This was published a little while ago.
Tenth Clinical Safety Review of the My Health Record System
June 22, 2018
Patient care is improved by enabling clinicians to efficiently identify and utilise relevant information and documents within a patient record. A well-designed user interface to access this information is therefore important for clinicians, particularly when dealing with complex records and large document volumes. Difficulties in navigating and searching large volumes of clinical documents in any paper-based or electronic system can potentially impede appropriate decision-making and management.
The objective of the tenth clinical safety review was to examine the current presentation of clinical documents and clinical information in the My Health Record system via connected Clinical Information Systems (CISs). The review offers usability-focused presentation and design recommendations to enhance clinicians’ interactions with the system in providing patient care.
Here is the link:
The ADHA takes 4+ months to review a 22 page authorless document and when you read it you know why.
Among the most interesting things you read are:
1. Almost all displays of myHR data are simple lists and nothing more.
2. Many of the document titles – which you have to open one by one – are not clear and don’t reflect document content.
3. While filtering and sorting functionalities assist with navigating clinical documents, it remains difficult for clinicians to determine which documents contain the information they require. It can be time-consuming to repeatedly open separate clinical documents to find specific information. This is particularly problematic where a patient record contains a large number of clinical documents, especially for chronically ill or polypharmacy patients.
4. The Shared Health Summaries often don’t reflect the data in the GP System.
5. “Some clinicians interviewed expressed concerns that usability-related feedback, provided during the development of the clinical document list specification, was not incorporated by the Agency. In addition, these clinicians indicated that they do not feel the My Health Record system readily supports their workflow or day-to-day activities.
The Department of Health and, since 1 July 2016, the Agency have undertaken a range of consultation processes with representatives of the health sector, software vendors and the broader community to inform future design of the My Health Record system and usability enhancements. While consultation is an opportunity to engage with the key stakeholders, it will raise design expectations for those having direct input to the process. It is acknowledged that there will always be potential differences among stakeholder groups in terms of workflow requirements and the challenges in adopting new workflow arrangements when moving from a paper-based system to an electronic system. Based on clinician feedback it is important that the Agency undertake a feedback process on the outcomes of the implemented design and apply this more consistently going forward.”
In summary the thing does not support clinical workflow and advice, over years, to fix it is just ignored!
6. You can’t easily identify new or update clinical information.
7. You have to open each document individually, and slowly, to know what it contains.
There is little point going on. The myHR is clearly, after six years, not fit for clinical use and the Agency does not have a plan to make it so that anyone is aware of. Read, at your leisure, all the other issues identified. I wonder why the authors are not credited - they are clearly aware what junk the myHR really is!
Basically it is just an overgrown document management system vintage circa 1995. Leave the thing alone until it is made useful and safe…if ever. It is hard not to blame the rather low-level incompetents who conducted the Royle Review for Minister Dutton for not recognising a lot more was needed than the move the opt-out. It needed a fundamental rethink as I have argued for years
David.
This is not a good look. There are many prominent persons out there claiming the opposite of this report. Are they being misinformed or mislead or simply load to?
ReplyDeleteThis really needs to get into the public domain.
I also note the public are starting to link Tim Kelsey legacy, care.data and the MyHR, they are not happy campers when the learn of Kelsey and his background and position regarding people personal information.
Kelsey may prove to be the undoing of MyHR and the minister.
Another reason to optout might be the fact the ADHA and the Minister seem to be silent all of a sudden. They seem content to let leaders address concerns as with the AMA President Dr Tony Bartone, on Weekend Sunrise, this morning. Anyone seen or heard from ADOHA?
ReplyDeleteProbably keeping their heads down hoping it will all blow over. Silly boys.
ReplyDeleteAnd just when is the prime minister and his cabinet going to get tough on these NHS migrant gangs terrorising citizens and lining up insurance companies and data miners for the onselling of private information?
ReplyDeleteAs for the Tim Kelsey link, this just came out:
ReplyDeletehttps://www.theguardian.com/australia-news/2018/jul/22/my-health-record-identical-to-failed-uk-scheme-privacy-expert-says
"My Health Record privacy framework 'identical' to failed UK scheme, expert says
Care.data was cancelled because drug and insurance companies were able to buy patient data"
Very interesting reading, it seems all the same "safeguards" about secondary data were in place in the UK, as proposed with MyHR, but didn't work, all semantics. Who would have thought it!
Tim Kelsey is not concerned with individual Australian motives, nor with the higher, philosophical questions of ethics and choice. Indeed, he presents an image of a person who cares more about control and really doesn't want anything to do with the individual.
ReplyDeleteIn my opinion anyway
I have been reading with growing concern this comparison with providing information to Facebook or google etc... If as we are witnessing private organisations cross the line then Governments step in and take them to task, the trouble with MyHR is it is owned and operated by the Government, who oversees them? Especially when in the hands of some piss-pot small Agency like ADHA that by all accounts couldn’t run a bath.
ReplyDeleteIf things are to change then everyone in management and above in operations to innovation needs replacing
HOW TO NOT OPT OUT AND YET STILL MAINTAIN YOUR PRIVACY…
ReplyDeleteIf you do nothing then you will have a My Health Record in October this year.
But don’t worry, if you have anything at all that you want to keep confidential, e.g. your medication for depression or a sensitive procedure (a termination, a vasectomy), then the MyHR has some features to manage access and keep your information confidential:
a) You can access your record online and set a password over your whole record, so that only those to whom you give the password to can access your record.
b) You can consider ‘hiding’ a particular document. E.g. just say you want to hide a certain prescription for a medication. You can hide the relevant prescription document, or even ‘effectively remove’ it from your record… but you should understand that this will not automatically prevent the corresponding PBS claim item (with the confidential medication name) from popping into your record for anyone to see. Note there is no relational integrity across documents in your My Health Record. You will need to be vigilant and check across all your documents – YOU will need to BE the referential integrity for your record.
c) You can also consider blocking a particular healthcare provider organisation from viewing your record or certain documents in your record. However it is worth noting that the granularity of ‘healthcare provider’ for the MyHR may mean that you need to block your whole state or territory from seeing your record or your confidential documents. As a corollary to this, you should understand that if you don’t block a health care provider, then your private information could be confided to the whole state or territory. Of course not everyone in the state should be looking at your record – it should only be those involved in your healthcare. Your audit/access trail will however only be able to show you the state/territory level of granularity. And if, as suggested in point a) above you have given your record-level password to a doctor who works for your state health system, then you are affectively enabling access to all the healthcare workers in that state.
Probably the easiest way is to set a record level password, but don’t give it to anyone.
So now you know all the wonderful ways to have a record and maintain your privacy!
Thanks for that. Now how do I keep the "Guvmint" and the Police out?
ReplyDeleteDavid.
If things are to change then everyone in management and above in operations to innovation needs replacing
ReplyDelete@ 7:26, you might be right, it is being reported this morning on radio that the ANC has obtained information indicating the ADHA is scrambling to rewrite the contacts for mobile app organisations using the MyHR. Just what have the ADHA done now?
It really is time to pause them and as 7:26. States, perhaps remove a bunch of incompetent managers as clearly they are putting the government and consumers and most likely software developers at great risk.
And another David - https://www.abc.net.au/article/10026644 - My Health Record agency adds 'reputation', 'public interest' cancellation options to app contracts
ReplyDeleteThese people are just making this up as the go, reactive policy implementation is not a viable option. Just what have these cowboys and cowgirls been doing and what loopholes have they created.
A train-wreck waiting to happen.
ReplyDeleteExcept it's happening before our very eyes.