Earlier today I tweeted this little contribution.
'Does anyone have a clear reason as to just why the Government wants to collect all our private health information in a large Government owned and operated data base and spend $billions doing so with no evidence of clinical benefit?'
Sadly the silence in response was deafening.
The source of my concern is that there has been altogether too much acceptance of the status quo and really a lack of asking the more fundamental questions.
Among these are questions like:
1. What is the evidence we actually need the myHealthRecord System with its very considerable startup and operating costs and rather weak justificatory evidence?
2. If we do need a secondary electronic aggregation of our health information (which inevitably will be partially incomplete and out of data at best) to be held by the Government are we going about it the right way in terms of utility, workflow support and useability?
3. Given we know the myHealthRecord System can never be a trustworthy or complete source of information for either clinicians or patients who and what is it actually for and why has Government spent so much on it?
4. Who would really notice if the system was simply turned off and a new voluntary system was built using modern technology to store the very basic emergency clinical information those individuals wanted to make accessible on line – perhaps curated by their GP?
5. Would it not be better if pathology, imaging and pharmacy providers made available their information directly to the patient and their doctor as appropriate, perhaps via a portal or app provided by their local practice etc.?
6. Would not co-ordination of complex chronic care be provided by local system providers with deep expertise and experience in the area?
7. What would be wrong with private system providers offering health record storage systems for individuals who want them to meet their specific needs for storage and access to their information?
We seem to again be seeing the myHealthRecord hammer as the nail for all Digital Health needs which is just nonsense.
Have we not just been lulled into the sense the very mediocre myHealthRecord exists so let’s use it rather that force change for something really useful and respective of our desire for access and privacy. Of course I suspect we could have better and cheaper outcomes with approaches along the lines mentioned above.
David.
David,
ReplyDeleteI think the answer to the first question is: It seemed a good idea at the time; others were doing it.
The core challenge for the Federal government is the growing cost of healthcare against the backdrop of fiscal sustainability. Fiscal sustainability is increasingly uncertain due in part due to the continuing impact of the global financial crisis and in part to erosion of the tax base. The federal government, regardless of political persuasion, faces the same challenge.
The stakes at risk are substantial given the returns to date on the MyHealthRecord investment.
The stakes in prospect with a new approach, one that addresses the productivity challenge facing healthcare, are enormous. Importantly there is a solution to the productivity challenge facing knowledge intensive service industries like healthcare.
I doubt that anyone would notice if the system was simply turned off.
Having said that, it would go better if there was a new way forward; one that made sense to the key stakeholders and really addressed the federal government's fiscal sustainability challenge in regard to healthcare.
The real issue however is does anyone actually care or are they too absorbed dealing with the here and now as opposed to the strategic and consequential. The silence is both deafening and debilitating.
The Government now is facing a growing number of vale driven consumer apps. The Government is not equiped to compete in the consumer market and not should it. Can the MyHR offer this type of useful service? https://medisafe.com/press-release/health-records-on-iphone-now-available-to-medisafe-users/
ReplyDeleteProbably not IMHO, and software like this is to attractive to end users.
I heard the optout numbers have started to increased considerable, 1.5 million was the number thrown about. The IT manager was scuttling about looking to build a solution to handle anticipated requests for record deletions and cancellations. Was trying to figure out if the old eHealth forms technology could be repurposed. The irony of using an eFax solution to axe the fax was not lost.
ReplyDelete@9:50 AM. The problem with your intel is - who would know? The secrecy around this whole fiasco is no one knows much and there is no where to find out the truth. Only when the senate committee demands it the optout number miraculously appear although we are told previously those figures are not obtainable.
ReplyDeleteIf true, this is really, really bad....
ReplyDeletehttps://twitter.com/TurnLeft_2018/status/1052012466664665088
@2.26pm... well that seems to confirm fears that the MyHR will be linked to other govt depts for unexpected purposes... Immigration!
ReplyDeleteNot to mention the truly extraordinary amount of time and effort needed to sort out errors...
You will be happy then that having sat through another all staff speech from Kelsey, he seemed to think all this is a bit a joke and the submissions are misinformed hysteria.
ReplyDeleteYeah, just domestic violence victims fearing for their lives. You know, those hysterical people.
ReplyDeleteNot to mention the many others – such as the head of the Law Council – who took the time to make submissions regarding highly concerning flaws in the system.
Well Scott Morrison and his merry men certainly demonstrated trustworthy leadership today. I am not expecting much change in the MyHR now.
ReplyDeleteYes today has been another example of how Government has lost the art of thinking. This is why people like the ADHA CEO can take them for such a ride and they keep coming back for more.
ReplyDelete