Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Friday, February 09, 2018

It Looks Like There Is Still A Problem In South Australia. There Is An Election In Seven Weeks!

I noted this the other day:

SA health system 'still in crisis', AMA warns

8:04pm Feb 1, 2018
The nation’s peak medical body has warned work conditions and stress levels in South Australia’s hospitals are at dangerous levels.
The state’s health system is still in crisis despite hospitals, including McLaren Vale, recently receiving a significant investment from the government, the Australian Medical Association (AMA) said.
“We are hearing failure after failure within the health system, and I think there's no doubt that the health system is still in crisis,” William Tam from AMA SA told 9NEWS.
“Even the best doctor in South Australia cannot work in a system that is broken, so we need to fix the system.”
The AMA has criticised all sides of politics for lacking health policies while rolling out its list of recommendations ahead of the state election on March 17.
A top priority for the medical body is improving patient safety by making it easier to access data.
“If the data is not available, then it certainly puts lives at risk,” Mr Tam said.
More here:
And also I saw these two headlines:
The Advertiser
It would look at (electronic patient record system) EPAS, its cost blowouts and how much it is really costing taxpayers, and whether it should be scrapped. Can a royal commission into SA Health stop the scandals and debacles? Take our poll. “It would also look at problems of waiting lists and ramping, ...
And here:

25000 patient records left without a clinical urgency rating after transfer to EPAS

The Advertiser
The chaos follows a transfer of patient histories to the controversial electronic patient records system EPAS at the $2.3 billion Royal Adelaide Hospital. However, officials insist the problem is not with EPAS, maintain no vital information has been lost, and that the patients were simply never assigned an ...
Rather looks like EPAS is still in the political gun!
The present SA Govt. is not amused:

SA govt blast Xenophon's health audit idea

The South Australian government says Nick Xenophon's call for a royal commission into the state's health system is unnecessary.
Australian Associated Press February 2, 20181:32pm

Nick Xenophon's bid to hold a royal commission into South Australia's health system is an "incredibly bad idea", the state's health minister says.
Health Minister Peter Malinauskas said Mr Xenophon's demand for a royal commission - should his SA-Best party hold the balance of power after the March election - highlights the party's lack of policy ideas in the health portfolio.
"What we don't need is a ridiculously broad royal commission which is going to waste years of time and millions of dollars rather than getting on with the job," Mr Malinauskas told reporters on Friday.
SA-Best leader Nick Xenophon wants a commission to look at cost blowouts in the construction of the newly opened Royal Adelaide Hospital, patient waiting times and ambulance ramping at different hospitals across the state.
More here:
It really has been the project that keeps on giving!
David.

7 comments:

Anonymous said...

‘Nobody knew that health care could be so complicated’

Only the ill informed would say that. People who know what they are talking about know full well that it's complicated. but they also know what to do about it. SA obviously listened to the wrong people. Probably project managers and bureaucrats.

Bernard Robertson-Dunn said...

"...improving patient safety by making it easier to access data"

Such a simple answer to a highly complex problem. A bit like health records.

Data is useless unless it is the right data - not too much, not too little, well managed, relevant, trusted, reliable, meaningful, in the appropriate context, accessed and easily understood by the right people.

IMHO, health care is moving into an era of too much irrelevant data.

Dr Ian Colclough said...

Overzealous bureaucrats and technocrats promote the "more data is good" message to the detriment of health care. The damage has been done, the pendulum has swung too far.

As Bernard said "health care IS moving into an era of TOO MUCH irrelevant data" - swamping doctors and other health service providers and undermining effective health care.

That is a major problem. What can be done to fix the problem?

Anonymous said...

@12:42 PM It's the culture of the IT world, data collection lies at the heart of their raison d'ĂȘtre whilst the customer is their target and revenue source. The urgency to secure the customer's business before someone else results in quick solutions and deficient software with problems to be fixed on the run. Quality systems engineering design approach is given too little attention leading to flawed systems like the My Health Record.

Dr Ian Colclough said...

If the objective is to collect more 'unfiltered' and 'unqualified' data and store it in the patient's health record which the patient has full access to (perhaps even control over) then unless the patient knows what to do with the data and how to interpret the data we can be confident the patient's doctor will find an increasing number of patients presenting will a lot of unnecessary worries and concerns. Please note the operative words here are unfiltered and unqualified.

Andrew McIntyre said...

Agree Ian,

I have a sinking heart when a patient appears with a huge volume of irrelevant, poorly organised data. A good referral letter with a summary and a medication list and downloading recent pathology results (And getting older pathology results if need be) allows you to start talking to the patient to try and find out what the problem is. Viewing cumulative pathology allows you to spot trends and look at years of data in a short time.

Being faced with an overpopulated myEHR (potentially containing hundreds or thousands of results) with slow loading pdfs which cannot be shown in a cumulative fashion is a nightmare scenario. It is likely to make things worse rather then better. It is the electronic equivalent with the patient arriving with a 30cm high pile of paper. It leaves limited time to talk to the patient, the advantage of computers is they can display data in intelligent ways, but there needs to be some intelligence in what data is put into the system and we seem to have have arrived at garbage in - garbage out nirvana.

Bernard Robertson-Dunn said...

Andrew,

In many cases it's good in - garbage out.

As you've pointed out too much data is a bad thing, even if some of the data is good data.

Old data could have been accurate at the time but can become irrelevant or incorrect if looked at in the wrong context.

Not to mention changes in the patient - the patient may have recovered from an illness, developed a new illness or just aged.

myhr is a dumb document management system with no intelligence or smarts at all. The best it can offer is to trawl through existing documents looking for mentions of medications and displaying a list of them. And that's touted as a major improvement.

As I've said before, the issue is not data, there's plenty of that around and it's easy to get even more, the hard part is making sense of it - that's what counts. myhr has nothing to offer, it just makes things worse.