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"

or

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

Friday, September 28, 2018

There Is An Open Secret At The Heart Of Why The myHR Is Looking Worse Every Day.

This appeared last week:

Improving data quality can lead to better health outcomes: RACGP expert

Doug Hendrie 17/09/2018 2:15:19 PM
Speaking ahead of this week’s RACGP eHealth Forum 2018, Dr Rob Hosking has called for a greater focus on improving the quality of patient data in general practice.
How can GPs improve the quality of their data?
Dr Rob Hosking, incoming Chair of the RACGP Expert Committee – eHealth and Practice Systems (REC– eHPS), said a widespread issue with poor-quality data is often a result of busy GPs inputting text into the incorrect fields in practice software.

‘Anecdotally, the problem of low-quality data is fairly high. It’s mainly a misunderstanding amongst GPs that it might be useful to enter it in the right place at the time of seeing the patient,’ he told newsGP.

‘People are busy, so they just do what they have to do with the patient in front of them. They don’t think that what they record will be potentially useful in future.’

Dr Hosking said low-quality data represents a missed opportunity to boost internal research and even a clinic’s bottom line.

He will raise the issue at the RACGP’s eHealth Forum 2018, to be held on Thursday 20 September, which will focus on the power of data in general practice.

‘If we can get high-quality data in GP clinics, we get better information for use in our own practices,’ Dr Hosking said.

Data extraction tools applied to high-quality data could, for instance, show a GP that their practice is not hitting immunisation goals for people over the age of 65.

Dr Hosking said there is also a financial incentive for GPs to keep high-quality data.

‘If they analyse their data, they might find they’re not billing the way they should be and missing out on certain interventions like managing diabetes. Or they might not be billing appropriately,’ he said.

Dr Hosking said there is currently renewed interest in general practice data from university researchers, Primary Health Networks and organisations like NPS MedicineWise. This has been particularly true since the end of the long-running BEACH program, which collected general practice data over 18 years.

‘Everyone is trying to get hold of general practice data – they’ve finally figured out that 98% of general practice clinics are fully computerised with a wealth of information stored in those systems,’ Dr Hosking said.

‘Someone might want to pay for de-identified data in the future. But some is of good quality, some is dubious.’

A common question raised by GPs interested in giving researchers access to their data is how they could be sure patient data had been thoroughly de-identified. Dr Hosking said the major data extraction tools broadly do a good job, with the best tools de-identifying and aggregating data before sending it outside the clinic.

Dr Hosking believes that high-quality data is ultimately beneficial to practices, whatever use they may intend for it in the long-term.

More here:
I have to say Dr. Hosking is spot on here. It is in the interests of everyone to have the highest data quality, especially if clinical decision making is to rely on it.
To date I believe we have profoundly underinvested in systems that assist in data quality maintenance and that until this changes the quality of data in any shared systems will be less than ideal.
David.

7 comments:

Anonymous said...

It certainly has a lot of merit and through the direct patient provider relationship the new FHIR app model would certainly provide a driver for change.

I have a read a lot of the senate submissions. There is a common thread. The one thing the ADHA will admit to be responsible for - that being the information and awareness campaign has proved to be a woeful failure. It now appears rather than being inclusive and appreciative of the very different stakeholders involved. It has been a journey of self indulgence and a complete indifference to those that “have to” interact with the redundant system.

Anonymous said...

It sounds good, hopefully it marks a change in focus and gets back to being about healthcare needs.

Anonymous said...

These sorts of comments by the likes of Dr Hosking are what bother me so much these days as a patient. Things like …"greater focus on improving the quality of patient data in general practice" and "If they analyse their data, they might find they’re not billing the way they should be…" where is the patient and patient-centred CARE in all of this? Sorry Dr Hosking but you are missing the point entirely about why the average person in the street goes to the GP and wants to feel that they can trust them, be assured, get quality medical attention.

Quality of patient care is what counts to me and the people that I converse with - not the stuff that some person may type into a computer that may or may not be correct, just so the practice can get paid. (So maybe the data is dubious for a reason perhaps?)

All the more reason to bow out of MyHR while you still can.

Bernard Robertson-Dunn said...

https://www.emrandehr.com/2018/09/28/practices-emr-implementation-drove-up-costs-for-six-months/

Don't forget this article refers to clinical systems, not the additional expense of a secondary, summary system.

No doubt Health/NEHTA/ADHA were and are fully aware of all these issues and have taken them into account when developing their multiple business cases which they will share with us all?

Anonymous said...

Bernard - http://www.thirdhorizon.com.au/my-health-record/

Anonymous said...

Ah the million dollar a day man. Remember the Howard year well. The clinicians revolted, Tim I hear has similar issues with his privacy folk.

Bernard Robertson-Dunn said...

Re: http://www.thirdhorizon.com.au/my-health-record/ and other claims that are based upon My Health Record being a "comprehensive" record

This is from the transcript of my evidence at the public hearing:

Senator MARTIN: Doctor, the majority of peak health bodies are supportive of My Health Record and the move to opt-out; they believe it will deliver significant clinical benefits. Are they wrong with their support?

Dr Robertson-Dunn: Yes.

Senator MARTIN: And do you want to expand a little bit more on your answer?

Dr Robertson-Dunn: The central myth is that it is a complete health record; it isn't. It's a secondary record which derives its information manually from other systems. It is inefficient in the way it gathers information. I included a calculation in the submission that I put in that said, if each GP spends three minutes considering whether to upload a shared health summary or actually does, it will cost between $500 million and $1 billion a year.

I have no idea if anybody has done the costing side of My Health Record. Information put out by the government is all about benefits. I have never seen the cost, the business case, for this thing. Professor Phelps called for it. I asked the ANAO to do an audit based upon the business case, but they have declined to do so.



IMHO, the people who show great support for myhr fall into two categories:

1. Those who do not understand the unreliable and trivial nature of the data and the costs of gathering what little data is in it.

2. Those with a vested interest in it. As it says in the Third Horizon article: "Andrew is the former CEO of NeHTA and head of the MyHR program. He is an e-health specialist and Director at Third Horizon."