Quote Of The Year

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

Sunday, March 18, 2018

There Is The Germ Of A Really Good Idea Here And One That Really Shows How Obsolete The MyHR Will Be Very Soon!

This appeared from the new New Zealand Health IT News Site A few days ago.

Cross-Tasman tech leaders consider creating a health ‘passport’

Wednesday, 14 March 2018
eHealthNews editor Rebecca McBeth
Development of a consumer app that holds verified medication information for clinicians to view if a New Zealander or Australian requires medical assistance while across the Tasman is being explored.
Health technology leaders discussed the creation of a health ‘passport’ at the Australia New Zealand Leadership Forum in Sydney this month.
The passport would start as a simple consumer app that holds verified medication information for clinicians to view if a New Zealander or Australian requires medical assistance while travelling across the Tasman.
The idea was tabled at the forum’s Health Technology Working Group by NZHIT deputy chair Ross Peat.
He says the passport would provide information to health professionals who sometimes have to treat patients without sufficient information about the medications they are taking, which creates risk in terms of adverse reactions and allergies.
Peat, who is executive director of New Zealand pharmacy software supplier RxOne, says the idea of a health passport has been discussed in the past, but it is a complex concept involving many parties and progress has been steady at best.
“What we wanted was to come up with an electronic passport Version 1,” he tells eHealthNews.
“It’s a very simple proposition and it’s not the end solution as it’s just medications, but we thought with this simple scenario we could get something going, and this health passport could become a building block upon which additional information could be added,” he explains.
The pilot concept involves a patient going to their pharmacy and requesting a copy of their medication record. The pharmacist verifies the consumer then selects current medicine information from within their own pharmacy system to send to the health passport system. 
The health passport system would create a blockchain record of the person’s medications and digitally sign the record after checking it against the New Zealand digital claim certificate or the Australian My Health Record certificate.
There is more here:
Reading through this article a few things came to mind.

1. Why isn’t the concept just as relevant for travel in and around NZ and OZ. If you are carrying it, it will be useful no matter where calamity strikes.

2.With a standard format – like say the Blue Button in the US (https://en.wikipedia.org/wiki/Blue_Button) – it might be created by your GP / Pharmacist and be something that it is up to you to ensure currency and accuracy.

3. The technical architecture could be blockchain or maybe something a little less experimental.

4. The necessary Standards already exist and can be fairly cheaply deployed.

5. I suspect even a national roll-out would have heaps of change out of the cost to run the myHR.

By keeping things simple those who want to have a shareable clinical record can have one which they control and need to have nothing to do with that massive ADHA database.

To me the small USB key beats the myHR pretty much every time.

What do you think?

David.

p.s. I have added a link to the NZ eHealthNews service in the favourite links panel on the blog home page. D.

 

8 comments:

Bernard Robertson-Dunn said...

Will the passport contain the instructions given to the patient regarding how much and when they should take the medication? Not all medication is regularly taken.

Will the passport contain details of what the patient has recently taken?

If a patient is regularly taking medication and is traveling, wouldn't most have the packets with them to show a doctor?

How many times would such a system have been of significant benefit if it had been available in the past?

I guess this is what is meant by "it is a complex concept".

At face value it looks like a simple solution to a complex problem and is based upon the assumption that just gathering more and more patient data is a good thing.

I do hope they think this through properly and can justify the expenditure, costs and risks.

Peter said...

the 'passport' would not be a USB key. The use of blockchain means it will probably require a network connection and therefore is downloading the data from some central server. That's good because no-one should *ever* plug in an unknown USB to their valuable machine. That's a prime infection vector for malware.

To read it would require all systems involved to understand (and write??) the standard. That's fine where there is one, but no so good where it is still being developed. I imagine this is where the complexity arises for both the content (as Bernand says) and agreement on the format for sharing (NOT PDF!).

As you say, I can't see the advantage of blockchain - which is used to store a series of transactions - to this scenario - where you want to combine results from different sources (pharmacies) into a summary of the current medication.

Anonymous said...

My Health Record is a bunch of technology thrown at GPs and hospitals, with very little or more likely no clinical benefits.

Blockchain is even further down the technology rabbit hole and further away from clinical usefulness. It might get technologists all hot and excited, but as a health care issue it is (or should be) a total yawn.

Bernard Robertson-Dunn said...

According to the myhr statistics as of 11 March there have been 1,659,214 Discharge Summaries uploaded. That's more than the number of Shared Health Summaries.

This is an article in today's (19 March 2018) MJA InSight:
GPs want clinical handovers, not discharge summaries
https://www.doctorportal.com.au/mjainsight/2018/10/gps-want-timely-appropriate-hospital-handovers/

Quote:
"In the real world, GPs are grappling with being thrown links to hospital electronic records through systems such as “The Viewer”. Investigations are likely to be uploaded (after a delay) to MyHealthRecord. These are raw data, unfiltered and disorganised, and more of a throw than a handover. Being thrown raw data and being expected to catch them in this way is akin to a hospital doctor being given the login to the GP clinic’s patient management system and being expected to extrapolate a referral."

Not happy Jan!

Bernard Robertson-Dunn said...

WTF?

ANZ's Maile Carnegie says Medicare data could build new e-health industry
http://www.afr.com/business/health/anzs-maile-carnegie-says-medicare-data-could-build-new-ehealth-industry-20180320-h0xpsi

'Medicare provides one of the best-organised and comprehensive sets of healthcare data in the world, providing Australia with a strategic advantage to create a new niche for the local technology industry while improving health outcomes for millions of people, said Maile Carnegie, the head of digital banking at ANZ.

In a session at the ASIC Annual Forum on how data can improve company decisions and grow the economy, Ms Carnegie, the former boss of Google in Australia, said if the government were to open up healthcare data to outside developers, advancements in artificial intelligence and genomics technology could "drive dramatically better health outcomes for the population and wonderful industries for the country and companies who can get onto it early".'

"Australia is one of the few nations in the world that actually has a quality healthcare database,"

The Medicare data in my myhr shows item number/detail, date, name of doctor providing service (which, in the case of a pathology lab is meaningless) and it involved a hospital.

The clinical data is zero.

Questions:

1. What does Maile Carnegie, the head of digital banking at ANZ, know about Medicare that I don't?

2. Without knowing what the econdary use of myhr consultation will say, is this some sort of softening up by industry wanting to get at myhr data?

3. I just don't understand what is going on, can anyone shed light on this strangeness?

Anonymous said...

I do understand that despite opposition the Govenment intension is to make secondary use opt out to avoid needing individuals consent. The man pushing the MyHR would love to give your data to any open cheque book

Anonymous said...

" I just don't understand what is going on, can anyone shed light on this strangeness?"
Perhaps when she refers to 'Medicare data' she is using the same definition as does the MyHealthRecord ehealth web site, i.e.

"Medicare information is collected by the Department of Human Services (DHS) and/or the Department of Veterans' Affairs (DVA), and may include:

* Medicare Benefits Schedule (MBS) information or, if applicable, Department of Veterans' Affairs (DVA) claims information;
* Pharmaceutical Benefits Scheme (PBS) information or, if applicable, Repatriation Pharmaceutical Benefits Scheme (RPBS) information;
* Australian Organ Donor Register (AODR) information; and
* Australian Immunisation Register (AIR)."

I agree the MBS data is not that useful, but the PBS data might be more useful perhaps? It might be useful to combine PBS data with other data (e.g. demographic) data to look for outliers from usual patterns, or increasing need for treatment by location.

Anonymous said...

Involving Banks and their opinions at this stage is probably not going to contribute in a positive way towards building trust.