Quote Of The Year

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

Monday, May 07, 2018

Weekly Australian Health IT Links – 7th May, 2018.

Here are a few I have come across the last week or so. Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

A huge week – read on!
-----

Vic government to spend $124 million on digital patient records

EMR system to cover four health services
Rohan Pearce (Computerworld) 01 May, 2018 12:32
Victoria’s 2018-19 budget will earmark $124 million for the rollout of electronic medical records at three health services, the state government revealed today.
The Victorian government said that the EMR rollout at the Peter MacCallum Cancer Centre, Melbourne Health and Royal Women’s Hospital will see the records linked to the currently operating EMR system at the Royal Children’s Hospital.
The rollout will reduce avoidable errors and duplications as well as help patients receive faster care, the government said. Once implemented, the measure is estimated to save  $34.1 million a year.
-----

Vic govt commits $124m to e-health records

By Justin Hendry on May 1, 2018 10:12AM

Three hospitals receive budget windfall.

The Victorian government has set aside $124 million to bring digital health records to three major Melbourne hospitals.
Minister for Health Jill Hennessy and Special Minister of State Gavin Jennings announced the funding ahead of today’s state budget.
The funding will deliver electronic medical records (EMR) to three health services in Melbourne's Parkville Precinct: the Peter MacCallum Cancer Centre, Melbourne Health and the Royal Women’s Hospital.
-----

Australia to get national data commissioner

By Ry Crozier on May 1, 2018 11:59AM

New custodian part of $65m package.

Australia is set to get its first national data commissioner, in part to build public trust in the government as the custodian of significant data assets.
The creation of the commissioner role is one of a series of measures unveiled by the government today that will collectively cost $65 million over the next four years.
They form the government’s official response [pdf] to a Productivity Commission report into data availability and use that was released a year ago.
Other major initiatives that the government has committed to include:
  • New legislative and governance arrangements to enable better use of data across the economy “while ensuring appropriate safeguards are in place to protect sensitive information”; and
The introduction of a consumer data right, which the government formally committed to at the end of last year
-----

Government’s $65m plan to establish a ‘National Data Commissioner’

By Stephen Easton • 01/05/2018
A new National Data Commissioner will independently manage the delicate balance between releasing open data from federal agencies for public benefit and risks to individual privacy, taking a lot of curly risk management decisions away from individual agencies.
Today’s announcement is the centrepiece of the Turnbull government’s long-awaited response to the Productivity Commission’s inquiry into Data Availability and Use.
Along with new consumer rights, allowing people to obtain some of their data from private companies, the government response also explains proposed legislation aimed at facilitating more data releases, sharing, integration and analysis.
-----

Open data: Government to establish a ‘National Data Commissioner’

Unveils $65 million push to make more government data available
Rohan Pearce (Computerworld) 01 May, 2018 10:50
A new position of the ‘National Data Commissioner’ will be established as part of a $65 million, four-year open data push by the federal government.
The creation of the new position is part of the government’s response to the Productivity Commission inquiry into the availability and use of public and private data by individuals and organisations.
The government in November revealed that it would legislate a new Consumer Data Right as part of its response to the PC’s recommendations. The government said that this will allow individuals to access data relating to their banking, energy, phone and Internet usage, potentially making it easier to compare and switch between service providers.
-----

Tom Burton: Canberra creates a brave new data world

By Tom Burton • 03/05/2018
It is hard to overstate the importance of the federal government’s decision to create a consumer right over the data created about them.
Spurred by various inquiries calling for measures to enable consumers to more easily shop around for their financial and utility providers, federal cabinet has created a right designed to give citizens control over the data that is collected about them. The right will enable consumers to send their usage data to a competitor, to get a better deal based on their actual spending, usage and saving patterns.
The new right is predicated on the view there are enormous economic and societal benefits to better understanding the modern world through shared data. Better competition has been called out, but the benefits in collating and integrating administrative and personal data across virtually every sector in the community, are now obvious to everyone.
-----

NSW health system could be fully digital in next decade

By Justin Hendry on May 4, 2018 10:30AM

CIO plots road ahead.

eHealth NSW's chief information officer Zoran Bolevich has predicted a “fully digitally-enabled and integrated” healthcare system in the state within as little as eight years.
Speaking at Oracle's CloudWorld event in Sydney this week, Bolevic expressed a desire to make the state's "world class" health system "even betterm smarter and more patient centric in the future".
“We’ve set ourselves an aim that in eight to ten years we will become a fully digitally-enabled and integrated healthcare system that places patients, carers, families at the centre, and consistently delivers great patient experiences and great patient outcomes," he said.
-----

Digital health in a decade, say NSW eHealth chief

NSW eHealth CEO and CIO outlines his vision digital transformation of NSW’s health system
Stuart Corner (Computerworld) 02 May, 2018 14:15
The CEO and CIO of NSW eHealth, Dr Zoran Bolevich, has outline the goal of the state having a fully integrated digital health service within a decade.
Bolevich is charged with the complete digital transformation of NSW Health. He heads a health IT agency with a team of about 1000 people responsible for planning, implementing and supporting the largest digital health program in Australia.
In a Q&A session with Oracle SVP and CIO Mark Sunday at Oracle Cloudworld in Sydney, Bolevich said NSW had set a goal that, within the next eight to 10 years “we will become a fully digitally enabled and integrated healthcare system that places patients and their carers and families at the centre.”
-----

A Big Bank has a message for us GPs — should we listen?

4 May 2018
We might not embrace the thought of dedicating more of our time and resources to digital technology, but at some point, we will have to.​
A GP goes to a financial planner at a big bank and asks “How do I go about getting a small business?”
“Easy,” comes the advice. “Borrow enough money to buy a big one and wait.”
This month seems like a dubious time for a bank to be dishing out business advice, but the Commonwealth Bank was perhaps too distracted by the Royal Commission to amend the release date of their report GP Insight: understanding the future of general practice.
This report on patient satisfaction with their GP found a few things wanting. The executive summary describes “a clear divide between patient demands and the services currently offered by practices”.
-----

ADHA tries to forge greater e-health participation

By Justin Hendry on May 2, 2018 5:29PM

Using a series of digital test beds.

The Australian Digital Health Agency is set to test new models of healthcare that are enabled or enhanced by the forthcoming personal e-health record.
The operator of the record system said it is looking to fund a series of test bed projects in partnership with industry and academia to feed into the creation of digitally-enabled services and new models of healthcare.
It will use the projects both to test digital technologies and to “produce evidence of the positive impact" new services or models of care might provide.
-----
ATM ID: DH1011

Agency: Australian Digital Health Agency

Category: 80141500 - Market research
Close Date & Time: 6-Jun-2018 2:00 pm (ACT Local Time)
Description:
Tasked with improving health outcomes for Australians through the delivery of digital healthcare systems and the National Digital health Strategy (Strategy) for Australia. The Australian Digital Health Agency is responsible for national digital health services and systems, with a focus on engagement, innovation and clinical quality and safety including coordinating and providing input into the Strategy. Our focus is on putting data and technology safely to work for patients, consumers and the healthcare professionals who look after them.
This is REI process is intended to enable the Agency to establish test bed projects that will produce evidence of the positive impact of new digitally-enabled services and models of care, and demonstrate that they are sustainable and scalable.
The Agency’s overarching business objectives are to:
1. promote innovation and create new digitally-enabled services and models of care that focus on priority health areas;
2. accelerate realisation of benefits attributable to digital health;
3. generate evidence to secure ongoing investment in digital health;
4. instigate sustainable and viable partnerships with industry and other organisations; and
5. inform the development of test bed framework for the enhanced models of care pillar in the National Digital Health Strategy.
The Agency is seeking Submissions to engage Respondents to provide services to establish geographical or health sector-based test beds. These test beds require a collaborative model of delivery and are intended to be partnerships  between industry, government and other organisations. The Agency is seeking proposals by Respondents that use new approaches and demonstrate outcomes (e.g. by creating a new digitally-enabled model of care, or by generating robust evidence of the impact of an existing digitally-enabled service) that can be scaled nationally, and provide further business opportunities for partners.
-----

Digital health leaders meet in United States to forge global plans

Digital health leaders from 16 countries, Hong Kong SAR and the World Health Organization (WHO) are participating in the Global Digital Health Partnership (GDHP), which has held its second Summit hosted in Washington DC on April 24-25.
Participants discussed approaches to global collaboration in a range of topics related to the delivery of digital health services and associated policy priorities.
The GDHP is a collaborative of governments, territories, government agencies, and the World Health Organisation to support effective implementation of digital health services. It was initiated in February 2018 in Canberra, Australia.
Argentina, Australia, Austria, Republic of Belarus, Canada, Hong Kong SAR, India, Republic of Indonesia, Italy, Republic of Korea, New Zealand, Kingdom of Saudi Arabia, Singapore, Sweden, the Ukraine, the United Kingdom, United States, and the World Health Organization (WHO) are participating in the GDHP.
The GDHP is a platform for international healthcare leaders to share best practice in the use of data and technology to advance health and care, said Tim Kelsey, CEO of the Australian Digital Health Agency, which hosts the GDHP secretariat.
-----

What was the government’s response to the King Review?

Health Minister confirms the government has rejected proposals of generic medicines tendering and machine dispensing, but has not ruled out keeping the $1 discount or abolishing HMR caps as yet

In a highly anticipated move, Health Minister Greg Hunt today announced the Federal Government has released its response to the Review of Pharmacy Remuneration and Regulation.
The Pharmacy Guild of Australia welcomed the response, saying pharmacists “appreciated the positive tone of the Minister’s approach to the Review and to the future of pharmacy”.
-----

My Health Record storing health information online

Posted on: Fri 4 May 2018
My Health Record is a means for people to have a summary of their health information stored online, for easy personal access.
Individuals control what goes into and who can access the record, including doctors, hospitals and other healthcare providers.
Wills Logue, Regional Communications Coordinator for My Health Record, speaks to Small Change’s Lisa Burns.
-----

Experts call for GPs to be more educated about data sharing

Call for more initiatives to educate GPs on tech literacy and avoid accidental data sharing
27th April 2018
Medical Director says it's being as “open as possible” about its plan to share GPs' de-identified patient data, after some doctors complained they had signed up without realising.
The company, which provides practice software to 45% of Australia's GPs, is asking for permission to extract information — including prescriptions and immunisation records of all their patients — as part of its latest program update.
Dubbed MD Heart, the scheme will allow GPs who agree to the handover to compare their activity with other doctors.
-----

UK’s NHS in breast cancer bungle that could cost 270 women their lives

  • The Australian
  • 6:38AM May 3, 2018
Up to 270 women may have died after a NHS computer error failed to invite around 450,000 of them to breast screenings
Britain’s Health Secretary has apologised for what he called a “serious failure” that resulted in the mistake, which he said appeared to be the result of a “computer algorithm failure” dating back to 2009.
Jeremy Hunt said about 450,000 women aged between 68 and 71 weren’t given a chance to have a mammogram. Of those women, he said experts estimated up to 270 might have died prematurely.
-----
30 April 2018

I couldn’t afford an EMR, so I bought a robot instead

Posted by Jeremy Knibbs
Something is definitely rotten in the state of Denmark (Australia) when a manager running a major Australian hospital’s information systems looks at buying a hospital-wide electronic medical records (EMR) system then decides instead to buy a surgical robot for one of their busy theatres.
 The most obvious “wrong” here is that the robot is winning in the return on investment stakes against an EMR.
You might question the competence of such a manager given the supposedly vital role EMRs promise in terms of both both safety and hospital efficiency.
But you’d have to think again.
-----

Be prepared for the expansion of My Health Record in 2018

What is My Health Record?
My Health Record is a secure online summary of an individuals key health information such as  medical history, medicines, allergies and adverse reactions, immunisations, discharge summaries,  and test and scan results.
For  Aboriginal and Torres Strait Islander peoples and communities, it means  their important health  information is kept together in one place that is accessible anytime by the ir authorised healthcare  providers, including in a medical emergency.
Who gets a record?
Currently, more than 1 in 5 Australians have a My Health Record. Later this year, the program will be  expanded to an ‘opt -out’ model, whereby every Australian will have a My Health Record created for them unless they choose not to have one.
-----

Wanting more for less: You can’t have your cake and eat it too

Dr Edwin Kruys 30/04/2018 3:19:56 PM
The Practice Incentive Program is shrinking, but the Government expects new quality improvement systems and GPs’ data, Dr Edwin Kruys writes for newsGP.
Dr Kruys believes the Federal Government is seemingly making ‘policy on the run’ in addressing changes to the Practice Incentive Program.
Most GPs were underwhelmed, to say the least, when they heard about the changes (read: cuts) to the Practice Incentive Program (PIP). Cutting the funding for nursing home visits is a hard sell for the Department of Health and the Federal Health Minister.

This is the wrong message at a time when there are more elderly people with complex chronic health problems in need of appropriate medical care, preferably in the community.
-----

G Medical's new e-store lets consumers buy Prizma medical smartphone case direct

Want to turn your smartphone into a 21st century medical monitor, akin to an early form of Star Trek medical Tricorder? Now you can.
Back on 26 October 2017, I conducted a video interview with Dr Yacov Geva, chief executive of G Medical Innovations, a man with decades of experience in business, life, success and the medical realm.
His company, G Medical Innovations, is based in Israel, but has since listed on the ASX, and was one of the reasons why Dr Geva was in town last year.
-----

When it comes to drug compliance, apps are no quick fix

3 May 2018
There’s a mountain of medical apps out there. But are they really any good? Can they prove their clinical worth in rigorous trials?
Researchers from the US took it upon themselves to find out by investigating the medication adherence app most highly rated for usability. That app is Medisafe, which promises to improve drug compliance by sending smartphone alerts if a patient doesn’t take their medicine on time.
In addition to alerts, it provides weekly adherence reports and allows users to set up a ‘Medifriend’, who receives alerts on their own smartphone if their friend doesn’t take their medicine, presumably so they can berate them about it. Sounds like a perfect combination of prompts to boost drug adherence in, say, people with poorly controlled hypertension.  
-----

ACRRM secures GP remuneration review in 'compact' with government

The deal echoes those agreed in secret by the RACGP and AMA last May
3rd May 2018
The Federal Government is promising to review the pay and incentives of rural doctors as part of a 'compact' signed with ACRRM ahead of next week’s federal budget.
It has also pledged to urgently finalise all outstanding legislative amendments required to grant the college full recognition as a certifier of specialist GPs.
The compact, made public on Wednesday, echoes those agreed in secret by the RACGP and AMA last May.
-----

Government denies ASD has plans to spy on Australians

The Australian Government has been quick to deny a story that the Australian Signals Directorate is trying to extend its spying powers to Australian citizens.
Foreign Minister Julie Bishop told reporters in Cairns: "The current laws safeguard the privacy of Australians but also provide us with an opportunity to keep Australians safe."
The story ran in Sunday editions of News Corp newspapers and cited correspondence between the head of the Department of Home Affairs, Mike Pezzullo, and Defence Secretary Greg Moriarty.
-----

Privacy Foundation expresses alarm over ASD report

The Australian Privacy Foundation says it is "seriously alarmed" about the weekend's report that the Australian Signals Directorate is trying to extend its powers to spy on Australian citizens.
The story ran in some News Corporation newspapers on Sunday and both the government and the secretaries of the two departments concerned, Home Affairs and Defence, were quick to deny that any such plans existed.
Adam Molnar, the co-chair of the APF's Surveillance Committee, said the move was "a dangerous precedent that would remove an already inadequate oversight mechanism that our nation’s top foreign intelligence agency has in relation to the rule of law and democratic accountability".
-----

Facebook: a canary in the data goldmine

  • Yohan Ramasundara
  • The Australian
  • 12:00AM April 24, 2018
Seeing Facebook’s Mark Zuckerberg face the Senate hearing in the US last week showcased something that we don’t get to see that often: a company, and its CEO, held accountable.
The furore over the revelations that Cambridge Analytica harvested data on 87 million users — including some 300,000 Australians — via an app that tied into Facebook and slurped up data without permission isn’t all that surprising: Facebook, YouTube, Twitter and others have built their business on user-generated data.
Cambridge Analytica caused such a backlash because it harvested this data without permission, and not only of Facebook users but also of ­people who have never used Facebook, thanks in part to “shadow profiles” gleaned from personal data.
-----

No need to fret, CBA says of mammoth data breach

Confirms data relating to 19.8 million customer accounts may have been misplaced
Rohan Pearce (Computerworld) 03 May, 2018 09:07
The Commonwealth Bank says there is “no evidence of customer information being compromised or suspicious activity” as a result of copies of financial data relating to some 19.8 million customer accounts being misplaced in 2016.
The bank confirmed a May 2016 incident when it was unable to confirm the scheduled destruction of two magnetic tapes with customer statements. The tapes included customer names, addresses, account numbers and transaction details from 2000 to early 2016, CBA said.
BuzzFeed News’ Paul Farrell broke the story, revealing that the incident took place when Fuji Xerox was decommissioning a CBA data centre.
-----

Be alert but not alarmed about mammoth CBA breach, say experts

By Ben Grubb
3 May 2018 — 5:10pm
Commonwealth Bank customers should be “alert but not alarmed” about a mammoth data breach in 2016, which the bank chose to keep private, Australia’s former privacy commissioner, Malcolm Crompton, says.
As the scandal-plagued bank faces the fallout from this latest incident — which has prompted the privacy regulator to re-look at how the bank handled it — privacy experts said even if a similar breach happened again, the bank might not be required to disclose it under new notification laws.
Yet another scandal plagues Australia's largest bank, with the Prime Minister Malcolm Turnbull labeling it an "extraordinary blunder".
-----

Health data governance enforceable undertaking for reidentification of MBS/PBS data

Australia, USA May 3 2018
In brief
The Australian Information Commissioner has concluded an investigation into the re-identification of Medicare service provider data within the de-identified Medicare Benefits Schedule and Pharmaceutical Benefits Schedule data published by the Commonwealth Department of Health on data.gov.au in 2016. Background and further information about the data published can be found in a LegalTalk Alert which was distributed on 11 May 2017. In the investigation, the Commissioner found that the Department of Health failed to take reasonable steps to protect personal information and to implement practices, procedures and systems to ensure compliance with Australian privacy laws.
The Department of Health provided the Commissioner with an undertaking, which included a requirement to establish an external review and audit into departmental policies and procedures for the release of data based on personal information.
The incident in 2016 has provided a valuable learning experience for Government agencies as they explore how to best realise the value of public data sets. Importantly, the Commissioner observed that the risk of re-identification may require limiting the sharing of some types of data to trusted recipients, and/or using secured environments to share information, rather than simply relying on de-identification techniques.
-----

New Zealand underinvesting in health IT

Wednesday, 2 May 2018   (0 Comments)
eHealthNews editor Rebecca McBeth
An investigation by eHealthNews has uncovered a low level of spending by DHBs on information technology, putting existing systems at risk and inhibiting the transformational change needed.
 New Zealand’s district health boards are spending around 2.3 per cent of their annual budgets on information technology, which is half the global average.
 Experts spoken to by eHealthNews say 2.3 per cent is barely enough to keep the legacy systems running and does not allow for investment in the transformational change that the health system requires.
-----

Answer: Telehealth. So what was the question?

…How can we transform healthcare?

Report by HISA’s Nigel Chartres and Dr Josie Di Donato

Genuine intent and achievement to transform care virtually, in a connected and codesigned way amplified the theme of the 2018 Australian Telehealth Conference in Sydney.

From Start-Up to Scale-Up

Opportunities for using technology that enables virtual, connected care were more and more apparent at this year’s Australian Telehealth Conference (ATC). Telehealth is no longer videoconferencing alone. It is no longer on the periphery and exclusive technology for the supported care of people living in the remotest parts of the world. Telehealth has stood the test of time and broadened the frame for healthcare delivery no matter where you live and no matter how far the nearest healthcare provider is located.
Telehealth has emerged beyond the veil of pilot and demonstration projects, as a key tool for achieving virtualised and connected care.
-----

Outgoing head of the Garvan talks about the rapid, inevitable transformation of the “last of the great cottage industries”

Lynne Minion | 02 May 2018
Within two years it will be unacceptable for cancers to go unsequenced and genomics analysis will be the standard of care for rare and undiagnosed severe disability, according to the outgoing head of Australia’s prestigious Garvan Institute, as healthcare transforms from the “last of the great cottage industries”.
A pioneer, soothsayer and pied piper: meeting Professor John Mattick it’s easy to see why he is described as a man on the vanguard of transforming clinical care through genomics.
A precision medicine evangelist, he is preoccupied with placing its diagnostic and curative powers – once the stuff of science fiction and the high-tech province of medical research – into doctors’ hands.
-----

Labor reiterates commitment to fibre in NBN rollout

The Australian Labor Party says it is committed to fast, reliable and affordable Internet for the country, and that means more fibre in whatever remains of the NBN rollout after the next election which it expects to win.
The party's acting shadow minister for communications, Stephen Jones, told iTWire in response to a query that work was continuing on the party's broadband policy for the next election.
In its draft policy for the next election, the word "fibre" has been left out, raising questions in some quarters that the party was planning to follow the current rollout policy for the national broadband network.
-----

Are unlimited 4G and future 5G plans the death knell for the NBN?

Unlimited 4G data plans for mobile phones have arrived in Australia at long last, and truth be told, unlimited 4G was actually launched long ago by VividWireless, but is this the end for the NBN?
COMMENT: Has the NBN been turned into the EndBN? Is it all over for Kevin Rudd and Stephen Conroy's dream of a national broadband network, since destroyed, as ordered by former prime minister Tony Abbott, and carried out by current Prime Minister Malcolm Turnbull's spectacularly inept handling of the NBN fiasco?
Given the fact that a robust, wired, nationwide fibre network is required for robust handling of the massive traffic volumes that today's 4G network and tomorrow's 5G networks require, it's easy to see that the answer is no.
-----

Morrow says copper is slower than fibre. And in other news, the sun rose in the east...

NBN chief executive Bill Morrow has given the clearest indication yet that he plans to continue working in Australia after he leaves the company at the end of the year, issuing a six-page "white paper" last week in which he acknowledged that the multi-technology mix NBN has suffered in speed terms due to the abundance of copper.
This acknowledgement has been interpreted in varied ways by people, with some saying he was criticising the federal government, others saying he was being frank about the problems posed by copper, and yet others saying he had finally seen the light.
But what Morrow did is common among people who are perceived by the public as having screwed up in style and want to make amends so that they continue in some other public role without looking too much like dunderheads.
-----

NBN Co chief gets frank about copper's problems

By Ry Crozier on Apr 27, 2018 1:24PM

Helped quicken the rollout but caused ongoing issues.

NBN Co’s outgoing CEO Bill Morrow has issued a frank assessment of how increased use of copper in the network has caused both the company and its customers problems.
Morrow stopped short of criticising the technology switch from majority fibre to a mix of access technologies - which happened under a change of government.
He still believed that reusing the copper and HFC networks was required to meet the expected pace of the rollout.
-----
  • Apr 30 2018 at 2:21 PM

Needless Bill Morrow NBN essay an effort in legacy building and blame dodging

In what has become a ridiculously regular occurrence, the construction of the National Broadband Network was again plunged into furious political debate at the end of last week, when departing chief executive Bill Morrow published a "position paper," laying out a range of historic and existing issues with the project.
The essay covered a perspective on the original need for improved broadband, a potted history of the countless funds it has had to give to Telstra for its existing infrastructure and a factual breakdown of why the copper used in the fibre to the node heavy rollout, mandated by Malcolm Turnbull, was slower and more prone to problems than the fibre to the premise (FTTP) model used by the previous Labor government.
He then concluded that, despite all of these problems, the government's approach was essentially correct in the context of building the NBN faster and cheaper than Labor's model, and providing a service that is good enough for now.
-----

Turnbull sabotaged NBN: Shorten

  • The Australian
  • 3:09PM April 27, 2018

David Swan

Supratim Adhikari

Opposition leader Bill Shorten says Malcolm Turnbull has sabotaged the NBN, following The Australian’s report that the head of NBN Co, Bill Morrow, had highlighted the Coalition’s multi-technology approach as source of customer confusion.
“Malcolm Turnbull has absolutely given Australia a second-rate NBN and even his outgoing CEO has confirmed that fact,” Mr Shorten said at a Melbourne press conference.
“Turnbull has stuffed up the NBN because he backed in a cheaper technology which is now going to deliver sub optimal outcomes.
-----
Enjoy!
David.

19 comments:

Bernard Robertson-Dunn said...

Have I read this market research tender correctly?

https://www.tenders.gov.au/?event=public.atm.show&ATMUUID=08370059-B569-9095-42C15D64E446175E

"This is REI process is intended to enable the Agency to establish test bed projects that will produce evidence of the positive impact of new digitally-enabled services and models of care, and demonstrate that they are sustainable and scalable. "

They want the test beds to produce "... evidence of the positive impact of new digitally-enabled services and models of care"

Does that mean they are not interested in negative evidence? That they will ignore negative evidence? That they will only use evidence that supports their preconceived notions and objectives?

Do these people know how proper science and research works?

Anonymous said...

Unless clarity is not a measure these days I think you are correct Bernard. I also found this in the ATM in AusTender.

3. generate evidence to secure ongoing investment in digital health;

It would appear to support you assumption

As someone made mention last week - Evidence is in the eye of the beholder.

How much more embarrassing can the ADHA get?

Anonymous said...

Perhaps what they meant to say was ‘ evidence of where new models of care might have a positive impact?’ However now the consequences ( and mounting disbenefits) Rolf the disruption out of control information technology is having on peoples lives, productivity and privacy might be a more worthy undertaking. Better to improve the broken. I get a sense ADHA is going down the path of ‘if it works let’s break it for the sake of it’

Anonymous said...

I am pretty sure the ADHA meant to state what it stated. The goal will be a library of referencable publications and other assorted things. Citations make for impressive documents and it disarms questioning of the currency and relevance. As they say it is about securing money through the tick box ATM.

Anonymous said...

Dr Kruys believes the Federal Government is seemingly making ‘policy on the run’ in addressing changes to the Practice Incentive Program.

Federal Government is seemingly making ‘policy on the run (and its Agencies) sums things up rather well I think.

Anonymous said...

This new Data Commissioner looks interesting and worth keeping an eye on. With the MHR secondary Use to be announced I can only ask that the ADHA not be selected to operate the secondary use, nor any form of data analytics. I am sure they would mean well but it is clear they have a tendency to bend facts or ignore data that does not support their agenda. Secondly it is clear they cannot operate even simply IT infrastructure. I can only imagine what sort of predicament we would end up in as they outsource to some third party like Microsoft or more likely Oracle. Good vendors, however could they be held accountable? could they be controlled? or trusted to not reuse data for there own purposes?

Bernard Robertson-Dunn said...

IANAL but, the current enabling legislation states:

"15 Functions of the System Operator [i.e. ADHA]

(ma) to prepare and provide de-identified data for research or public health purposes;"

My reading of the above is the ADHA can de-identify (whatever that means, it isn't specified) myhr data and hand it over to the ABS as part of the MADIP program as well as to other unspecified bodies.

and

"70 Disclosure for law enforcement purposes, etc.

(1) The System Operator is authorised to use or disclose health information included in a healthcare recipient’s My Health Record if the System Operator reasonably believes that the use or disclosure is reasonably necessary for one or more of the following things done by, or on behalf of, an enforcement body:

...

(c) the protection of the public revenue;"

This seems to mean that an enforcement body (e.g. one of the agencies charged with investigating fraud or suspected fraud) can ask for and get myhr data.

Neither of these require patient consent or notification.

Going opt-out seems to have trashed the requirement to get patient consent to either register them for a record or obtain their approval to upload to or access data in their record.

The default will be: everybody is registered for a myhr, all data is accessible by approved health care professionals and a few, select others, the government has the legal power to access all data (historical, deleted, access controlled) for research and in "the protection of the public revenue".

WCGW?

The government has already been accused of releasing the PFAS (RAAF Base toxic chemical) report in budget week to take attention away from it. “You’d almost think the intention would be that it slip under the radar.” MP Cathy O’Toole said.

If the secondary use report comes out this week, it may well look the same.

Bernard Robertson-Dunn said...

I'm still puzzled by the Request For Expressions Of Interest For Digital Health Test Beds (not market research, my bad)

The REI tender document says:

The first tranche of test beds should include use of the My Health Record system and how it can be utilised to create new, digitally-enabled services and models of care, particularly where these can be rapidly implemented or are already underway. This is with a view to leveraging the significant efforts underway in 2018 to raise awareness of the My Health Record and expand participation, and to use this national infrastructure as a platform for innovation. The program will also inform the development of the test bed framework for the enhanced models of care priority set out in the Strategy.

It is not clear if ADHA wants a test bed to identify the benefits of "new, digitally-enabled services and models of care" or they want someone to come up with "new, digitally-enabled services and models of care" that can be tested.

If it is the former, does that mean the government has created something it doesn't know what to use it for? If it is the latter, why are they doing in now, during the opt-out period while people are expected to decide if they want to opt-out.

Whatever the answer is, it would appear that in the 6 odd years since PCeHR went live, nothing has been tested in terms of health outcomes.

And I was wondering if the description on austender was not a faithful representation of the tender itself, but having looked at the REI itself, ADHA is definitely only interested in identifying benefits. There is no requirement to identify or report on negative consequences or increased costs.

I wonder what ADHA's opinion of articles like this is:

It Ain’t Necessarily So: The Electronic Health Record And The Unlikely Prospect Of Reducing Health Care Costs
Much of the literature on EHRs fails to support the primary rationales for using them.
https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.25.4.1079

And that was published in 2006, so NEHTA/ADHA between them have had a while to address these issues.

Recognising that myhr isn't even an Electronic Health Record\

Something doesn't make sense.

Bernard Robertson-Dunn said...

I'm still puzzled by the Request For Expressions Of Interest For Digital Health Test Beds (not market research, my bad)

The REI tender document says:

The first tranche of test beds should include use of the My Health Record system and how it can be utilised to create new, digitally-enabled services and models of care, particularly where these can be rapidly implemented or are already underway. This is with a view to leveraging the significant efforts underway in 2018 to raise awareness of the My Health Record and expand participation, and to use this national infrastructure as a platform for innovation. The program will also inform the development of the test bed framework for the enhanced models of care priority set out in the Strategy.

It is not clear if ADHA wants a test bed to identify the benefits of "new, digitally-enabled services and models of care" or they want someone to come up with "new, digitally-enabled services and models of care" that can be tested.

If it is the former, does that mean the government has created something it doesn't know what to use it for? If it is the latter, why are they doing in now, during the opt-out period while people are expected to decide if they want to opt-out.

Whatever the answer is, it would appear that in the 6 odd years since PCeHR went live, nothing has been tested in terms of health outcomes.

And I was wondering if the description on austender was not a faithful representation of the tender itself, but having looked at the REI itself, ADHA is definitely only interested in identifying benefits. There is no requirement to identify or report on negative consequences or increased costs.

I wonder what ADHA's opinion of articles like this is:

It Ain’t Necessarily So: The Electronic Health Record And The Unlikely Prospect Of Reducing Health Care Costs
Much of the literature on EHRs fails to support the primary rationales for using them.
https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.25.4.1079

And that was published in 2006, so NEHTA/ADHA between them have had a while to address these issues.

Recognising that myhr isn't even an Electronic Health Record\

Something doesn't make sense.

Anonymous said...

Bernard, you might find NHS test beds and NHS new models of care more informative, everything from think like a patient, act like a tax payer to bonfire of the fax is a poor ripe off from the UK. Which is perfect as the NHS is what DoHA want

Anonymous said...

Are you suggesting the ADHA is like some cheap cover band?

Anonymous said...

Oh yeah!
ADHA could do a tribute to ABBA with 'Money Money Money'

Anonymous said...

These test beds, I find them a little constrained, there is no requirement to provide evidence of scalability or even sustainability. If we are to have digital health become part of medicine then is it unreasonable to ask that digital health technologies follow a similar evalauation pathway as any other technology in health, such as medicines? We don’t just present a power point on the benefits of a new treatment and then test it in the population without due diligence based of scientific methods.

The government health record has not even been audited by the Australian computer scociety. There is enough evidence from members of the community that suggests the MyHR is perhaps less than fit-for-purpose

Bernard Robertson-Dunn said...

It's not the test beds or even new models of care based upon myhr that concern me it's the strong impression the tender gives that they are only interested in identifying benefits. Increased costs (such as making GPs manage two eHRs) and risks (such as old data, inaccurate data, incomplete data, privacy risks) do not seem to be in scope.

Anonymous said...

Has anyone seen any mention at all of ADHA, Digital Health, the womb to the tomb surveillance of all Australians, sorry, the Baby Book, in last night's budget?

Anonymous said...

@7:25 that renewed attempt (there have been a few now) to create an child record is probably a COAG initiative. The federal budget would not call it out the figures would be to small.

The ADHA is now just an administrative entity overseeing the GovHR. Overtime it’s budgets will be reduced to operating costs and whatever mammoth licensing, hosting and operating cost the GovHR system will cost.

I predict COAG will establish a new entity to tackle eHealth proper. Maybe something similar to what AHHA proposed in their blueprint.

I feel for many at ADHA who signed up to make a difference and have been used to justify the central PDF repository which seems less and less to do with healthcare

Bernard Robertson-Dunn said...

A digital baby book.

https://www.themandarin.com.au/92441-federal-budget-2018-digital-government/

'Not all new aspects of Australia’s immediate “digital future” that are funded in this year’s budget are labelled as such, however.

One that seems likely to ring the privacy alarm bells is a new “national digital baby book” costing $5m over two years. One glossy budget brochure explains this will “ensure all newborn Australians have access to a lifelong electronic health record” instead of the old hardcopy versions, while the budget entry for the Healthy Active Beginnings program, to which it belongs, states the digital baby book will “enable Australians to use technology to support the vital first 2,000 days of a child’s life”.'

It doesn't seem to be mentioed in the ADHA budget papers:

http://www.msac.gov.au/internet/budget/publishing.nsf/Content/2016-2017_Health_PBS_sup3/$File/2016-17_Health_PBS_4.03_Digital_Health.pdf

An app is mentioned in the ADHA strategy "Child Health mobile app replaces paper book", although it does also say:

"The children’s health test bed will examine how every child in Australia can have access to a comprehensive digital health record, readily accessible by parents and healthcare providers, to track key childhood healthcare interventions (e.g. immunisations) and ensure that healthcare providers are able to offer safe, high-quality care. A number of sectors will need to collaborate to investigate how to harmonise state and territory systems into a national child health record that can be easily adopted."

Talking about a mobile app, here's one launched 5 years ago:

"Australia Launches Child's eHealth Record App

https://www.digitalhealth.gov.au/news-and-events/news/australia-launches-childs-ehealth-record-app

Created on Monday, 3 June 2013
On Sunday 2 June

The Minister for Health, Tanya Plibersek launched the new child eHealth mobile app that allows parents to keep their children's important health, growth and development information at their fingertips."

It's all very confusing, and there's nothing I can find in the major print media.

Bernard Robertson-Dunn said...

Re “provide newborn Australians with a lifelong electronic health record” - the News limited papers seem to have covered it somewhat.

HealthcareIT has by far the best coverage:

http://www.healthcareit.com.au/article/budget-boost-health-tech-windfall-federal-budget-critics-say-immediate-patient-needs-are

"An additional $5 million over two years will go towards the development of the previously announced national digital baby book, a project led by the National Children’s Digital Health Collaborative and designed to provide newborn Australians with a lifelong electronic health record."

So what's the relationship with myhr/ADHA?

...

"Meanwhile, the AMA claimed the national digital baby book is a digital health infrastructure investment that will improve patient care for kids."

How anyone can call an application "infrastructure" I don't know.

"'[In] terms of the safety advantages that electronic health records bring, we have a fragmented health system and the idea that someone at the start of their life might have every single health intervention, whether it be a vaccination, an x-ray, or as we age, things like protheses, et cetera, allergies, serious allergies like anaphylaxis, all recorded in a document which can be visualised wherever you're being looked after, in a public hospital, in a private hospital, that's good news,' AMA President Dr Michael Gannon said on SKY News today.

'This is being done in other parts of the world; this is another way of adding to the electronic health record, which is the future for the Australian healthcare system.'"

but wait, there's more...

"But digital health advances – including the Federal Government’s My Health Record – are an increasing burden for radiologists, with the Royal Australian and New Zealand College of Radiologists voicing disappointment that changes to rebates for radiology and radiation oncology were overlooked when they currently don’t cover the costs of treatment.

'Another budget has now gone past with no change to radiology rebates. After 20 years of frozen rebates it is no surprise to see patients paying higher out of pocket costs than ever before,' RANZCR President Dr Lance Lawler said.

'We have also raised with the Government increasing costs for radiology practices that will arise in the increased use of digital health technologies such as the My Health Record. The high rates of bulk billing quoted by the Health Minister recently are hiding a dark secret – it is becoming more difficult to access imaging, a core element of diagnosis and treatment.' "

So will opt-out help them? It isn't clear, but it is unlikely to reduce their workload - add that to GP's increased workload.

More confusion.

With the states busy implementing or enhancing their own eHR systems any what appears to be different government departments building their own systems, the AMA's observation that "we have a fragmented health system" looks as though it's just going to get worse.

Last week's poll was "Is It Possible To Create A Digital Health System That Is Optimally Useful And Functional For Both Clinicians And Patients?". David's comment was:

"Looks like a little over half agree that you can’t serve two masters optimally."

Not only that, but a single system is unlikely to serve hospitals, specialists, dentists, pharmacists and GPs. There is no way myhr can meet everybody's needs so all that is happening is that the myhr and potentially other systems such as the National Children’s Digital Health Collaborative's cute little digital baby book is going to make it worse.

I supposed all will be made clear at the NPC on 24 May.

Bernard Robertson-Dunn said...

Further to the relationship between ADHA and the digital Baby Book:

It is an initiative of the Australian Digital Health Agency.

https://www.digitalhealth.gov.au/news-and-events/news/media-release-a-new-national-digital-collaborative-to-improve-child-health

It is not clear if the digital baby book is part of My Health Record or if it is a separate system that interfaces with it. The article says that "New South Wales and Victoria are leading this work." And it is not known how it relates to ADHA's "Child Health mobile app".

If the data does end up in My Health Record it means that the government will be able to track every Australian who has one, their health problems from birth, how much the government has paid for their health care, who has treated them, how well they have treated them, where they have ever lived, their contact information and their relatives.

Of course I may be over sceptical, but I’m sure ADHA will contact me and let me know where I’ve got it wrong.