Sunday, October 21, 2018
At Least One Acknowledged Global Expert Thinks The #myHealthRecord Is Going In The Wrong Direction.
This appeared late last week:
Grahame Grieve | 17 Oct 2018
HL7 is close to publishing the fourth milestone release of the FHIR standard at a time of increasing uptake that the US Office of the National Coordinator for Health IT recently said could soon approach critical mass. These are exciting times.
In a blog post, ONC's Steven Posnack and Wes Barker wrote that the US "might be at a turning point when it comes to the adoption and implementation" of HL7's FHIR standard, supercharged no doubt by the integration of the standard by mammoth companies such as Apple.
But there is still much to be done both here and internationally to get health systems sharing patient information and fuelling quality care – which is what our work is all about.
FHIR contains the foundation content for exchanging data about all parts of the healthcare process. It supports exchanging patient clinical summary, care plan management, medication management, diagnostic reporting, as well as clinical decision support, administration, financial management, and even clinical trial administration.
From the beginning, the mission of the FHIR community – which I am privileged to lead – has been to change the way healthcare is practiced by providing the technical infrastructure that allows applications to connect in new ways, ways that erode the barriers to improved care. We’ve seen other industries disrupted by the combination of technologies and scalability that the web offers, and we want to bring that to health.
I should be clear, at this point, that many of the barriers to improved care are not technical – there’s massive cultural, political, legal and financial barriers to improving healthcare. FHIR isn’t solving those – it’s part of a wider movement to change the way healthcare works. But we, the FHIR community, think that what we have to offer is a game changer.
There is a window of opportunity here in Australia to leverage all this into something useful.
As I write this, the Senate inquiry in My Health Record is due to report back on the direction of the platform. The MyHR – and the National Digital Health Strategy generally – intends to make good on the vision I outlined above. But our current reality is very different – the system we have is based on an architecture that largely predates the emergence of the current web, and the gap between vision and reality is driving the current political challenges.
We’re about to reinvest in a new technical infrastructure for the national system – still based, for the moment, on the same central document repository architecture. That doesn’t make sense – if we’re going to invest, it needs to be in a solution that care providers and receivers want and demand so they can get improved health care and outcomes. Also, it should be an infrastructure that vendors want to leverage because its benefits are obvious and systemic. Let’s take this opportunity to pivot to a different architecture, one that can break down our silos instead of building new ones.
Real change, however, is bottom up. We don’t have to wait for the senate to decide the future of healthcare in Australia. The world is full of highly motived patients who want to get care differently – see Mike Morris’ story. We’re all patients and we all need better care. Since there’s many barriers to improving care, there’s many opportunities to develop solutions to our challenges. FHIR is just one small part of that picture.
So, today, don’t wait. Ask yourself: how can I make a difference today?
Grahame Grieve is the creator and global project lead of HL7’s FHIR, and the Principal of Health Intersections.
Others have made the same point with the technology being a decade old or so.
If you read Grahame’s Mike Morris story you will realise that the current myHR has a snowflakes chance in hell of enabling such care.
What do you think of the message Grahame is sending and how can we have it actioned.
Posted by Dr David G More MB PhD at Sunday, October 21, 2018