Quote Of The Year

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

Tuesday, January 16, 2018

I Must Have Missed The Announcement All These Apps Accessing The myHR. So To Make Up Here Is What I Know So Far And A User Review Of myHR Access.

This appeared at some time in the past:

Apps that Connect to your My Health Record

You are now able to interact with your My Health Record using mobile apps. This means that with your permission information uploaded by you, your healthcare providers, or by Medicare could be accessed with an app.
The My Health Record system is committed to strong security and safeguarding your privacy. We require apps to obtain your informed consent before accessing your My Health Record. You can set access controls in your My Health Record to remove apps if you no longer wish for them to access your data.
You will need to have a My Health Record before you use apps that connect to your record. If you don’t have a My Health Record, visit our Registration page to register.
Apps that are authorised to connect to your My Health Record:

1. HealthEngine

HealthEngine Pty Ltd

Features

Booking your next health appointment is quick and easy with HealthEngine. With doctors, dentists, physiotherapists, chiropractors, and many more listed around Australia, HealthEngine connects you with health practitioners when you need it most. HealthEngine also securely connects with your My Health Record, allowing you to view your important health information such as allergies, current conditions, and medications, and pathology/imaging reports.

Help

For app support:
Email: info@healthengine.com.au (9:00am - 5:00pm AEST)
In-app support: Settings > About HealthEngine (support options on the bottom) (9:00am - 5:00pm AEST)

2. Healthi

Chamonix Health Solutions Pty Ltd

Features

Get Healthi: Advance your family’s health with a summary of recent healthcare visits, allergies and medications. See what’s in your My Health Record: prescriptions, lab test results, imaging reports and hospital discharge summaries.

Help

For app support:
Email: support@yourhealthi.com.au (24 hour support)
In-app support: visit FAQ and online query form (24/7 support)

3. HealthNow

Telstra Health

Features

Talk to a doctor any time and schedule consultations by phone with specialists, mental health professionals and more. You can view your My Health Record, find emergency care nearby, and store and share important care contacts. HealthNow connects you with the information that’s vital for managing your health.

Help

For app support:
Email: support@health.telstra.com (9:00am - 5:00pm AEST)
In-app support: Settings > Under Settings > Contact Us (9:00am - 5:00pm AEST)

4. My Child's eHealth Record

The Australian Digital Health Agency

Features

The free My Child's eHealth Record app is a simple way of keeping track of your child’s health information, development and immunisations- all in the one place.
Before you use this app register for or sign in with your MyGov account to set up access and link to your child’s My Health Record.

Help

For app support:
Call: Help line on 1800 723 471 (24/7 support)

5. Tyde

Tyde Australia Pty Ltd

Features

Tyde is an application that puts you at the centre of your health, securely consolidating all your health information in one place, giving you secure fingerprint access to all your records. Tyde allows you to create your very own ‘personal health journal’, so no details are lost along the way.

Help

For app support:
Call: Help line on 1300 546 126 (9:00am - 5:00pm AEST)
Email: help@tyde.com (24/7 support)
In-app support (24/7 support)
Online live chat (9:00am - 5:00pm AEST)
----- End List
List location:
So I stupidly thought I would try an app from my iPhone 8 despite being the most hopeless typist known to man on these devices.
Sadly it was a rather painful experience given my typing prowess!
Once I was registered with HealthNow  (with typing complex passwords many times till I got them matching) the thrill was then to log on to myGov – more complex passwords to type – and to make it to myHR.
Once I got there it was really just a small and less easy to read version of the myHR I know on / from the web. (Indeed the display was simply in the Safari Browser)
What can I say other than the view was more cramped, less easy to navigate, slower and complex document were either in tiny type of needed a lot of scrolling around to be read.
The level of concession to the mobile environment was minimal to zero and the PC based web really is more user friendly. Interestingly the app seemed to remember the myGov login and went straight to the record - so there is only one password on the app that controls access once set up - or so it seemed.
Maybe this is version 1.0 and we will see innovation flow from now – as it has not to date. Just what you would really do with this rather eludes me at present.
Others can try the other apps and let us know via comments maybe?
David.

26 comments:

Trevor3130 said...

Here's an ADHA approved healthcare provider with tablet in hand, but is it his or his patient's?
As for Apps that are authorised to connect to your My Health Record I'm not so sure. Google just sent a message to say they had updated their security protocols and I should look at my settings. Did that, found a list of insecurities, some to do with third-party access to my stuff. Also, for the first time, I looked at the fingerprint lock for my phone. Found it surprisingly easy to set up and efficient to use. So far.
Now, if I happen to be in a hospital bed when Mr Hunt, the Chief Medical Officer and the hospital CEO happen to wander in just when I'm logged in to MyHR with my phone I'll feel more empowered to ask "How did you know I was using MyHR, let alone logged in right now?"

Bernard Robertson-Dunn said...

Or you could use Meditracker and not need myhr at all.

http://meditracker.com.au/faq/patients/

"How is MediTracker different from My Health Record?

If you have a My Health Record, and your GP has uploaded your shared health summary to My Health Record, the summary is available as a static (PDF) ‘document’. Whilst it is a snapshot of your main clinical indicators, the information is not updated unless your GP chooses to upload another summary. MediTracker, however, is updated whenever your GP updates your medical record at the practice, so will always contain your most up-to-date medications.

MediTracker also collects more information than the current My Health Record. For example, it collects and shows standard pathology results, like cholesterol levels and blood glucose levels. It also tracks key measurements taken by your GP, such as blood pressure and BMI, and graphs this information over time.

With your consent, MediTracker also shares your self measurements extracted from Apple Health or Google Fit with your care team."

If your GP uploads a SHS to myhr, it is available in Meditracker and you can keep it on your device so if you go on holiday or overseas, you'll have it with you.

Meditracker doen't need myhr, doesn't connect to myhr and has far more than myhr.

Tell me again why anyone would need myhr?

Declaration of interest. I have no interest of any sort in Meditracker and I don't use it.

Trevor3130 said...

I won't be using Meditracker, not even if they provide details of
(1) Who they are
(2) How they handle Medicare Number and IHI

But, on the face of it, looks more useful than MyHR.

Anonymous said...

It would be far better if the ADHA set the standards, conformance and policy compliance to keep these service safe secure and within the law to protect consumers and healthcare professionals/organisations. Rather than compete with them.

Anonymous said...

@6:35 PM why would you not use MediTracker if it does what is described above as described by Bernard?

Surely it's such negative attitudes which create huge barriers to progress in the eHealth space.

Anonymous said...

Exactly. If he won't embrace Meditracker or the MyHR what will he embrace? Perhaps he wants to preserve the status quo, silos, fragmentation, duplication, etc.

Trevor3130 said...

Anon @ 10.07
First, I'd wait to see consumer assessments.
Second, general rule, discount any website asking for my particulars if it doesn't supply financial disclosures, etc, for the principals.
Three, I'm pretty fussy about use of identifiers.

So, it's not so much my negative attitude that creates barriers. Just caution.

Anonymous said...

@9:26 PM. Totally agree, however they are now wedded to the MyHR. It might be the AHHA realise this and are thinking along the same lines. The allud as much in their recent published blueprint.

As for MediTracker, It appears to be a great consumer focused tool on the surface.

Bernard Robertson-Dunn said...

re: "Exactly. If he won't embrace Meditracker or the MyHR what will he embrace? Perhaps he wants to preserve the status quo, silos, fragmentation, duplication, etc."

The alternative to myhr and its attached apps is not "do nothing"

Many people say that the future of medicine is patient centric health care. The logical place to start is the patient-clinician relationship, which is where the primary medical data should be located, not with the government.

As a starter, make the GP primarily responsible for patient data, use interoperability capabilities to populate the GP's system and permit specialists and the patient to access the GP's system - with access to appropriate views of the data.

Instead of spending vast amounts of money on a system that has no logical clinical value, then spend a fortune maintaining it, then spend money trying to bribe GPs to use the system (why would they? they've already got more data than will ever be in myhr), they could have done a bit of thought, read the medical literature and developed a strategy that would actually deliver some value to health carers and patients.

But, no, some dumb IT evangelists who understand nothing about the practice of medicine decided to build a useless database. And now the poor sods in ADHA are trying to push a string up a hill.

Peter said...

If the MyHR record is just a PDF (such as SHS) there is no much a mobile app can/does do other than display it - as a PDF. It could only be rendered differently if it arrives as separate fields which can be displayed in a mobile friendly form.
This is a consequence of how MyHR has been designed - a point which has been talked about in detail before.

Mobile devices all have a unique Id which is used to connect to the network. The same identifier can, and is, used to authenticate to most apps. In other words, they don't tend to use username/password in the same way as normal computers and by default you stay signed in to services. Indeed it is often difficult to log out with some apps.
This is why it is highly recommended that you have security set up on the phone.

Bernard Robertson-Dunn said...

All this IT and Digital Health and claims that Australia is a world leader .... in what?

NSW worst for elderly health costs, global study shows
SMH
18 January 2018

NSW has been ranked the worst for healthcare affordability among older patients in the latest survey that pits Australia’s most populous state against international health systems.

The results showed a larger proportion of NSW patients 65 and older struggled with their medical costs than their counterparts in Australia overall and 10 other OECD countries.

NSW fared worst when it came to the percentage of respondent who said they had problems paying their medical bills (15 per cent), compared to just 1 per cent in Sweden and 10 per cent in the US, found the survey of 24,000 people including 1175 in NSW.

More than one in five (22 per cent) reported spending $1000 or more in out-of-pocket healthcare costs, the third largest proportion after Switzerland (53 per cent) and the US (37 per cent), and well behind the top performer France (3 per cent), according to the the 2017 Commonwealth Fund International Health survey findings released by the Bureau of Health Information (BHI).

Over 20 per cent of older people in NSW said they had skipped a dentist visit when they needed it due to the cost, tying with the US for the poorest result after Australia (23 per cent).

A total of 14 per cent of NSW respondents said they had skipped prescriptions, consultations or treatments due to cost in the previous year, the second lowest score after the US.

One in four NSW respondents said they found it "very difficult" to access medical care after hours without going to a hospital emergency department, trailing the US and seven other countries.

Overall, 71 per cent of NSW respondents said they were either completely or very satisfied with their healthcare, though this was the third worst result among comparators and 13 percentage points behind the best performer, Switzerland.

The survey sample excluded people living in nursing homes.

BHI acting chief executive Kim Sutherland said NSW and Australia had consistently recorded high out-of-pocket costs compared to other jurisdictions.

Federal Health Minister Greg Hunt recently announced an expert committee would investigate bill-shock and exorbitant medical costs as a matter of "considerable community concern".

The survey also exposed a yawning disparity between the experiences of the state’s sickest and healthiest older patients.

Fewer than 58 per cent of "high needs" patients (people with three or more health conditions) said they were very or completely satisfied with their care in the previous year, compared to 81 per cent among patients not classified as high needs.

NSW also had the highest rates of psychological distress, yet one of the lowest rates of accessing professional psychological help.

Bernard Robertson-Dunn said...

This is a link to the "NSW ranked worst for healthcare costs and access, international comparison shows" story.

http://www.smh.com.au/national/health/nsw-ranked-worst-for-healthcare-costs-and-access-international-comparison-shows-20180116-h0jh1u.html

The graph shows that people in NSW and Australia had a harder time paying their medical bills than even the USA.

I guess someone has to pay for all the IT; pity it's the elderly.

Bernard Robertson-Dunn said...

This might offer some sort of clue as to NSW/Australia's abysmal ranking re health care costs and access for the elderly:

Ophthalmologists Worry That EHRs Decrease Productivity, Boost Costs

https://www.emrandehr.com/2018/01/16/ophthalmologists-worry-that-ehrs-decrease-productivity-boost-costs/

"A new study has concluded that while EHR use among ophthalmologists has shot up over the last decade, most of these doctors see the systems as lowering their productivity and increasing their office costs, according to a survey published in JAMA Ophthalmology."

It is America and only one discipline, but remember, in Australia, the Federal Government wants health care professionals to use not one, but two eHR systems - their own and the government's.

Bernard Robertson-Dunn said...

Here's another clue:

https://data.oecd.org/healtheqt/computed-tomography-ct-scanners.htm#indicator-chart

Look at the number of CT scanners (just another form of Health IT) per million population.

https://data.oecd.org/healtheqt/computed-tomography-ct-scanners.htm#indicator-chart

Australia has 59.6/m, the next highest is the USA at 41/m. We have 50% more scanners per million people than the next highest.

We are not quite so bad when it comes to MRI scanners, but still way above most other countries.

Blind faith in technology is not getting us anywhere.

Anonymous said...

You will fine this of interest then Bernard. It came across my new feeds this afternoon

www.forbes.com/sites/oracle/2018/01/17/australias-electronic-health-record-program-already-showing-benefits/amp

I then thought, what else has been in Forbes in the past, so 2014

www.forbes.com/sites/toddhixon/2014/12/10/can-healthcare-become-user-friendly/amp/

And a few section in I find this

the UK’s National Director for Patients & Information, reported that the UK will give every citizen real-time on-line access to medical records next spring, helping UK citizens take charge of their own health.

I get the feeling history is repeating.


Bernard Robertson-Dunn said...

Gee, the amount of misinformation in that Forbes article is astounding.

"The records contain information about each individual’s serious illnesses, surgeries, prescribed medications, and family medical histories"

Only if the patient and their GP puts it up there and I'm not sure where "family medical histories" would go.

As of 14 January's statistics 5,476,996 registrations and 1,380,911 shared health summaries have been uploaded in the life of MyHR. That is 25%. Assuming about half have been updated that's about 12.5% of SHSs are even remotely current. So not many people have a MyHR with much in it, apart from Medicare/PBS data (which isn't health care data. A consultation with a GP tells you nothing about why the patient went to see the doctor

"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."

Apart from the fact (AFAIK, nobody has corrected me yet) paramedics are not registered health professionals and so are not legally permitted to view a patient's MYHR, all that data is probably not in a MyHR. a) there's no place for it and b) as above not, many people have even a SHS.

"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."

Diagnostic tests are not automatically uploaded. AFAIK, most aren't

"Electronic records eliminate the need for patients to fill out those annoying paper forms over and over again."

AFAIK, when you go into hospital, you have to fill in a paper form, or you can do it electronically. There is nowhere near enough information in a MyHR to meet the requirements of hospital admission. I went into hospital for a test last year and they didn't even ask me if I had a MyHR - they just gave me a form to fill in.

"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."

I wonder where he got that information from.

And the last line is "Linda Currey Post covers science and technology advances as a senior writer at Oracle."

Ah, that explains everything - it's a vendor's sales brochure.

Maybe one of the many journalists who read this blog could ask Tim if he stands by all the statements in this article. He doesn't like it when he gets a bad press, I hope he doesn't mind being asked to justify his claims.

Bernard Robertson-Dunn said...

On the ADHA website: "There will be a planned outage from 8pm Friday 19th January to 6am Saturday 20th January."

https://www.digitalhealth.gov.au/news-and-events/news/my-health-record-system-release-9-2

This is amazing:

a) they have to take the system down to do an upgrade and

b) they have chosen a Friday night to do it ????? Isn't a Friday night one of the busiest nights for A&E?.

Isn't one of the supposed benefits of myhr that medical staff can get access to a patient's data in times of an emergency?

Health outcomes don't seem to be one of their concerns.

Anonymous said...

So we still have outages, that is amazing in this day and age. As for the Forbes article, yes it is an advertisement. I also read this morning the ADHA does not intend to advertise opt out other than something in GP clinics. So to inform the public they are betting everyone visits a GP in the next few months and states at the wall and spits a flyer amounts many flyers and takes time to read it. What a joke, I get more advice and guidance buying jellybeans in a chemist.

Bernard Robertson-Dunn said...

There's a guest opinion on Pulse+IT's blog today.
https://www.pulseitmagazine.com.au/blog/4137-opinion-reflections-of-a-health-consumer-with-greater-expectations

"Reflections of a health consumer with greater expectations"

It says this about the author
"Adam Powick is a senior partner at Deloitte and is one of the old stagers of the national eHealth agenda. He was the lead author of the 2008 National eHealth Strategy and has worked across most parts of the health sector over the years. With the onset of middle age he is now taking a more personal interest in how well our health system really supports consumer needs."

If you look at what Adam wants, you discover that what he wants is exactly why myhr is so useless - the priority is data. What he doesn't say he wants is better health care outcomes for himself or for all Australians: He's a technologist and so all he sees and wants is technology.

This is what Adam wants:
"... here are a few personal healthcare expectations that are both technologically possible and well within the expectations we would have as consumers interacting with virtually any other service sector:

1 I want access to a complete, secure and up-to-date electronic record of my health conditions and interactions with the health sector

2 I want to own and share this dataset, not have parts of it hidden from me by my service providers

3 I want to have my key health indicators proactively and remotely monitored and I want to be alerted when there is a discrepancy that needs attention

4 I want to access first-level diagnosis electronically from my home at a time that is convenient to me (and this is rarely during normal working hours)

5 I want my drug prescriptions to be automatically fulfilled and delivered to my home

6 I want to have transparent access to consumer ratings of doctors, drugs, treatments and clinical facilities (i.e. a ’tripadvisor’ for health)

6 I want to book all of my healthcare appointments online

7 I never want to fill out another paper form again or repeat my details as I navigate the health system

8 I want access to reputable, best practice healthcare information

9 I want periodic, tailored, full-service health check-ups – if it is good enough for my car, it should be good enough for me."

it goes a long way to explaining why myhr is so useless. Adam doesn't want any health outcomes - his highest priorities are for data. Which is exactly what myhr tries to do - gather and store health data and not do anything useful with it.

One day the Digital Health cowboys will realise that it's not data, nor even technology that is important - it's what you do with the data - the right data, to inform the right decisions to deliver better health outcomes.

Digital Health cowboys are ill-equipped to understand or predict the future of the practice of medicine - all they understand is IT and databases. In fact they risk making things worse by overloading doctors by creating a need for more and more data.

With Digital Health cowboys advising the Department of Health, it's no surprise myhr languishes unused and, largely, unwanted. Forcing it on everyone won't fix the fundamental flaws in the concept.

Anonymous said...

If push comes to shove I would sooner be treated than tweeted. We do seem to spend a lot of money on this stuff that seems to have been in a continuous minimal viable product state

Anonymous said...

On the ADHA website: "There will be a planned outage from 8pm Friday 19th January to 6am Saturday 20th January

So did anything get impacted? Did A&E Departments struggle because the GovHR was possibly offline? Was anyone’s life at risk?

Are budget cuts to our health system making life easier for those who fund the health system (us)?

Anonymous said...

they probably analysed the usage of myhr and realised that nobody ever uploads stuff outside business hours so Friday night was an OK time for an upgrade. And as for anyone actually using it for health care, that never happens at all outside the phony, unbelievable examples they put on their website and youtube.

Anonymous said...

I doubt it was as scientific as that. People are certainly painting a picture of chaos an anarchy that only this MyHR can fix. That is not my impression interacting with the health system or my GP. They seem to use IT for recording stuff, they seem to be able to communicate with each other, and I get to where I need to eventually. I think the eventual part is the problem. We seem to be lacking in availability of some services due to a ratio. I don’t see how MyHR is reducing waiting times. The other aspects like me have access to my information, book appointments, get reminders for medications etc all seem to be achievable through personal apps. I time will come when I am to sick or elderly to read a smart phone or access electronic information, then what? Will this exclude me? Will I become a statistic? Left to whither away in a corner somewhere because I no longer contribute to some data lake?

Anonymous said...

AnonymousJanuary 18, 2018 6:59 PM
You will fine this of interest then Bernard. It came across my new feeds this afternoon

www.forbes.com/sites/oracle/2018/01/17/australias-electronic-health-record-program-already-showing-benefits/amp

That is not a good move by a senior level APS employee. The association to a supplier is borderline if not breaking APS rules. It would certainly rule the CEO of ADHA out of being anywhere near the tendering for the MyHR contract which is comming up. This makes a case for conflict of interest.

Anonymous said...

I believe Oracle have already been signed up and this is a "thank you"

Anonymous said...

Oracle would have to be resigned the MyHR software licenses would not be freeware. I do agree that this does test the Public Service Code of Conduct. However, I do not believe it to be a material breech. I am sure the ADHA is riddled with actual material breeches which would erode public trust and place the CEO in a less than comfortable position. Quite probably present an unwanted distraction.