This appeared on Friday, 13 April 2018 (An omen?)
Announcing the $200 million Digital Health CRC
Publicly released: Fri 13 Apr 2018 at 1001 AEST | 1201 NZST
The $200 million Digital Health CRC will be launched on Friday. The Digital Health CRC will join up data in the health system creating an improved system benefiting all Australians. Our researchers, from 16 universities, will work with our health partners to develop and test solutions that work for real patients in real hospitals and other settings of care. And our business partners will work alongside them to ensure that the solutions are scalable and implementable. We’ll develop them in Australia, then take them to the world.
Organisation/s: CRC Association, Digital Health CRC
Media Briefing/Press Conference
From: Digital Health CRC
Announcing the $200 million Digital Health CRC
Embargo: 10 am, Friday, 13 April 2018
Media call: 10 am, ‘Fountain Courtyard’, Sydney Hospital, Macquarie Street, Sydney
A $200+ million opportunity to transform health delivery: improving health outcomes; reducing waste in the health system; building businesses and jobs.
With
- Senator Zed Seselja, Assistant Minister for Science, Jobs and Innovation
- Professor Christine Bennett, Interim-Chair of the Digital Health CRC
- Dr Bronwyn Evans, Chair of MTP Connect
- Dr Zoran Bolevich, Chief Executive, eHealth NSW
- David Jonas – CEO Designate of the Digital Health CRC
Australia’s health system has contributed to a transformation in the human condition. We’re living longer – a child born today will on average live to 83 and see in the 22nd Century. We’ve largely defeated infectious diseases and our roads and workplaces are safer than they’ve ever been.
But
· Our longer lives bring with them a greater risk of chronic and degenerative diseases which are difficult and expensive to manage and treat.
· Obesity and Type 2 diabetes are on the rise. The health system can’t keep up. Australia’s annual health expenditure has passed $170 billion which is more than 10 per cent of GDP.
· And the system is splitting at the seams. It’s too complex: for patients and their families, for health professionals, for industry, and for government. For example, adverse drug reactions in Australia are responsible for over 400,000 GP visits a year, and for 30 per cent of elderly emergency admissions. The cost is over $1.2 billion. We believe that half the cost is avoidable.
The Digital Health CRC will
§ Improve the health and wellness of hundreds of thousands of Australians
§ Improve the value of care and reduce adverse drug events
§ Join up data in the health system creating an improved system benefiting all Australians
§ Save the Australian health system $1.8 billion
§ Create at least 1000 new jobs in the digital health and related industry sectors
§ Create new companies and products for Australian and global markets
§ Create a new digital workforce and build the capacity of clinicians and consumers to become digital health ‘natives’
The Digital Health CRC’s 80-member organisations represent every segment of the health system from patient to community, hospital to insurer, start-up to big government. Our researchers, from 16 universities, will work with our health partners to develop and test solutions that work for real patients in real hospitals and other settings of care. And our business partners will work alongside them to ensure that the solutions are scalable and implementable. We’ll develop them in Australia, then take them to the world. To catalyse the latter, we are partnering with US-based company, HMS, that provides solutions and services to health insurers and their customers across 48 US states.
---- End release:
There is some excellent coverage of the announcement found here:
and here:
I have had a wander around the website and this page especially struck me.
Research Themes
Purpose and research themes Potential outcomes
While the research agenda will be shaped around industry partners’ challenges and opportunities, it is expected that the potential outcomes will be in the following three major areas:
1. Improve health, welfare, quality of life, and wellbeing of citizens through
a. Improved safety & quality in the provision of healthcare & social services
b. Increased participation of consumers in all aspects of their health & healthcare
c. Prevention: reduction in unnecessary procedures & drug interventions
d. Improved medicines adherence/persistence
e. Getting sick and injured people back to their regular daily activities faster
2. Improve the efficiency & integrity of Health Services
a. Reduce fraud, abuse, waste and errors
b. Ensure efficient and complete data flows to enable seamless care
3. Increase the value of every health dollar spent
a. Direct majority of funding to appropriate and timely care
b. Reduce consumer out-of-pocket health expenses
c. Increase the value derived from public & private health insurance
Here is the link to the page:
I also noted the overall purpose:
“PURPOSE
Optimising the use of evidence to improve personal healthcare, wellbeing and health & human services policy, planning & management and in doing so advance the Australian economy.”
Now all this sounds wonderful until you start to wonder just what the problem is that the CRC is aiming to solve and just what the co-ordinated framework is that is to bring this rather large number of partners together to solve the priority problems which are not yet clearly defined as far as I can see. I have seen similar lists from all sorts of health entities for at least the last 30 years.
The mission statement has the same issue - To improve the quality of healthcare for all, through evidence – of wanting to act in some way without diagnosing the problem!
Additionally there does seem to be a much more “financy” rather than clinically focussed and trying to solve health / clinical problems – but that is probably my bias!
Overall I get the feeling that the CRC leaps from problem (not really clearly defined) to action without an evidence gathering and problem definition step.
I also would want to have strong public disclosure and accountability so we can all see what progress is being made! I bet no one ever proves the claimed benefits of $1.8 Billion and I doubt they will accrue! (Why do these projects keep making these silly claims?)
In summary I want to stand back for a year or so and take another sounding on how it is going. If good things flow great – if not it is not really a huge investment (compared with the myHR) as long as the CRC does not get subverted as an arm of the myHR / ADHA project, which has to be a risk!
David.
23 comments:
Rather than distorted by ADHA, this probably signals the end of ADHA as having any role other than a MyHR operator.
What I find interesting is that they have outcomes they will achieve and they have solutions. There's not a problem or question to be asked in sight.
I always thought research was about asking questions and finding answers. This lot are so clever that they can start with the answers - a bit like myhr.
All those industry partners.. Makes you wonder about motive.
"Ain't no money in the cure, the money's in the medicine...that's how a drug dealer makes his money, on the comeback." Chris Rock
https://www.youtube.com/watch?v=G7P4iFg048k
This raises some fundamental questions such as:
1. $200 Million - where is the money coming from?
2. What is the role of the ADHA in this CRC initiative?
3. What is the role of the Department of Health in this CRC initiative?
@5.09 PM - good questions.
The media coverage says:
The Federal Government will invest $55 million from its CRC fund.
The Digital Health CRC will have at least $111 million in cash funding, and $118 million in-kind funding to invest over its seven-year life.
(Hence the Federal Government is providing 50% of the cash)
The Digital Health CRC has the support of the Australian Digital Health Agency and MTP Connect – the government’s medical technologies and pharmaceuticals industry growth centre.
How very interesting. There seems to be something amiss here but it's hard to put one's finger on it.
Perhaps Bernard nailed it when he observed "There's not a problem or question to be asked in sight."
"The Federal Government will invest $55 million from its CRC fund. Overall, the Digital Health CRC will have at least $111 million in cash funding, and $118 million in-kind funding to invest over its seven-year life."
https://www.computerworld.com.au/article/636114/digital-health-crc-launches-targets-care-system-savings-1-8-billion/
The Federal Government's share will come from the savings made by the use of My Health Record over seven years.
Oh, hang on a minute. They've still got to fund ADHA and they don't expect to cover their costs. That's why they are paying for it out of their CRC fund.
Forget I mentioned it - it's less than $8million a year. It's not as though they need the money for other health care initiatives like this:
https://www.smh.com.au/money/planning-and-budgeting/wait-home-care-packages-elderly-nursing-homes-20180411-p4z92u.html
Looks like the troughs have been topped up again and there is money on offer. What is in any way open about this venture? I think they have to much money to throw around, no doubt it will be siphoned off to no general benefit. Crazy... so just normal
They have a CRC budget that has to be spent on something. This is something. So they spend it on the latest technology hype. It keeps a load of researchers in work and everybody can tell themselves that they are doing cutting edge work.
I'm sure your readers will be reassured to learn that the CRC's current Chair is Christine Bennet.
Christine was Chair of Kevin Rudd's Health & Hospital Reform Commission which, as an after thought, came up with an IT position recommending the Personally Controlled Electronic Health Record (PCEHR).
It seems money is no obstacle.
The benefits section I am guessing was written before the over excited communications/marketing team arrived - https://www.digitalhealthcrc.com/#mission scroll down to benefits to industry and Universities. The intent behind these seems like a worthy cause. I would like to see an ethics committee overseeing all this.
Not sure why they fell into the trap of all those 'crusade' and mission from God statements splattered everywhere else.
Time will tell I guess as you point out David. Does it have the potential to be meddled with? Hell yes, I also find it interesting there is no mention of standards?
I suggest David Jonas sees it quite differently. In his minds eye this is all very plain English. If this is the CEO starting position it will be a fun year endless badly.
8:12AM why do you suggest this person sees things differently?
Chris Rock has a point, although I doubt he understands the full significance of it.
The biggest drag on improving health care is vested interest. The whole health care system wants to keep the status quo unless it benefits them. By definition, the future of health care and clinical medicine means doing things differently.
What the government doesn't understand is that by creating solution oriented bodies like ADHA and this CRC, all they are doing is entrenching the past, creating new vested interests and making the future harder to get to.
ADHA thinks that the future is getting GPs to spend more time putting data into health record systems, when the future lies in reducing the need for GPs to do manually intensive data gathering, entering and interpretation. GPs need better tools that help them do what they do best - cure sick people. Turning them into data entry clerks won't help them or their patients.
The CRC is aimed at helping existing "industry partners" rather than creating innovative ways of structuring the health care system (which is mainly under the control of the government through its regulations and funding models) and of better conducting clinical medicine through a patient centric approach.
The government will suffer from unintended consequences; the health care system and clinical medicine will stagnate, health care will continue to cost more.
The sad thing is that the consequences are unintended from the government's perspective but not unforeseen by those without vested interests.
IMHO, two words best describe health care in Australia: Hubris and SNAFU.
... and if you were wondering if this CRC is about health care, clinical medicine or even digital health ...
David Jonas
Bachelor of Commerce
Bachelor of Accounting
Higher Diploma in Business Information Systems, IT, Finance, Accounting Economics, Law
https://www.linkedin.com/in/david-jonas-2265a54/
He was joint author of a paper, available from here:
https://flyingblind.cmcrc.com/consumers-digital-health
The first two recommendations are:
* Enable the expanded use of existing datasets to deliver fully informed healthcare for individual consumers.
* Enable the expanded use of existing datasets to improve policy and resource allocation decisions.
In other words, tinker with the existing system.
Draw your own conclusions.
ADHA, and the CRC, leadership in automating the past.
Maybe a clue lies in the fact that, AFAIK, there is nobody in ADHA or the CRC who knows the first thing about automation. Technology? yes, Automation? no.
Bernard said: "The biggest drag on improving health care is vested interest. The whole health care system wants to keep the status quo unless it benefits them. By definition, the future of health care and clinical medicine means doing things differently."
"What the government doesn't understand is that by creating solution oriented bodies like ADHA and this CRC,all they are doing is entrenching the past, creating new vested interests and making the future harder to get to."
.... and I would add that because the politicians and the bureaucrats have limited exposure to and limited understanding of the inner workings of the health system per se they eagerly embrace the vested interests in the forlorn hope that they know what is needed to 'fix' a 'broken' health system to make it function 'better'.
Who would have thought the fax machine was so complicated?
Until organisations like this and the government move away from the need to plaster everything with pointless marketing language and pie in the sky claims I really do not think we will move much further than ADHA need to create some sort of ‘community of the people’ cult.
If you boil down the intent of this CRC it seems about connecting academia/research bodies with industry so that jointly they can benefits from each respective skill and knowledge basis and hopefully one or two ventures create something wonderfull.
Just keep things simple and plain speaking.
I suppose time will tell.
However, would I be overly cynical to suggest that this is yet another example of 'snouts in the trough'? Where the vested interests ensure that that opportunity for real improvement don't get a look in.
Am I wrong to think that the best we can hope for is the proverbial 'well-groomed tail on the mangy dog'?
All I can see is yet another example of tinkering around the edges of the real problems facing healthcare in this country.
For example, the cost of health is increasing at a rate faster than almost any other sector of the economy. This is not sustainable. Moving to a sustainable system (with real high-level buy-in) while at least maintaining services has to be the common goal. Yet, I dont see this stated anywhere.
The irony is that the government, whose vested interest (the cost of health care) is different from most other stakeholders (apart from patients) - is playing with the wrong people.
IMHO, the Federal government should be looking at its own role in health and health care (they are different beasts) and working out what it can do to reduce barriers to change and how it can facilitate alternative approaches.
The government is giving every impression it is at the mercy of the existing players.
If they were really interested in reducing the cost of health care they would attack the demand problem. How about a sugar tax? It would a) reduce the consumption of a product that is harmful when over consumed and b) generate tax dollars that could be put to good use.
How about health skills in schools?
Expecting people to "take more responsibility for their health care by giving them access to their health data" is either sheer naivety or a smokescreen - or both.
The government should get its own house in order before messing about in areas it doesn't understand. As Ian pointed out "... the politicians and the bureaucrats have limited exposure to and limited understanding of the inner workings of the health system", they just think they know more than they do - it's called hubris.
And I prefer the "its like lipstick on a pig" simile.
There's every reason to think that a sugar tax would make the problem worse by keeping people alive for longer, and incurring even more costs. Health abounds with perverse incentives. Btw, Bernard, you have plenty of hubris of your own in display in this thread.
Lets not have personal remarks from Anon. commenters please. If you feel that need please use your name. Thanks David.
On prevention, I sent Why I'm giving up on preventative care to a friend.
“A cynic might conclude that preventive medicine exists to transform people into raw material for a profit-hungry medical-industrial complex.”
His response was that, considering most people will ignore that kind of good advice, he will buy shares of diagnostic & screening companies. I wouldn't like to think that one of the objectives of the CRC is to facilitate more testing & screening.
The things that hurt the most that are evident from these announcements are:
The obvious damage the ADHA has done to the broader communities trust in and perception of national entities. It seems an artificial class system has manafested. The blind faithful and the less faithful, resulting in only the voices of the high priests being listened to.
Trust in national entities has seemingly diminished to a point where suspicion is rife
The language of scientific communities has been corrupted by buzz words and meaningless and unmeasurable statements that have no place in these domains and in fact greatly devalue what is really trying to be achieved.
Everything seems to have to be about the end not creating a means to an end
No one is able to stipulate the ‘why’
David, re "Btw, Bernard, you have plenty of hubris of your own in display in this thread.".
It doesn't bother me that anon doesn't use their name, there may be many reasons why they don't want to identify themselves.
That they disagree with me isn't a problem; differences of opinion are useful and can lead somewhere.
The problem is that accusing me of hubris without an explanation of why they think I'm ignorant and arrogant, doesn't and cannot lead anywhere.
If the commenter has a problem with my suggestion about a sugar tax "There's every reason to think that a sugar tax would make the problem worse by keeping people alive for longer, and incurring even more costs." the same could be said of any health care initiative. At least a sugar tax would raise extra revenue to help cover the increased cost.
But I'm guessing.
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