Wednesday, February 27, 2019

I Have The Feeling That The CEO Of The ADHA Has Become Seriously Detached From Reality.

As evidence I cite apparent quotes from the two articles linked below:
Article 1.

My Health Record reflects 'new consensus', says CEO Tim Kelsey

By Bo Seo
Updated Feb 19, 2019 — 1.31pm, first published at 1.14pm
The government's controversial My Health Record was part of a "new consensus" on digital health, said chief executive of the Australian Digital Health Agency (ADHA), the government body tasked with its implementation.
Tim Kelsey told The Australian Financial Review Healthcare Summit on Tuesday that despite many individuals' decision to opt-out of My Health Record, the system and the national strategy behind it enjoyed support across government, industry, and communities.
Without providing an update on individual opt-outs, Mr Kelsey said 84 per cent of community pharmacies and 75 per cent of public hospitals were connected to My Health Record.
Article 2.

We need to get the digital basics right and quickly: Tim Kelsey

Hafizah Osman | 21 Feb 2019
With many real-world problems still present in Australian healthcare, the time for change in healthcare is now, according to Australian Digital Health Agency Chief Executive Tim Kelsey. 
Speaking at the recent AFR Healthcare Summit, Kelsey said the industry must make take the action needed to improve access to digital health instead of disrupting it.
“Delivering on digital health is not easy, there are many challenges ahead of us. The reality is, the world of fax machines is not safe and does not empower us to take more control of our health environment. A world of fax machines is not a world for precision medicines,” he said. 
Quotes from Article 1 that support my view are:
"Time for action [on digital health] is now. We have the mandate. We have the strategy," Mr Kelsey said.
….
Australia is the first country of its size to provide summary mobile records for every citizen. The ADHA said that "by 2022, all healthcare providers will be able to contribute to and use health information in My Health Record."
…..
First, he highlighted specialist and aged care as target sectors for encouraging greater adoption of digital records.
…..
"We have to make sure that what we don't do, by accident, is worsen the digital divide. [Our goal] is to improve the equity of access and not make it worse," Mr Kelsey said.
Quotes from Article 2.
“The time for action is now. We’ve got the mandate and we have the strategy. We just need to get the digital basics right and quickly.” 
……
“So far, secure digital messaging has had interoperability issues. But now, we have industry agreements in place to share information securely. That now will be the basis in which secure messaging will be an important step forward,” he said. 
Kelsey said this is the result of a new digital health strategy that the federal and state governments committed to 18 months ago in the aim to deliver safe, evolving healthcare and the creation of modern healthcare in Australia. 
…..
“By 2022, providers in Australia will have connected all their care services so that clinicians in and out of hospitals have access to the right patient at the right time.”
…..
“A recent report identified, quite astonishingly, that in today’s high-quality healthcare in Australia, that 1.2 million Australians will have experienced an adverse medication event in the last six months. 250,000 hospital patients are seen each year because of medications misadventure. A key cause is the absence of real-time medical records at the point of care – a key benefit of MHR,” he said. 
…..
“What this means is comprehensive coverage. A GP will have the most up-to-date information currently available on the patient and in that way, we will reduce the number of accidental misdiagnoses,” he said. 
The next step for MHR, Kelsey said, is to work closely with the specialist communities and aged care to build connections. 
…..
“Recent PSA research found that over half of residents in an aged care facility in Australia are exposed to at least one potentially inappropriate medication. Technology can be a very strong support to reduce those instances,” he said. 
“And the MHR provides those rights to citizens to decide with whom they share their data and at what time.”  
----- End quotes.
All I can say is what Mr Kelsey is talking about as the #myHealthRecord and the Australian Digital Health ecosystem, I sure don’t, for one, recognize. To be even close would need more lipstick on that pig than currently exists!

To claim there is 'consensus' around the #myHealthRecord or that there is being anything even remotely approaching a speedy implementation of Secure Messaging is just not true for the world most of us live in!

The ADHA also continues to be in denial about the 30-40% of the population who can't / won't come to grips with the great health data vacuum machine. 

What do others think? Is all this fact and is the Kelsey / ADHA version of reality about to bring great savings and benefits or is it just fantasy that they hope will become real if they market / push it hard enough? 

I would love other people's views to ensure I retain some link to reality!

David.

24 comments:

  1. Excuse me, you have got me confused I thought Tim is claiming 90.9% now have a My Health Record

    ReplyDelete
  2. Consensus, strategies, plans, intentions, exaggerations, claims for myhr that are patently untrue.

    e.g he claims that myhr is a "real-time medical record" and imply that it is capable of prescription monitoring.

    The only explanation is that he knows he won't get away with it and expects to be moving on before he is called out on it. He probably hopes there is an early election to muddy the media waters.

    Its a common strategy of an incompetent but ambitious public servant. Make a loud noise, make outrageous promises get noticed, jump ship to a new job before the shit hits the fan and blame their successor for not delivering.

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  3. He and his precious strategy claimed 98% of Australians would have a my health record by the end of 2018. We got 500% more not wishing to be part of that system, we got a glimpse into how broken the system is and we got legislation and delete function that simply make the whole thing a sordid mess.

    One thing that might come out of this is a majority have learned to operate quite well without government help.

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  4. 8:32 PM well highlighted, Tim seems to have bowled himself out for a bit of a duck.

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  5. The desperate splattering of someone exiting the scene. Trouble with a national effort such as this is that it has been observed internationally. Tim I am sure will be in the cheap seats at the Global Digital Health cloud he is so pride to be a meme Ed of

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  6. I would not think Tim will be absorbed into the Public Service. The Governments Health Record system will be and I am sure that is not later than 18 months. I predict by end of May a changing of guard at ADHA and it will become a service contract management function within a branch of the department.

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  7. David it is worth looking back at the first board papers, same content free statements that we hear today. Promises a lot of candy coated visions, but never seems to deliver the goods as promised. What he does deliver such as opt-out was just a train wreck and has created significant damage to mankind and machine alike. Katherine King could not have paid for such a gift hoarse as nice but dim.

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  8. >11:51

    Sounds on the money. Why would the Department of Health be happy for the ADHA to run around trying to set policy and do research, when their own Digital Health section has been shrinking, and everyone is competing for funds?

    ADHA isn't currently funded past June as far as I know, will be interested to see what the next Budget holds..

    ReplyDelete
  9. AnonymousFebruary 27, 2019 8:36 PM
    8:32 PM well highlighted, Tim seems to have bowled himself out for a bit of a duck.


    Where you playing on the news regarding Tim cassplash for his mates at the SCG? $100k of tax payer money and guess who his special guest is?

    And the $100k excludes travel, accomidation and other expenses to be claimed.

    ReplyDelete
  10. March 01, 2019 9:33 PM What do you refer to, I found something along those lines by behind a paywall.

    ReplyDelete
  11. Bernard Robertson-DunnMarch 02, 2019 10:32 AM

    This is probably what you are referring to, outside the paywall

    "The agency in charge of the My Health Record had planned a $100,000 training event at the SCG"

    https://privacy.org.au/the-agency-in-charge-of-the-my-health-record-had-planned-a-100000-training-event-at-the-scg/

    ReplyDelete
  12. This is not a good look but is a very good indicator how removed the ADHA board , CEO and COO are from reality. As always they are thin on numbers, there appears to be another $55,000 in hotels per night (if only 1 night - 300 staffx$185). This would also exclude return flights ( day 500 x 300 staff = $150,000) that is some $305,000 of tax payer funds. There would also be staff expenses and travel allowance. May Timmy could cancel his mate Roger as the main speaker (no idea what his relevance would be) and send the cash to the North Queensland farmers he thinks the MyHR is be used to make life easier.

    The ADHA is out of touch and out of control. Again I applaud those person able to and willing to expose this BS.

    ReplyDelete
  13. Thanks Bernard interesting read and again Timmy caught out by facts. It certainly looks like Tim and Ronan have been over doing the juniper berry juice.

    Interesting how Tim arranges (for a fee I am sure) his co-author or that book of theirs. Tim is certainly a demonstrator of open government.

    And a thanks to Sue Dunlevy for highlighting this news

    ReplyDelete
  14. Bernard Robertson-DunnMarch 02, 2019 2:30 PM

    A quick rip round of some of Tim Kelsey’s recent statements:

    https://www.healthcareit.com.au/article/we-need-get-digital-basics-right-and-quickly-tim-kelsey

    "A GP will have the most up-to-date information currently available on the patient and in that way, we will reduce the number of accidental misdiagnoses,"

    ADAH stats show that the maximum number of My Health Records that contain a Shared Health Summary cannot be greater than 36%

    In the calendar year 2018 the number of Shared Health Summaries uploaded represents a maximum of 15% of registrations. This means that at least 85% of people registered for a My Health Records have either an empty Shared Health Summary or one that is over 12 months old.

    Most myhrs are empty of any useful health data. The “most up-to-date information currently available on the patient” is with their GP. myhr can at best only hold a small proportion of that data – that is how it has been designed.

    He also said:

    "A recent report identified, quite astonishingly, that in today’s high-quality healthcare in Australia, that 1.2 million Australians will have experienced an adverse medication event in the last six months. 250,000 hospital patients are seen each year because of medications misadventure. A key cause is the absence of real-time medical records at the point of care – a key benefit of MHR,".

    myhr is not a real-time medical record. It was never designed to be one and can never be one.

    Furthermore, Mr Kelsey is implying that myhr is a system that has the capability of real time prescription monitoring. This will probably come as a surprise to those who are working hard to deliver such a system.

    https://www.zdnet.com/article/health-hands-fred-it-au23m-for-australia-wide-prescription-data-sharing-exchange/

    https://www.healthcareit.com.au/article/work-start-national-real-time-prescription-monitoring-system

    And here’s a reminder of what Greg Hunt announced in July 2017

    http://www.health.gov.au/internet/ministers/publishing.nsf/Content/health-mediarel-yr2017-hunt071.htm:

    "The Turnbull Government will invest over $16 million to deliver the national roll-out of real time prescription monitoring for medicines to directly address the needless loss of life from misuse of these drugs.

    The Real Time Prescription Monitoring system will provide an instant alert to pharmacists and doctors if patients received multiple supplies of prescription-only medicines.

    This system will save lives and protect the community. This is something of absolute national importance."

    No such system yet exists; myhr certainly isn’t one.

    Those who are seriously looking into myhr will probably be very aware of these public statements and how just far from reality they are.

    ReplyDelete
  15. And Bernard, let us not wash over the fact that under the ADHA watch a significant flaw was aloud to continue that rejected clinical documents from being indexed into the Dropbox. Not exactly the sort of leadership one would want in a system Tim and is right-hand dream of

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  16. The Government and no doubt the Opposition are hoping this embarrassing disaster will just quietly die, keep it out of the news, both parties are equally responsible for allowing it to continue and neither know or are prepared to terminate it. They must be 'hoping' the Auditor-General will make that recommendation, although that is unlikely. Therefore the only option is to cut the ADHA's funding in the forthcoming budget. If that doesn't happen it will most likely become a significant election issue - disastrous for the Liberals and embarrassing for Labor.

    My Health Record could be $2 billion waste - Daily Telegraph
    https://www.dailytelegraph.com.au/...health-record...2-billion.../3254d15f70b48e2e6a97...

    1 day ago - The event was due to take place at the Sydney Cricket Ground but now ... Seven years after its launch and $2 billion down the track there is not much to ... Sue Dunlevy is News Corp Australia's National Health Reporter.

    and ....

    My Health Record: doctors refuse to use $1.7 billion ... - Daily Telegraph
    https://www.dailytelegraph.com.au/.../health/...billion...health-record.../d66506e321302...

    Jan 18, 2018 - Taxpayers spent $1.7 billion on a health record doctors don't use. Sue Dunlevy, National Health Reporter, News Corp Australia Network.
    Missing: sydney ‎2

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  17. I will not be surprised if it stagnates, neither being decommissioned or ‘replatformed’. There simply is no gain or political capital in the system, unlike at the dawn of this decade it was exciting and bold, it no longer is, they have been at it for so long it’s brand is tarnished and is associated with failure and violence.
    Desperate attempts to relate its value with floods in Queensland simply indicates some are not yet taking advantage of cheap secure cloud storage. Most have more than enough free storage lying around to support regional and rural practices and pharmacies. Can the ADHA keep pace with cloud infrastructures platforms - no, should government be competing with cloud technologies - no.

    Do government have a roll, yes although they have lost a lot of the knowledge and experience in those areas.

    ReplyDelete
  18. Dr Ian ColcloughMarch 02, 2019 11:34 PM

    Another option, not to be discounted, is the privatisation pathway, similar to what the government did a couple of decades ago with its very early attempts to develop an integrated health network.

    The project became a political liability until a management buyout was engineered resulting in the privatisation of the project and freeing the government of any further involvement.

    Of course that might not be possible with MHR because the core of the system is the huge database of every Australian's registration details which surely would not be passed over to a private entity!

    ReplyDelete
  19. Dr Ian ColcloughMarch 02, 2019 11:46 PM

    The following article / commentary from 14 years ago should help give a sobering perspective on the ADHA's My Health Record project.

    https://cpd.org.au/2005/06/healthconnect-a-major-rethink-required/

    HealthConnect – A Major Rethink Required? Health30 June 2005 By David More

    The overall Australian HealthConnect Program (previously Health On-Line and MediConnect) began in 1999.

    HealthConnect is envisaged as a largely passive repository for patients’ Initial Health Profiles (containing basic identifying and health information) and a series of ‘event summaries’, which are created each time a health service is provided. These two components go to form a lifetime electronic health record which is made available to healthcare providers under strictly controlled circumstances.

    The current strategy documents from HealthConnect (June 2005) recognise that the availability of suitable integrated clinician systems will not happen even in the medium term – up until then it is planned the clinician will use the Internet to access the central repository.

    ReplyDelete
  20. Privatisation is an interesting one and the current political culture would make this a serious if not wreckless reality.

    On the subject of this weeks poll and earlier commentary. Does anyone else find the whole thing a little disturbing or embarrassing? It comes across as - The Board will not be extending Tim’s contract and he will be stepping down in May 2019. Tim announces at the Executive leaderless meeting and there is a discussion on a farewell party. The discussion rotated around how this can be done within the ‘APS rules’. Devoid of imagination but desperate to be ‘the one’ the executives agree to circulate the idea at the following general managers gathering as they are ‘always banging on about wanting more responsibility and say in things’. Obviously Tim’s premature departure is removed and some thanks to all the staff is inserted instead. This creates the disorder lack freenzy, with the predictable ladder climbers and excitable GM’ so desperate to please and stay relevant commence dragging their teams off important work to engage in
    ‘brainstorming’ sessions, no doubt one of two bring in ‘ideas consultants’ to facilitate ........ and we get this.

    A two day extravaganza at the SCG posing as a workplace health and safety trading session, let’s roll out the minister to give it legitimacy (ignoring the fact May election and he might be busy. Let’s add Tim mate from the UK to talk, even though this is WHS and he has bugger all in relation to the subject matter, he happens to be in the country so why not fund his trip. Then there is Timmy himself, you can only image the attraction of speaking to staff and dignitaries via the SCG video screens.

    You have to wonder about the ADHA and its grip on reality.

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  21. Bernard Robertson-DunnMarch 03, 2019 1:27 PM

    The white elephant in the room is funding.

    myhr has not delivered massive savings that were projected by all those complicit consultants. There are no signs of the rivers of gold.

    myhr is obviously deficient and the ADHA knows this full well. It will cost a fortune to re-platform, in the mean time the ADHA will be operating a system that has already reached its use-by-date - which never really existed anyway. As has been pointed out myhr is just the latest in a long series of stupidities.

    There is no ongoing funding model.

    Where is the money to continue with this folly coming from?

    Privatisation is not an option.

    The Auditors will be asking that question. The answer will be most interesting, but it will reflect reality.

    Tim may well end up in India, although he may well find life even less easy than down under.

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  22. @1.27 PM "Where is the money to continue with this folly coming from?"

    The May Budget will allocate similar funding as last year.

    The Morrison Government has no appetite for disrupting the status quo as it approaches an election. They will leave it to the Opposition to be the 'bad cop', and if Labor choose to follow that path Morrison will turn it against them and Hunt them down.

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  23. March 03, 2019 11:57 AM Hypothetical and wishful thinking. I have to wonder about your grip on reality.

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  24. 6:09 PM, not defending 11:57 AM but having work at the ADHA that is actually how things generally work.

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