Wednesday, September 19, 2018
The Arguments For Staying In The myHR Pretty Flimsy I Believe. Let’s Us Explore A Few Facts.
There is a lot of exaggeration in the arguments we hear from the increasingly desperate proponents of the myHR.
The first argument is that myHR will allow us to get rid of the dreaded fax machine (which apparently contributed to the death of a patient a while ago – which is only partly true given the failure of physicians to follow up tests they ordered.) and what fabulous boon to all that would be.
Sadly, with extremely rare exceptions, the fax machine has worked very well and has got thousands of results accurately and cheaply into the hands of the right doctor when needed – including specialists – who right now do not have the alternative is place, as what they have works well 99.9% of the time. The clinical community does not see the myHR as useful but over time they may just see secure message relayed reports as useful. Time will tell but saying messages good, faxes totally bad ignores the reality for now or in the foreseeable future. The simple truth is that the fax will die out when there is a better, cheaper and easier to use substitute that has widespread connectivity and interoperability. Over to you technology innovators and implementers!
The second argument is that the myHR is a useful record in an emergency. If someone looked it up in an emergent situation and it actually had current easily accessible information that just might be true. With so many GP not wanting to have a bar of the myHR most won’t and presently with so many ‘zombie accounts’ (about 4 million of the 6 million records) even with opt-out it will take years – if ever.
There are a lot of simpler and easy alternatives like a short summary printed out by your GP and carried in the wallet etc. Remember the cost in GP time to have myHR records updated at reasonable frequency will cost over a $1billion a year. The thing would want to make a huge proven difference to be worth anywhere near that amount! An honest cost / benefit analysis of the whole program is well overdue.
Third and linked are all the claims for savings with better medication information, test results and so on. There is just no on the ground evidence for this is the community environment that I know of - and I have looked. Sure this works to a degree in highly automated hospitals but using the myHR as an information source – slow, incomplete and clumsy as it is - will not get similar results and has not been shown to be able to. It is all hope against experience.
Fourth the claim for endorsement of all the peak Digital Health entities is weakened by their close, often financial relationships with the ADHA, and for some of them an increasing recognition there are still many questions to be resolved with opt-out. As for the claim of supporting innovation most of the Digital Health industry thinks the opposite is true! (Note: I do understand the worry many of these peak entities have regarding ongoing funding etc. from Government if the myHR falls over. The point is that the myHR is a fundamental enemy of the sort of innovation that is actually needed - we are letting the awful be the enemy of the worthwhile and useful!)
When you mix this with all the risks with various populations – adolescents, the digitally deprived, the mentally ill and HIV carriers etc. this is a national experiment which needs to be rethought and done properly – not done at the behest of some data hungry health bureaucrats.
This is all not as simple as the ADHA propagandists would have you believe.
Posted by Dr David G More MB PhD at Wednesday, September 19, 2018