This article appeared last week.
CSIRO lays out action plan for Australia’s digital health future
Staff writer | 12 Sep 2018
Consumer distrust in data sharing, poor digital health literacy and system interoperability problems are major challenges to the effectiveness and sustainability of Australia’s healthcare system, according to a new CSIRO report aimed at highlighting solutions.
Released on Wednesday, the Future of Health: Shifting Australia’s focus from illness treatment to health and wellbeing management report is aimed at shaping future investments in the health system to help shift the focus on illness treatment to health and wellbeing management within the next 15 years.
“While there has been a broad social shift, purposefully and inadvertently, to sharing personal information in other sectors, consumer trust can be rapidly eroded if the confidentiality, integrity, or availability of their information is threatened,” the report’s authors stated.
“In a survey of over 300 Australian health professionals, only 3 per cent said they trust data sharing in the medical industry.”
CSIRO recommended five actions to help overcome barriers to data sharing:
- Build on existing initiatives to develop frameworks for improved health and medical data-sharing, with a focus on privacy-preserving techniques for patient data.
- Improve healthcare networks and infrastructure, such that all new systems and upgrades are secure by design, promoting safe and effective information exchange.
- Develop incentives for competing healthcare providers to collaborate on building cyber resilience into their systems, such as medical indemnity incentives or education credits for health professionals.
- Facilitate data sharing by clearly outlining to consumers why, how and when personal health data is being collected, and what the intended outcome is (i.e. the value to the consumer who owns the health data).
- Ensure comprehensive consultation of Australian stakeholders and communities in developing laws and guidelines around the ownership, sharing, and management of health data to account for ethical and cultural diversity.
Increasingly, digital and health literacy are becoming vital for patients to be able to access the best healthcare available, the report found.
“Almost 60 per cent of Australians aged 15–74 have a health literacy level that is considered inadequate,” CSIRO found.
“This challenge is compounded by a lack of digital literacy, with approximately 40 per cent of Year 6 and 10 students failing to meet a proficient standard of ICT literacy.”
Among the solutions CSIRO has proposed is to ensure AI-backed digital health initiatives use input data that is relevant to the intended target demographic.
“Most health apps in the market are designed for the masses and their underlying algorithms can be biased by incomplete training data that does not reflect minority groups,” the report states.
“Ensuring the design of these tools considers contextual information specific to the demographic it is applied to is essential.”
While acknowledging current efforts to develop national interoperability standards, the report stresses this is not enough.
“While Australia is not large enough to significantly impact international interoperability standards, it is important that governments, researchers, and businesses participate in discussions to ensure national planning and investment is aligned with global needs,” it states.
“Ensuring new health software adheres to standards around language, terminology, openness, and data security and privacy will help facilitate the effective and safe sharing of individual health data across Australian service providers as well as with international organisations.”
As well as highlighting the rapid global uptake of the Australian-developed FHIR, the report suggested three enabling actions on interoperability:
- Invest in digital and data infrastructure to ensure digital health data can be transferred quickly and securely between and within health organisations.
- Ensure Australian representation in international discussions around the global harmonisation of interoperability standards.
- Develop strategies at the healthcare organisation level for a hybrid standards environment – aggregating data from a variety of systems.
More here:
Three comment on the myHR struck me:
First – Page 11:
Attempts have been made to link systems through My Health Record. While the program has had limited adoption to date, improvements may arise from the recent move to an opt-out model, with more data increasing the potential value. All initiatives designed to link existing and emerging sources of health data will need to carefully consider data privacy, access, and handling arrangements, as well as the communication of these protocols to all relevant stakeholders.
Second – Page 32
Facilitating Electronic Health Record Engagement
Whether it be the national My Health Record or smaller‑scale solutions, having accessible electronic health records (EHRs) will be key to unlocking many of the holistic, preventative, and precision health offerings of the future. EHRs can improve health outcomes by enabling safer medicines management, improving care coordination, and helping inform treatment decisions.95
Successful EHR platform roll-outs require five things:
- Clear value communication – The value must be understood by the consumer, the health professional, and any other parties involved to ensure uptake and engagement. This includes clearly articulating what the platform will and will not do.
- Ease of use – Data entry and management needs to be simple enough so that its use is not a significant change in the daily activities for health professionals or consumers. The scope could initially be limited to a simple data repository of metrics that rarely change (e.g. allergies, blood type, medical history, lifestyle habits) – those deemed most useful and time saving for health professionals and consumers alike. Expansion to more complicated data collection can evolve once health professional and consumer behaviours begin to accept the new norm.
- KPIs around usage – The success of the record system needs to be measured based on outcomes such as health professional and consumer engagement and health decisions that have been informed by the collected data, not registration numbers that can give a false indication of usage.
- Interconnectivity – A range of service providers must be able to securely share certain data points in order to provide the most impactful and efficient health solutions.
- Effective education and training programs – As with any new tool, those using it will require education and training to become familiar with the process of uploading data, data handling protocols, and how the tool can and cannot be used. This is required for both consumers and health professionals.
To ensure these five characteristics are met, large scale digital infrastructure programs could leverage elements of successful international systems and be developed in conjunction with the market; for example, through Public‑Private Partnerships.
Third – Page 34
Ensuring Interoperability
Interoperability is the ability for different information technology systems and software applications to communicate, exchange data, and use the information that has been exchanged. Interoperability is critical to unlocking the value inherent in pooling different data sets together for new and consumer-centric health services. At present, the fragmented Australian system has various regions adopting different systems from a range of technology providers using different standards.
In addition to assisting the sharing of information between healthcare providers within existing systems of information exchange (e.g. My Health Record), interoperability can also unlock completely new and more personalised structures for health data sharing that give consumers the choice to manage their health information the way they want to. This consumer-centric structure of data sharing is already present in the banking sector which will be further bolstered by Open Banking; the first implementation of the Consumer Data Right.
----- End quotes.
I have to say it really rather feels that the CSIRO and the ADHA have different views on that is important an what should be being progressed. The ADHA Strategy seems hardly to be mentioned in the CSIRO report.
CSIRO also seems to be suggesting the myHR is way off track in all sorts of ways as far as the second quote is concerned!
David.
7 comments:
CISRO also sound like they know what they are talking about
https://journals.lww.com/jbjsjournal/Fulltext/2018/09190/The_Impact_of_Electronic_Medical_Record.2.aspx
September 19, 2018 – Implementing an electronic medical records (EMR) system at an orthopaedic clinic may have unanticipated effects on clinic efficiency and productivity – including a temporary increase in labor costs and a lasting reduction in time spent interacting with patients, reports a study in September 19, 2018 issue of The Journal of Bone & Joint Surgery. The journal is published in the Lippincott portfolio in partnership with Wolters Kluwer.
Even after an initial learning period, introducing a new EMR system may affect several aspects of clinic workflow, according to the paper by Daniel J. Scott, MD, MBA, of Duke University, Durham, N.C., and colleagues. They write, "Healthcare systems and policymakers should be aware that the length of the implementation period is approximately six months and that implementation may alter the time that providers spend with patients."
Introducing EMRs Could Have 'Negative Trade-Off' for Patient Care
I wonder if anyone has done a study into doctors having to manage two record systems - an EMR and a summary system requiring different data?
And it's not as though this is new:
Hope And Hype: Predicting The Impact Of Electronic Medical Records
https://www.healthaffairs.org/doi/full/10.1377/hlthaff.24.5.1121
September/October 2005
The current fascination with electronic medical records (EMRs) is not new. For decades, vendors have capitalized on this enthusiasm. But hospitals and clinics have ended up with little to show for their large outlays. Indeed, computing at a typical hospital has not gotten much beyond what was available twenty-five years ago. The RAND analysis continues the tradition of hope and hype. Unfortunately, behind their impressive predictions of savings lie a disturbing array of unproven assumptions, wishful thinking, and special effects.
There's a report in today's SMH about the royal commission into banking:
"The peak committee governing the self-regulated general insurance industry says while it has recorded 31,000 breaches of the industry code it has not sanctioned a single company for them."
The Department of Health wants us to believe that the self regulated My Health Record (i.e. government owned and regulated - and don't think the OAIC will be able to do much with its paltry funding) will be much better.
The Government has a vested interest in not highlighting and/or pursuing miscreants - it would further erode trust in the system.
There are so many conflicted and self interested parties to this record system that getting a real, full, balanced view of the thing is just about impossible.
The audience of David's blog is probably the most informed in Australia which makes the results of the many polls very credible.
Telling the government it's a total waste of time effort and money is like warning a child about a hot-plate. They won't understand until it affects them directly.
In the case of the government, I suggest in a decade's time when the evidence is so overwhelming that it serves no useful function, is being ignored by the medical profession, is costing a bucketful and there are much better alternatives, it might just get put to sleep.
If there's a data breach, it might happen earlier.
The audience of David's blog is probably the most informed in Australia which makes the results of the many polls very credible.
And they don’t get a cent for doing it.
Tim may well have painted himself into a corner, he has to say they remain independent as quite a few have certainly expressed views that do suggest the MyHR is a distraction at best. To say otherwise would raise many more questions.
Nothing against Tim in fact I am sure he is a bloody nice bloke. He should step aside, on a high as he would say. To much damage has been done
The ADHA CEO, might like to paint a picture of inclusiveness. However it does look as if they formed these committees as a shield to exclude rather than include, to drown out voices rather than listen to others.
9:08 AM. Might well be the case, easier to ring fence them as simple archaic critics.
Timmy also tried to distance himself from care.data and laugh MyHR to be more like the current NHS attempt. This is an insight into the new NHS attempt - https://www.opendemocracy.net/ournhs/phil-booth/is-government-telling-us-truth-about-gdpr-and-your-nhs-medical-data
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