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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."

Wednesday, February 20, 2019

Spinner Alert - The ADHA Claims Success With Opt-Out When It Is Really An Amazing Failure Of Public Acceptance!

This release just appeared:

9 out of 10 Australians to have a My Health Record

20 February 2019
The Australian Digital Health Agency has today announced that 9 out of 10 Australians will have a My Health Record following the conclusion of the opt-out period.
Based on the number of people eligible for Medicare as at 31 January 2019 (25,459,544), the participation rate is 90.1 per cent, with a national opt-out rate of 9.9 per cent. 
While the opt-out period ended on 31 January 2019, Australians are able to cancel and have their My Health Record permanently deleted from the system at any time in the future. Similarly, individuals who may have opted out can create a record at any stage if they choose.
When you have a My Health Record, your health information can be viewed securely online, from anywhere, at any time – even if you move or travel interstate.
A My Health Record also allows healthcare providers involved in your care to view your health records. Health professionals can upload, view and share documents, giving them a more detailed picture with which to make decisions, diagnose and provide treatment to you.
There are strict rules and regulations about who can see and use your My Health Record to protect your information from misuse.
My Health Record has multi-layered and strong safeguards in place to protect your information including encryption, firewalls, secure login, authentication mechanisms and audit logging.
Records created through the opt-out process will be available shortly.
You can securely access your My Health Record via the myGov portal.
If you do not have a myGov account, find instructions on how to create one and link it to your My Health Record
Here is the link:
However that is more people than Australia has according to the ABS:

Population clock

On 20 February 2019 at 02:14:03 PM (Canberra time), the resident population of Australia is projected to be:

This projection is based on the estimated resident population at 30 June 2018 and assumes growth since then of:
  • one birth every 1 minute and 40 seconds,
  • one death every 3 minutes and 16 seconds,
  • one person arriving to live in Australia every 57 second,
  • one Australian resident leaving Australia to live overseas every 1 minute and 49 seconds, leading to
  • an overall total population increase of one person every 1 minute and 15 seconds.
Here is the link:
Just how there can be more Medicare Card holders that the total population I will leave as an exercise for the reader but in terms of #myHealthRecord users the population is the number you have to use.
The opt-out number is thus 2.520 million. (At Estimates Mr Kelsey said the number was 2,517,921 I think!)
So for all practical purposes – when you consider who could actually opt-out (not internet deprived, have already been dragooned in by Aspen etc., mentally challenged,  not over say 12 etc. etc.) the figure will be much closer to 15% or more!
A lot of the population don’t like this program!


Anonymous said...

Not sure I even trust their figures. Seems like to workshopped this and came to the conclusion of it is just short of 10% they can get away with it.

Remember this is an Agency and Department that believe innovation is based on build something and force adoption through legislation, not on merit.

Bernard Robertson-Dunn said...

Those numbers look sus to me. 90.1% and 9.9%?

I'd like to see the calculations, but I bet they won't be made public.

Here's a guess.

The number of people who don't want a myhr is 9.9% of 25,459,544 = 2,520,495

Excluding the number of cancellations (300,000) and opt-outs from the trials it looks as though about 2.1million opted out. Which fits with the guestimates and leaks.

The number of people who could opt-out in the recent period is 25.46 million - 6.45 million (current registrations) - 4.0 million (children and others) = 15.19 million (the true number is lower than that if you exclude those who did not know or are not able to - for whatever reason)

This could well mean that 2.1 million out of 15.19 million people opted out i.e. = 13.8%

The average of 9.9 and 13.6 is 11.85% which is probably closer to the truth but which would be less acceptable to the spin doctors.

The whole exercise is futile anyway. Its a bad idea, GPs know its a bad idea and a GP's objective is to help patients, not protect the government.

Bernard Robertson-Dunn said...

Here's a factoid, the government might want to ignore:

In the "Evaluation of the Participation Trials for the My Health Record"
Final Report November 2016

It says this:

"The opt-out rates of individuals in opt-out trial sites was low (1.9%), which is in line with international experience with opt-out systems for electronic health records."

Two comments

a) 9.9% (which is the absolute minimum estimate of the opt-out rate) is way higher than the 1.9% in the trial
Conclusion? the opt-out trials were very poor predictors of the full opt-out.

b) The international experience of opt-out models is about 1.9%
Conclusions? The Australian experience is a dismal failure.

Put the two together.... Conclusion? ADHA has done a terrible job.

And for the ADHA CEO to call this a "new consensus" on digital health, raises the question? What else is he exaggerating?


Here's another quote from It's worth looking at the evaluation report.

"Opt-out rate in Northern Queensland
Across both opt-out trial sites in Northern Queensland and Nepean Blue Mountains, 1.9% of the population opted-out of having a My Health Record automatically created for them.
It is important to note that people were given the option of opting out over a fixed period (between 4 April and 27 May) and that local trial activities to support individuals in their awareness and understanding of the My Health Record were only properly underway from May 2016. This opt-out rate may have been less if there had been a longer lead time and more intense communication efforts at the national and local level to address these concerns."

The reality was that the more publicity given to the opt-out process and the longer it went on the more people opted out.

Here's a genuine question: What, if anything, has gone right with the PCEHR/myhr that justifies $2billion out of the health budget? Especially if you think about the good that $2b could have done for the poor and sick and aged.

Anonymous said...

Amazing how 9.1 is a smoke and mirror image of 1.9

I agree with the earlier comment it looks to artificial to be true.

Anonymous said...

Yes and what about the poor dead people who were unable to opt out?. We may never know what percentage of the new records are theirs. Their records will simply sit there, making the stats look better. Hey, and less active records must mean that people are healthier, right?

Anonymous said...

Mr Kelsey would not comment on how the opt-out rate compared with similar e-health systems overseas, saying there was "no other personally controlled electronic health system of this kind" anywhere else in the world.

"There really isn't a comparison for a similar kind of opt-out rate in a similar scheme," he said.

This seems to contradict the supposed international comparisons?

Anonymous said...

Old sloppy Timmy is sleepwalking Australia into a massive cyber incident.

Bernard Robertson-Dunn said...

Just think - if they hadn't closed the myhr opt-out period on 31 January, the number of opt-outs would be even greater.

It would be interesting to see the daily opt-out numbers.

There was very little advertising in December/January but I bet the numbers kicked up at the end with the media attention.

If the numbers weren't trending down then it can be assumed that many people still wanted to opt out but hadn't/couldn't.

It would seem that ADHA has no intention of telling everyone who hasn't opt-ed out that they have been "given" a myhr. And/or that they now have the option of cancelling their record.

ADHA must be in a bit of a bind. If they try and widely promote myhr, people will want to opt-out. If they keep their heads down, people will ignore it. GPs will ignore it anyway. Specialists are already ignoring it.

If the reports of the senate committee yesterday are correct, ADHA is planning to hold a big party in May for almost 500 staff to celebrate the success of the opt-out campaign, although it could be Tim's farewell party - one way or another.

That'll be a laugh. Tim's made so many enemies in the media that it is unlikely that it won't go unnoticed. More publicity, more cancellations. But wait - the call centre staff will be at the party so cancelling will be a problem. More publicity.

And on and on it goes. A long slow, expensive train wreck.

Anonymous said...

Wonder if the party will be funded out of the FOI revenue? Why the need for a party? It was not really successful. You could look at it another way - out of the 3 million who bothered (2.6m opt-out and 0.4 opt-in). 91% said no and that would constitute a large proportion of people that would have been valuable able customers.

Anonymous said...

Senator Murray Watt (Qld)Labor, was very much on the ball with his persistent questioning.

Most notable was the revealing pregnant pause that followed his question about staff numbers. Embarrassingly Tim Kelsey was unable to provide a direct and immediate answer. Bettina also looked blank. Much shuffling of papers followed. Tim looked around at staff behind him in the hope they might have the numbers.

Eventually we learnt there was a ceiling cap on the Agency's FTE of 250 but the organisation had a few less than that. Then followed the painful discussion about contractors, are they included asked the Senator. Then as an afterthought Tim proffered that there are also some staff employed in the Primary Health Networks.

When the Senator had finished the number of staff had risen to around 450 (employees, PHN, contractors.

Apart from this episode reflecting a general degree of confusion in the ADHA's response it indicated how out of touch the CEO was on one of the most fundamental metrics of the organisation. Headcount, current status, breakdown into FTE, part-time and contractors as well as staff turnover rate. These basic numbers should be at the fingertips of every CEO, monitored and updated weekly in a report from HR. One of the most important parameters of an organization was not at the CEOs fingertips.

It seems as though the 450 will be attending the May get-together; possibly, it seems, maybe, the CEO is still looking at that.

Anonymous said...

For clarity that figure of 250 is what is termed in government - Average Staffing Level (ASL) this is the cap of full-time staff, above and Beyound that cap contractors must be engaged. Hence small government creates huge contract/consultancy costs.

For the CEO and COO to be dumb-struck simply reinforces the fact these people cannot run an organisation and have been awarded the wrong position titles.

I hear in their wisdom the only executive qualified to run the organisation has been let go.

Can’t run a system, can’t manage specification and software, can’t run a business and are hopeless at media,comms and marketing. Wonder if they can run a bath?

Anonymous said...

I don't recall Tim using the words ASL Average Staffing Level at Senate estimates. It certainly took a bit of tasing to get him to state the number of contractors in addition to the ASL.

I thought the most impressive bit was Tim's response to the question about the Benefits of My Health Record. Tim eagerly picked up a piece of paper, which clearly was a press release (probably just finalised and ready for sending to media) outlining how the My Health Record has been such a great success in Northern Qld following the floods - a person's medications now available at any pharmacy and medical practice through the My Health Record. He was obviously quite excited about this great North Qld success story and enjoyed reading the media release to the Senators very much.

Anonymous said...

The challenge they have with rembering staffing number is that staff are people and people are resources to be consumed at spat out when needed.

I am sure many in Queensland will be releived that although there is no pharmacy operating they can retrieve a record of a prescription. Can the giver be used to obtain a prescription.

Anonymous said...

@4:28. I doubt timbo would know an ASL from his elbow. 250 ASL is the staffing level granted by the Department of Health (avaliable through portfolio papers) . The Department of Finance allocates government department staffing levels (headcount).

That aside they are not experienced to operate a federal agency or even a newsagency in an abandoned town.

Anonymous said...

The ADHA does seem to have a troubled history with its Human Resources relationships. Not really a good image for such an entity.