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"


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

Friday, August 10, 2018

Surely When You Are In A Hole The First Thing To Do Is Stop Digging!

They say you get the politicians you deserve but I am not sure I deserved a collection of Digital Health illiterates like the present lot. Last week they put out this release.

State and territory governments reaffirm unanimous support for My Health Record

Health ministers from across Australia unanimously reaffirmed their support for My Health Record and the national opt out approach at the Council of Australian Government Health Council meeting in Alice Springs.
3 August 2018

Health ministers from across Australia unanimously reaffirmed their support for My Health Record and the national opt out approach at the Council of Australian Government Health Council meeting in Alice Springs.

I welcome the bi-partisan support from both Labor and Liberal state governments for this important health reform.

As health ministers noted at the meeting, the expert clinical advice is that My Health Record will deliver better health care for patients.

I also want to acknowledge the strong support from all ministers regarding a strengthening of privacy provisions under the My Health Record Act, removing any doubt regarding Labor’s 2012 legislation.

Labor’s 2012 My Health Record legislation will be strengthened to match the existing Australian Digital Health Agency policy.

This policy requires a court order to release any My Health Record information without consent.

The amendment will ensure no record can be released to police or government agencies, for any purpose, without a court order.

The Digital Health Agency’s policy is clear and categorical - no documents have been released in more than six years and no documents will be released without a court order. This will be enshrined in legislation.

This change to the My Health Record Act will therefore remove any ambiguity on this matter.

In addition, the Government will also amend Labor’s 2012 legislation to ensure if someone wishes to cancel their record they will be able to do so permanently, with their record deleted from the system.

The Government will also work with medical leaders on additional communications to the public about the benefits and purpose of the My Health Record, so they can make an informed choice.
Yesterday I agreed to extend the national opt out period by an extra month, this was a key request of both the AMA and RACGP.

COAG health ministers statement on My Health Record:

“Jurisdictions reaffirmed their support of a national opt out approach to the My Health Record. Jurisdictions noted clinical advice about the benefits of My Health Record and expressed their strong support for My Health Record to support patient’s health. Ministers acknowledged some concerns in the community and noted actions proposed to provide community confidence, including strengthening privacy and security provisions of My Health Record.”

The communique is available on the COAG Health Council website.
Here is the link:
To a man / woman their enthusiasm was undimmed.
I suspect they will come to regret their haste. This COAG meeting was a real opportunity for a “pause that refreshes” with a considered review of just where all this is and what is likely to happen next.
It is my belief that within the next 12-18 months the unthinking spruikers will realise that the myHR will never really deliver on many of its objectives and will need to be fundamentally rethought and re-imagined.
I would also not be surprised to see fundamental changes in the leadership of the ADHA.
Come back to me then and see how I have gone with prediction.


Anonymous said...

COAG is caught up in other issues and again we suffer the MyHR because it was probably and easy trade-off in a bigger game. I don’t see the communication or the positioning of the MyHR in the minutes as an endorsement but rather a ‘not important who cares not my problem’ response.

The real problem for the Minister is the CEO of ADHA, this appointment is going to cause him issues.


Anonymous said...

Well if the CEO does go can he please take the hang of four running organisational and IT functions. They would make Emma Husar blush.

Anonymous said...

The extra time until opt-out closes will allow more informed commentary and questioning of the whole enterprise, which is a good thing. One issue I have seen come up several times on social media concerns the finality of a decision to opt-out. Can any one confirm the concern that even if a citizen opts-out, there is nothing to stop some health providers still creating a record for them. I've heard it said that public hospitals are by law required to create a myHR unless specifically told not to. Possibly also if path reports are uploaded if the 'do not upload' box on the form is not checked. If any of that was true, then there is no opt-out, just an ongoing process of telling everyone not to create a record for you forever. I hope that's not the case because that would mean the whole opt-out period, which gives the impression of finality, is untrue. Would love to hear from anyone in the know what the situation really is. Am I forever opted out, until I specifically request to opt back in? Or will I be opted-in the next time I forget to tell a pubic hospital not to do so?

Anonymous said...

The way the protocol works is that the source clinical system queries to find out whether you have a record. The answer is 'yes', or 'no'. By default, at present, the answer is 'no'. That is proposed to change to 'yes'. But if the answer is no, the source clinical system cannot change that, or upload documents.

The reports of people having a record and being unaware appear to relate to the past drives to sign people up to the system through face to face encounters at the clinical service provider. They probably didn't understand what they were agreeing to, or don't remember... but I don't have any data to suport that guess.

Btw, there's a real lack of clarity around what 'having a record' means. Does it mean
- I said yes to having a record
- there's actual useful information in there
- I am able to login and view the information

In general, the numbers decrease as you go down the list. I'm sure the agency has the numbers for each of the 3 categories, but I've never seen them report which of the numbers they are reporting (they generally go for an obscure number like 'number of SHS documents' rather than 'number of patients with an SHS', when I've paid attention).

Anonymous said...

@5:17. Having seen similar commentary on social media I rang the ADHA and asked if a record would or could be created by a public hospital or other means without my knowledge and consent. The help desk was unable to provide any assurance and refused to state that in writing. When I asked if someone could assist I was told ( very politely and professionally) that the ADHA role was only to undertake the communications aspect of optout and that I would possibly try the Department who formulated the policy and legislation. The only advice that could be provided was that which is public ally available. The service desk was unable to provide a contact number at the department

Clearly something is not right here.

Anonymous said...

Bring back the PCEHR, and make it Opt-out by stealth!!!!!!!

Anonymous said...

If the ADHA role is now suddenly just communications then they are not doing very well. There has been no sign of them for the past few weeks.

Anonymous said...

...and they want people to make an informed decision? The biggest risk to all Australians is government stupidity and incompetence.

Anonymous said...

On the subject of holes, the ADHA might want to plug a few on their network. It is a very over engineered network and you have a very messy authentication setup. Last warning

Anonymous said...

What do you do? You visit the trial regions, search for people who will say something positive and get into the local paper

From the blue mountains:

New data shows 203 healthcare provider organisations are now connected to My Health Record in the Nepean Blue Mountains Primary Health Network. This includes:

100 per cent of public hospitals and health clinics
100 per cent of private hospitals and clinics
84 per cent of general practices, and
70 per cent of pharmacies.
Springwood pharmacist Sheryn Phillips said she has observed many clinical benefits to the system since the Nepean-Blue Mountains region was included in a My Health Record opt out trial in 2016.

Observed many benefits but presumably not experienced any or able to provide examples.

I live in the blue mountains, the health record is not well known or referenced in any engagement I have with my GP, pharmacy, pathology or the out patients at the local hospital.

One suggestion I would make in regards to assuring people remember what medicines they are on - provide them with human readable names. Pharmaceutical terms are not part of the day to day language

Anonymous said...

@7:17 AM. Based on the figures provide on adoption across the blue Mountains health organisations and with some 98% of residents registered with the system. Is there any evidence that cost savings have been made? Are hospital budgets been reduced? Have unnecessary tests been greatly reduced? Have medication errors been reduced? Has anyone been saved in an emergency room - all as a direct result of the governments assistance through their health record?

This if provable would be of great public interest. Just were are the benefits?

Dr David G More MB PhD said...

I would lay London to a brick that if these benefits were demonstrable there would be a gale of press releases and TV spots. Have not seen any so we must assume we are still to see that this $2B is making much difference!


Anonymous said...

Very true David, instead the ADHA CEO seems he’ll bent on telling unions they are mugs, legal experts they don’t have a clue, privacy and security advocates they are scaremongering tin-hat wearers and trying to shut down the free press.

Personally I would give minister the benefit of doubt and take on face value he is willing to act on the technical, privacy, legal and business recommendations, however Tim Kelsey is an issue and shows tendencies of a pathological liar, who is happy to make a repeat false claims and has a demonstrated history of this and for using government to harvest patients data. He cannot be trusted

Greg Twyford said...

Reading "Anonymous said... 'Based on the figures provide on adoption across the Blue Mountains..' ", two issues have come to my mind.

The easy one: How many of the vaunted 6 million enrolments in MyHR actually been a product of the opt-out trials, and therefore don't represent informed consent-based 'decisions' made by individuals to join MyHR. Similarly, the hospital waiting room sign-ups of 2013 have questions over informed consent.

Secondly, the only evaluation report I've seen regarding the Blue Mountains trial does not address clinical outcomes, but seems mostly concerned about assessing how well the 'opt out' communication strategy has worked in terms of public acceptance, and the impact of this on doctor enrolment as data providers for MyHR.

It'd be nice to hear the opinions from people involved in this, and other trials, about their awareness of what was happening to them. Even nicer if their was a health benefit.

Trevor3130 said...

Weekend news item Six-week wait for doctor as GP shortage bites, leaving regional Victorian town 'in crisis mode' centred on Horsham but also noted the dozens of vacancies for family practice in all rural regions. How could MyHR be relevant?
First thing to say is that the proposition put that "If only we had more doctors we would attract more residents to our town" probably has it back-to-front. That is, regional towns can't hold their GPs because they are not attractive to younger medicos with families.
Maybe a proper functioning (that is, non-centralised & federated) NEHR could be crucial to enabling FIFO schemes where experienced GPs & specialists could work in rural practices on contracted (funded by State government) part-time structure. However, I doubt that lack of electronic health summaries is one of the main reasons that experienced GPs find it difficult to stay on and provide cradle-to-grave services for multiple generations of residents.

Anonymous said...

And coming out of Queensland

A special summit of experts will look into maternity services in remote parts of Queensland amid concerns a lack of obstetrics care is putting expectant mums and babies at risk.
The death rate in rural areas without birthing services is 23.3 babies per 1000 born, almost four times higher than in towns with an obstetrics unit, The Sunday Mail reported.
Rural doctors say the closure of 40 country obstetric units is forcing women to either deliver their babies at home with no medical support or to risk a roadside birth trying to get to hospital.

Maybe Tim could take a mid-wife with him on his journeys.