central, government owned database of patient medical data.

Apple will let you keep your medical records on your iPhone or Apple Watch

https://www.cnbc.com/2018/01/24/apple-coo-williams-says-new-health-record-beta-is-right-thing-to-do.html

Nobody sees your health data apart from you, the data provider and anyone you chose to share it with. It also offers the potential of much more than myhr; there's more data and you can take it overseas with you (health professionals overseas have the devil of a job accessing myhr).

I wonder what ADHA's response to this will be. Will they try and block it? Endorse it? Recognise it as a much better solution to the data sharing/interoperability problem than myhr? Will they update the Forbes article?

We wait with bated breath.

Anonymous said...

Nobody sees your health data apart from you, the data provider and anyone you chose to share it with

Bernard Apple will be all over it, with our Government deeep into collecting citizen data they are not in a position to clamp down and protect us.

The ADHA by all accounts could not run a bath so don’t look to them for guidance.

Anonymous said...

I one across this supposed international interest in the MyHR but can find no evidence of it referenced in international eHealth publications or in any literature!

Does anyone know of any research or other documents that backup this claim?

Anonymous said...

@8:53PM that is not surprising. Basically there is nothing of substance to reference.

Everything produced by ADHA is marketing fluff and meaningless unsubstantiated claims verging on irrelevance.

Anonymous said...

You will find little if any published references internationally. I am sure ADHA in the international travels come across people in polite settings that will nod and say how wonderful. That is not necessarily their actual view. Australia is holding a torch for a custard cream long passed its due by date.

The fate of ADHA is tied to MyHR, succeed or fail, they will not be able to engage with the community in advancing eHealth and I struggle seeing how they can lead anything like standards and interoperability with paying for people’s names and time but even then I would find it a challenge to trust them

Dr Ian Colclough said...

Based on all available evidence it is becoming increasingly apparent that with Digital(e)Health and Paul Madden no longer appearing anywhere on the Health Department' Org Chart, the State's showing increasing evidence of going their own way, the reluctance of doctors to engage with the MyHR and the increasing System Operator responsibilities and accountability being transferred from the Department to the ADHA that the only valid conclusion one can arrive at is that the project is being allowed to slowly die absent palliation.

Anonymous said...

@7:44 PM. As an alternative perhaps the Department has removed any direct ownership to eleviate any internal power plays and politics. I am no PS expert but the operating model does seem to rely on complicated staffing matrix’s. That being an SES role needs to have a certain cohort of direct reports etc. The Public service is also constrained by head count, removing positions enables other more important work to be resourced.
ADHA could just become an extension of the DTA or DHS, I do not think it is an indicate the MyHR is going anyway.

Anonymous said...

10:05AM you have overlooked the Gov'ts overriding desire to exercise centralised control.