Sunday, November 25, 2018
The War has Been Won. The Important Thing Now Is To Win The Peace! It Won’t Be Easy!
On Friday, after the Wild Health Summit, I published a blog pointing out just how much the ground around the myHR and the ADHA had shifted, based on reporting around the summit.
This can be read here:
In summary what seemed be the consensus at was that the present plans and future direction of the current manifestation of the myHR had essentially become untenable and that the time had come for some reality to be injected into the situation.
The essential problem, right now, is that the ADHA is, deliberately or not, being an horrific drag on Digital Health innovation by driving this it’s the myHR way or the highway agenda in Australian Digital Health.
Bluntly this is arrogant and ignorant foolishness and needs to be called out for what it is.
A day or so one of the Australian fathers of digital health published an interesting blog which I am sure he won’t mind me quoting.
Posted on by Grahame Grieve
Yesterday, I spoke at the Wild Health Summit, along with John Halamka, Eyal Oren from Google, and other Australian Health IT leaders.
During my talk, and in regard to how to move forward in regard to Interoperability, healthcare it, the MyHR, and the continued use of faxing in Australian healthcare, I spoke about the need for us to have courage. Today, as a follow up, someone asked me:
“What kind of things should we do to have courage?”
Here’s my top 3 ways that we should act with courage in Australia.
1. Have the courage to speak the truth, and say unpopular things.
Note that this not excuse for being rude, or causing trouble. Nor is it ok to ‘speak the truth’ without first investing time to make sure it’s the truth. But if it really is the truth, we should say so, even if it’s unpopuler. And there’s a strong view right now in Australia that people need to toe the party line. In regards to healthcare IT, that’s hurting us right now.
An obvious corollary to that is not to punish people for speaking the truth – even if you don’t agree it’s the truth. If they’ve made a good faith effort to find it, then open discussion can follow
2. Have the courage to recognise when you fail, and do something else
To many of us get ‘locked in’ to past choices – it’s a variant of the sunk cost fallacy. Particularly when it’s group activity. How does your department/company/professional society look at projects and decide they’ve turned into a death march? Is the bar to kill a project lower or higher than to create one? Do you have any evidence that you broke the sunk-cost pattern any time?
And don’t think that everything you do will succeed either. If you think it does, then either you’re not trying hard enough, or your analysis is not objective enough.
3. Have the courage to change how you are accountable to other people
Providing healthcare is a team game, a rich complex eco-system with 1000s of specialties. The real challenge with healthcare interoperability is not getting computers to talk to each other, but getting people to change their behaviour when technology and IT means there’s better ways to do things – different kinds of accountabilities between the players in the team.
Too often, change is too hard. Even something as simple as using faxes – a constant theme of the day yesterday. There’s no technological reason to use faxes; they’re risky, and costly, but we still are using then extensively – because of human factors. The reaction of our international guests to that discussion (and the MyHR) was revealing: astonishment at the discussion we were having.
Things aren’t going to change unless we have courage. But too many people who listened to me yesterday heard my call to courage as intended for someone else other than them. But you can’t change someone else, only yourself. You, reading this blog, ask yourself:
Do I have courage? Does it show?
Here is the link:
Without putting anything in anyone’s mouth I see three messages here.
The first is that change is required and that we can’t just press on as we have been as the costs and pain are becoming too high.
The second, linked to the first, is that it is vital to recognise that there comes a time when the commonly accepted paths and directions are no longer sustainable, difficult though that may be!
The third is that options, other than the holy writ of the ADHA, need to be developed, refined, supported and implemented.
The work needs to begin now to start to develop the frameworks, standards and so on to move from the difficult to use collection of CDA documents that are the myHR to other ways that the agreed use-cases surrounding the myHR may be developed. We have spent way too long travelling down a railway that has little chance of arriving somewhere useful – and it is only the Digital Health practitioners who can do the work to define what the clinicians and patients actually want and would value. We need a new overall model for how and what Digital Health can deliver and I am not sure I see the ADHA as the ones to deliver that!
The myHR is a dead end, we all know that, and what needs to happen is that we need to define what usefully comes next. What part the ADHA plays is up to it, but being a ‘dead hand’ stifling innovation needs to be at an end.
Maybe the MSIA meeting on Wednesday in Sydney might be a good place for some initial discussion and ideas to be raised. The blog is here to help distribute and workshop ideas if people want to use it.
Posted by Dr David G More MB PhD at Sunday, November 25, 2018