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"


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

Sunday, December 09, 2018

We Are All Being Played For Being Total Idiots By The ADHA Board And It Is Really Time It Stopped!

I think we can now safely conclude the ADHA Boards are a collection of dishonest and non-transparent agents of Government concealment. – and yes I am being polite!
This popped up from the Board Minutes the other day:
Agenda Item 17

My Health Record performance statistics

Meeting: 22-23 August 2018  
OFFICIAL: Sensitive
That the Board note the current participation and use of the My Health Record by consumers and healthcare providers and the status of the Healthcare Identifiers Service, the National Authentication Service for Health and the National Clinical Terminology Service (provided at Attachment A).
The Participation and Use Dashboard provides the Australian Digital Health Agency (the Agency) Board with a range of metrics which demonstrate current use of, and participation in the My Health Record (MHR) system up to 29 July 2018. The National Authentication Service for Health (NASH) and Healthcare Identifiers (HI) Dashboards provide statuses of these services between April and May 2018. The National Clinical Terminology Service (NCTS) Dashboard also provides a status between April and June 2018.
The layout and appearance of the Dashboard has remained unchanged since the June 2018 meeting.
As at 29 July 2018, there were 6.01 million Australians with a MHR which represents approximately
24 per cent of Australia’s total population.
Consumer Participation (Pages 1 to 4 inclusive of Attachment A)
In the 12 months to 29 July 2018, a total of 1,006,877 consumers were registered for a MHR, at an average of over 19,000 per week. Generally, the majority of consumers have been registered by healthcare provider organisations. However, in July 2018, more consumers have chosen to register themselves
(Chart 3).
Chart 5 shows that in the last 12 months, there has been a 56 per cent increase in the number of consumers who have had their MHR viewed by two or more healthcare provider organisations.
The remaining consumer usage charts continue to reflect an increase in activity around two events – the end of a Practice Incentives Program eHealth Incentive (ePIP) quarter and July when tax returns are prepared. However, there has been a notable increase in July 2018, coinciding with the start of the opt out period.
Healthcare Provider Organisation Participation (Pages 5 to 10 inclusive of Attachment A)
There continues to be a steady increase in the number of healthcare provider organisations registered for the MHR with a noticeable increase in pharmacies registered since March 2018 (Chart 14). In the last
12 months, the greatest proportion of registrants have been general practice organisations and pharmacies.
Clinical document uploads (Charts 17 and 18) continue to increase with pathology reports showing the greatest rate of increase over the last 12 months.
General Practice Organisations
General Practice (GP) organisation use of the MHR continues to be influenced by the timing of ePIP quarters. Overall the number of organisations uploading documents (Chart 21) has increased over the last 12 months. Over the same period, the number of GP organisations viewing documents has also increased (Chart 22).
Both public and private hospitals have demonstrated a clear increase in their use of the MHR in the last
12 months. Not only has the number of documents being uploaded steadily increased, but the total number of hospitals uploading and the total number of views has noticeably increased.
Overall, as with hospitals, pharmacies have noticeably increased their use of the system in the last
12 months, particularly the number of pharmacies uploading documents (Chart 29). The number of documents being uploaded (Chart 27) varies from month-to-month which is likely to be associated with batch processing of uploads as well as only one in five consumers presenting with a MHR.
HI/NASH (Pages 11 and 12 of Attachment A)
The dashboards for the HI and NASH Services are rated orange due to the number of missed service levels for the reporting period. There continues to be substantial use of the HI Service.
NCTS (Pages 13, 14 and 15 of Attachment A)
The NCTS is rated as green.
No impact.
Delivery and Adoption.
Noel Riley
A/g General Manager
Governance, Reporting and Secretariat Services
Tim Kelsey

Chief Executive Officer

Attachment A:  My Health Record Participation and Use, HI, NASH and NCTS Dashboards
Here is the link:
I looked hard for the Attachment which has all the actual meaty contents but of course it is not there and without the actual figures the whole document is useless to make any assessment of just what is going on with the actual usage of the #myHealthRecord – especially as regard clinician look up of clinical data. It is spectacular just how carefully the header document has been constructed to conceal any useful information.
Of course you can be 100% certain that if the figures for clinician look up etc. were even half way respectable there would be weekly ADHA press releases – however they are secretive and silent. What does that tell you? It says hardly anyone is actually using the damn thing!
Another angle is to see the total (over 6 years) consumer activity. Here it is – amazingly.

Consumer documents

Total number of consumer documents uploaded to the My Health Record system by consumers.
Document type
Consumer entered health summary
Consumer entered notes
Advance Care Directive Custodian Report
Advance care planning document
As expected it is low – just 2% or so of those who have a record – 6.35Million - have entered any of their own information. What a waste of space and tells you all you need to know.
What value do you reckon there is in the close to 1 billion PBS and MBS docs which are gently aging in the growing and increasingly useless database.
The whole thing is an expensive national scandal led by a secretive, lazy (meeting every 2 months) and obfuscatory Board. I wonder what all the other matters on the agenda are about since we get a bit of only 4 of at least 17 agenda items.
What do others think? I think it stinks!


Dr Ian Colclough said...

Your comment that the "Total number of consumer documents uploaded to the My Health Record system by consumers" totals 214,648 is quite amazing. I'm sure that Minister Hunt would have something to say about that.

I have no reason to doubt the accuracy of those figures. I don't think the Agency intended to make them public; that they did make them public was probably and administrative oversight.

You suggest the 241,648 figure equates to just 2% of those who have a record - 6.35 Million. Indeed, that is one way of looking at it.

However, on closer scrutiny of the numbers, they indicate to me that most likely there are less than 140,000 people who have uploaded any data. Anyone who did so would probably also enter a consumer health summary and one or more of the other documents.

140,000 max.!

Bernard Robertson-Dunn said...

Here's a statistic people might ponder.

As of 2 December 6,360,410 people are registered for a myhr.

From 7 January this year there have been 901,219 Shared Health Summaries uploaded - that's 14% of registrations.

Just how useful is a Shared Health Summary that is over 11 months old (86% of registrations)?

and ...

in six years 2,263,673 SHS have been uploaded.

Or to put it another way, over 4 million people (64%) with a myhr have never had a Shared Health Summary uploaded.

Tell me again how useful this largely empty database is?

Anonymous said...

The thing that bugs me the most is the protective marking - OFFICIAL sensitive. This would indicate a conscious choice to actively prevent this information being released to the public. Other than legal advice or certain HR and financial information nothing should be hidden from the public.

Oliver Frank said...

"Document type
Consumer entered health summary
Consumer entered notes
Advance Care Directive Custodian Report"

Is it misleading to call these "documents", since they are not documents that are uploaded by the consumer, but in fact are information that the consumer types in to their My Health Record while online?

Anonymous said...

Just how far reaching are the half truths, distorted facts and filtered information. Perhaps the board are not being openly and truthfully informed, perhaps that misinformation is being based of overly optermistic data from the CEO executives who in turn and being told what they want to hear.

At 2.6 documents an hour I would think you could run the myhr processing needs off the back of a cheap mobile phone.

Anonymous said...

They (ADOHA) are also very sla k on publishing the annual report. Wonder if it is all a bit to much for the executives.

Anonymous said...

Oliver Frank said "Is it misleading to call these "documents", since they are not documents that are uploaded by the consumer,"

I'm sorry Oliver, but being on an advisory committee one would have hoped that you and your other committee members would have pointed this 'misleading' labeling of documents out to the ADHA Executive and ensured they corrected the error.!!! Surely they listen to you people, else why have they appointed you all?

Anonymous said...

When Oliver asks .... "Is it misleading ...." perhaps he should have said 'it is misleading',or else he should have answered the question he posited, unless he doesn't know the answer!

Anonymous said...

Agree the ADHA is rather late with their annual report. Recall last year it was a bit self congratulating. Should make for an interesting read this year. How will they gloss over the fact they are stuck in a sandpit with wheels spinning and the crowd wants it money back

Anonymous said...

It is up to the advised to heed the advise provided, it is not a guarantee advice is always taken. I am sure these committees have spared us far worse embarrassments.

Bernard Robertson-Dunn said...

"Doctors Work 2 Hours on EHR Tasks For Every 1 Hour of Time With Patients – Are You OK With That?"


And that's with their own EHR systems. And the government wants GPs to spend even more time feeding the myhr for zero return on effort.

myhr is intended to be a system for the patient and controlled by the patient with little or no significant clinical value, but clinicians are expected to spend time doing data input and managing the record on behalf of the patient.

It's totally unsustainable.

Andrew McIntyre said...

"Doctors Work 2 Hours on EHR Tasks For Every 1 Hour of Time With Patients – Are You OK With That?"

Absolutely not! What motivated me to explore eHealth was the pile of paper results that you had to make sense of in order to understand what and when problems appeared in a patient with a good timeline. Good eHealth reduces this burden and makes it much easier to understand whats going on. Bad eHealth increases this burden and MyHR is bad eHealth. It presents you with a pile of view only results, especially wrt pathology that you cannot analyse pragmatically/automatically and basically is a regressive step. I can digest hundreds on HL7V2 pathology results in a few seconds. Hundreds of pdf renderings takes us back to the 90s!

Bernard Roberson-Dunn said...

VA launches its first health API based on FHIR standard

"The Department of Veterans Affairs has launched its first health application programming interface based on HL7’s Fast Healthcare Interoperability Resources standard.

The VA Health API, which enables veterans to view their medical records, schedule an appointment, find a specialty facility and securely share their information with providers, is the latest effort by the VA to map healthcare data to industry standards."

Oh, look. A widely implemented FHIR API would permit people to view their existing medical records. Guess what that means? - there is no need for myhr.

All the documents that are uploaded from other system to myhr could stay where they are.

What would be needed is infrastructure that delivers access controls based on need-to-know and a consent model. The infrastructure would have no medical data at all and the access controls should be distributed, not centralised.

It's no wonder the ADHA seems rather slow in promoting FHIR.

Its becoming more and more obvious that myhr and ADHA is in a bubble all of its own. We will know when that realisation has sunk in at the top.

Dr Ian Colclough said...

Bernard, Andrew,

Sometime, it is difficult to predict when, the Department and the ADHA will announce they have heard what experts like you and others have been saying for many years and in a moment of enlightenment, with huge bravado and lots of publicity (some call it marketing), they will announce how they are (and for some time have been) working on redesigning the system to address all the difficult problems that have been raised.

That will buy lots more time and attract a great deal more money to start a new project under the guise of expanding-revamping-redesigning-replatforming (call it what you will) the project for the future.

Regardless of what claims they may make to the contrary the last 2 decades provide the strongest of evidence why government and bureaucrats should step away from attempting to develop such a complex project as the My Health Record which they are ill-equipped to undertake.