Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Wednesday, November 21, 2018

I Have To Wonder Just What Is Going On Here? It Does Not Feel Quite Right.

This appeared last week:

Hidden conflict: My Health Record boss privately giving advice to health firms

By Esther Han
15 November 2018 — 12:00am
The chairman of the agency responsible for the bungled My Health Record rollout has been privately advising a global healthcare outsourcing company.
The Herald discovered the relationship between the UK based government contracting giant Serco and the Australian Digital Health Agency (ADHA) chairman Jim Birch after obtaining internal documents that detail the board members' conflicts of interest.
The revelation comes as federal Health Minister Greg Hunt was forced to extend the My Health Record opt out period after a compromise deal with the Senate crossbench and a last minute meltdown of the website left thousands of Australians struggling to meet the original deadline.
Since April 2016, Mr Birch has been ADHA chairman with oversight of the My Health Record system, which will automatically generate digital medical records for millions of Australians who do not opt out by the end of January.
The ADHA board's "Personal Interests Disclosures Register", released under Freedom of Information laws, shows Mr Birch began "providing strategy advice to Serco" in November 2017. The register is not publicly available.
After the Herald submitted questions last week on whether the relationship posed a conflict of interest, Mr Birch quit the advisory role.
Serco has won a number of multi-billion dollar government contracts to privately run - and in some cases deliver healthcare in - some of Australia's prisons, hospitals and detention centres.
The ability of Serco to navigate the controversial area of digital health records would be invaluable to any future expansion plans, given its "global healthcare strategy".
A spokeswoman for Mr Hunt said all 10 board members had declared their interests.
"Board members do not have access to system operations and board members cannot be present while a matter is being considered at a board meeting in which the member has an interest," she said.
Lisa Parker, a public health ethics expert at University of Sydney, said the public had been asked to trust that the agency is acting in its best interests. She said it should make public any information relevant to that trust.
"Some members of the public may select not to place their trust in board members who they perceive to have conflicts of interest," Dr Parker said.
"This does not mean that transparency is wrong, rather it means that allowing associations that give rise to real or perceived conflicts of interest threatens the viability of the potentially important resource that is the My Health Record."

More competing interests exposed

The register also shows Mr Birch knows the chief executive of health-tech startup Personify Care, Ken Saman, and has been giving him advice since August last year.
The software company recently released "Personify Connect", a product that provides hospitals with "seamless integration" of its original patient monitoring platform with My Health Record.
November 15th is the opt-out date for My Health Record, but exactly what does this data system mean for Australians?
Despite being scheduled to speak at a "Personify Care breakfast seminar" later this year, Mr Birch has never publicly declared this potential competing interest.
Mr Birch is also chairman of another startup called Clevertar that allows businesses to create "virtual agents" and offer "personalised healthcare support, delivered at scale". This relationship is on the public record.
Do you know more? ehan@fairfaxmedia.com.au
More here:
The first thing to be said it that one can be pretty confident the facts provided are correct as a story of this potential impact would have been “legalled” to within an inch of its life before seeing the light of the SMH website.
That said it does seem to me the ADHA Chair should not be offering private advice to Digital Health startups. Speaking at open conferences is one thing but providing one-on-one advice ought not be happening I believe.
This feeling is amplified by the secretive way the ADHA goes about it business – the latest, very partial minutes that have been published now being 4+ months old. (Mid. June, 2018)
Disclosure of interests are also not easy to find as noted in the article, and they are sure not obvious as they should be.
This looks like the section covering disclosure in Commonwealth  Agencies.
Lastly it is hard to imagine just how much worse the Board’s stewardship of Digital Health could have been. In my mind they have led the myHR program appallingly. Most would agree I believe. The Chair needs to be held accountable for this as well.
All in all I believe there is no reason to believe he, and many with him, have not reached their use-by dates.
David.

19 comments:

Anonymous said...

I agree David, there is something not right here and this is probably only a glimpse of the ice berg

Anonymous said...

There are certainly question that need answering. As pointed out the ADHA has proven to be a beacon of trust. I don’t wish to divert from the issue in your posting, nor show disrespect to this incoming CDO at ADHA, but can anyone show me how on paper this chap was even considered let alone selected? Who even applied, there are many in Australia that could have satisfied far more of the criteria -

The Australian Digital Health Agency (ADHA) will begin advertising today for a senior executive with extensive technical, design and strategic skills for the new role of chief digital officer. Rather than a direct replacement to fulfil the vacant position of innovation and development manager, ADHA says it is looking for someone with industry or vendor experience who will act as the key design authority for national digital health solutions. The person will be expected to be able to take a whole of health system view of digital health and service design, with a focus on consumer and provider experience. Reporting to the CEO, the job entails leading community co-design on the direction of the agency's digital strategies, delivery of the five-year My Health Record roadmap and chair of the internal Technical Design and Delivery Authority. The job description entails a focus on stakeholder engagement in areas such as open innovation, design integration, specifications, product development and benefits evaluation. Specific responsibilities include: · Lead the future direction and vision for digital health in Australia · Responsible for driving change and transformation of the national infrastructure · Act as the architect/key design authority for the national digital health systems and services, focused on optimisation, usability and functionality for all end users of these systems · Lead and manage the national digital health system architecture, providing ongoing guidance, design integration advice to programs and projects on design, architecture and technical matters · Responsibility for the design of ADHA's digital services development priorities · Strategic input into national digital health work architecture and investment · Develop capacity to attract and capture innovation in care models and software design and support clinical pathways and patient journeys · Act as the agency’s senior representative for the national digital health work program on a range of government and non-government committees, advisory groups and boards · Ensure the high level roadmap of technical architecture supports the delivery of projects and programs. · The successful candidate is expected to have extensive management or consulting experience, expert level business and technology capability demonstrated through industry or vendor roles, and significant commercial experience in public or private sector enterprises. The position will be advertised on Seek this week.

Bernard Robertson-Dunn said...

That's nice, more technology solutions.

It would be good if they had someone who could work out what the problems are first.

Otherwise it will be the same old story of promises, potential and "could be"

Here's a hint - most problems in today's health care industry are to do with people and the practice of clinical medicine. Better records management is way down the list. And myhr isn't even better records management.

Anonymous said...

stakeholder engagement in areas such as open innovation, design integration, specifications, product development and benefits evaluation. Specific responsibilities include:

· Lead the future direction and vision for digital health in Australia · Responsible for driving change and transformation of the national infrastructure

· Act as the architect/key design authority for the national digital health systems and services, focused on optimisation, usability and functionality for all end users of these systems - probably not, but it only asking for an actor.

· Lead and manage the national digital health system architecture, providing ongoing guidance, design integration advice to programs and projects on design, architecture and technical matters - no - no background in health.

· Responsibility for the design of ADHA's digital services development priorities - Maybe

· Strategic input into national digital health work architecture and investment - a PHD and call centre management does not make an architect leader

· Develop capacity to attract and capture innovation in care models and software design and support clinical pathways and patient journeys - definitely not and probably the key criteria.


In reference to the original blog, if you look at what’s is happening in parramatta then probably perfect to join the club, Jim and Tim will be pleased.

Anonymous said...

Tim has no need of homegrown expertise. Ask why he is outsourcing the interoperability reviews to NHS personal.

tygrus said...

They forget to include the required:
* Ability to dance and play the accordion with one hand tied behind your back.
* Ability to fall on your sword if you fail to blame others for failures.

Anonymous said...

The $2 billion question is: What can the Health Department do about the huge mess they have created?

It is easy to say close the project, or do nothing, or buy time by conducting another review or changing the leadership. None of these have any upside, but they do have plenty of downside. The closer they get to the election the worse things will become.

Anonymous said...

So what am I meant to be looking at in Parramatta?

Anonymous said...

It would be good if they had someone who could work out what the problems are first.

Some might advise the ADHA to start with hold a mirror up to themselves would be a good place to start.

Anonymous said...

Wonder what will get announced today being Friday?

We have reports the Fepsrtment has had to scrap the MyHR requirement from the Health Care Homes project

We have the ADHA Board Chair potentially not following APS policy and creating at minimal a perception of a conflict of interest, raising question over the integrity of the Board, the ADHA executives.

We have Dr Moy defending the informed remarks the MYHR is built on out of date thinking and is little more the digitalised paper. Dr Moy being of the opinion that Dr John Halamka. Moy says he is careful about listening to people coming from overseas because they might not know much about the system. I assume that paying UK NHS folk to review our SDM and Interoperability approaches is fine as they are being paid to stroke the CEO ego.

The MyHR has turned out to be a PR disaster, the effects being felt far and wide and many people not to pleased with Roman and Timmy

The new CDO on the surface could be mistaken for being brought in to fix and replace Roman as the ADHA has failed to operate a call centre and a service desk.

There is always the Cancer Screening Registry work, that rushed federal government decision to pull cancer screening registers out of the nonprofits that used to run them. Forecasted to be delivered end of 2019, it has been a month or two, another stuffup might be a nice distraction for the other ongoing stuff-ups

Anonymous said...

I listen to the Dr Moy price this morning on the radio. I was left wondering if Moy himself understood the challenges or if things are becoming clear and perhaps he had not previously appreciated the complete picture.

It did seem like we are having to go back to the start due to the lost of 5-7 years as we mucked about flogging a dead hoarse. Need for standards for authentication, messaging, encryption, I think he even went as basic as a naming convention and ‘words’ ( which I took as requiring ontologies/taxonomies).

Anonymous said...

Did he claim to represent the AMA and ADHA or just the AMA?

Anonymous said...

Why has the MyHR Opt-out communications campaign suddenly stopped when the Opt-out deadline has been extended to 31 January 2019?

It can't be the cost, can it?

Why don't they write to every Medicare Card holder informing them of the changed deadline and explaining that even if you don't Opt-out before the deadline ends you can Opt-out at any time after that and your record will be totally deleted?

Come to think of it, why do they talk about an Opting-out deadline if you can Opt-out at any time before or after the deadline?

It all seems so random. It's a good think the Department is not building our new billion dollar submarines!

Anonymous said...

Even my families local GP had to print out a sticker to place over the supplied ADHA marketing poster. I’ll drop by and see if they know it’s change dates again.

Anonymous said...

I suspect they are having a lot of internal arguments about what it all means and how to do something that doesn't make them look more stupid than they are already. The problem is that doing nothing is not a viable option.

Anonymous said...

@9:04AM. AMA I believe. He did clearly refute that the My Health Record's purpose is to centralise data.

Dr Ian Colclough said...

@ November 22, 2018 10:42 AM, November 23, 2018 11:10 AM & 7:17 PM

First and foremost the Minister has been made to look rather silly even though much of it is his own fault for not asking the right questions rather than taking at face value the empty rhetoric of his advisers.

Secondly, the ADHA, particularly its CEO, is probably the major culprit for not asking deep and perceptive questions and for not examining the entire project from top to bottom when he signed on, rather than arrogantly rushing in simply accepting the assertions that the project is built on solid foundations and that all that is required is to give it momentum and ensure its uptake with a solid marketing push. That the leadership is bereft of experience at the grass roots of the most basic of health domains is now patently obvious; something that should have been expected by the Department at the outset.

Thirdly, the Department, being responsible for having started the project in the first place based on flimsy advice posited by the National Health and Hospitals Reform Commission, has to bear some of the blame for the current situation. However, once the ADHA had been established in its own right the Department surrendered much of the control, responsibility and oversight to the ADHA and its Board.

The only way to now right the situation and bring the project - or some iteration of it - under control is for the Department to take back firm control;

1. to save face for the Minister, the Government and the Department,

2. to defuse an embarrassing situation and quarantine potential problems, which will continue arising, until after the election,

3. to appoint a unique core leadership team with the skills and expertise to 'right' the project in 'whatever' way is needed.

Unless 3. is undertaken with absolute skill, caution and care, everything else will be to no avail.

Anonymous said...

Unless 3. is undertaken with absolute skill, caution and care, everything else will be to no avail.

Recent events would suggest

1. The ADHA has no intention to do so
2. Anyone qualified can probably work out the ADHA has painted itself into a corner and is best avoided.

Anonymous said...

the ADHA has painted itself into a corner

and in that corner it is digging a hole which it can't get out of.

Oh what fun!!!!!

Tim's hope for a gig with the Global Digital Health Partnership must be looking very bleak these days.