Monday, February 04, 2019

You Really Have To Wonder How The #myHealthRecord Will Work With These Poll Results.

I looked this up today.

Poll

My Health Record: staying in or opting out?
  • Opting out (73%, 405 Votes)
  • Staying in (27%, 153 Votes)
Total Voters: 558


Start Date: August 6, 2018 @ 12:05 am
End Date: No Expiry
Here is a link to the page:
If even half of GPs don’t want a bar of it (the myHR), it is hard to see just how it will actually be of much use.
What do you think?
David.

12 comments:

  1. I think in time the government will mandate all doctors must use the system. Subsequently the AMA will lodge a High Court challenge.

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  2. Looking at this article How To Radically Renovate My Health Record
    https://aviralupdate.com/how-to-radically-renovate-my-health-record/
    by Paul Shetler and Catherine Thompson ....

    When they say Radically Renovate, what they're really saying is that what has been developed is a load of rubbish and that something totally different is needed in its place - something that would bring real benefits, at the population health level.

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  3. Bernard, I agree that what has been produced is rubbish.

    I suggest before we go off proselytising for a new technology solution (e.g. Radically Renovate My Health Record) we would be better advised to take the road less travelled. That is, put the technology aside and focus on how we put people at the centre of the system.

    The distinction between solutions and people is quite important. The solutions are the machinery, technical applications. What is central to my argument is that people are the centre, the technical applications come afterwards. We have to put people at the centre of our human systems.

    The strategic challenge is a 'NEW IDEA' to replace the 'OLD IDEA'. Truth happens to a new idea as it demonstrates its value. In the e-health policy and strategy context the truth is that the MyHR has not and cannot deliver apparent value to all stakeholders. As Peter Drucker was fond of saying ABANDONMENT is the key to innovating both because it frees up necessary resources and because it stimulates the search for the new that will replace the old. (Inside Drucker's Brain, Jeffrey A. Krames, 2008, Penguin Books, page 33).



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  4. John

    I agree and so does Todd Rose, in The End of Average: "The hardest part of learning something new is not embracing new ideas, but letting go of old ones."

    In fact the idea behind that book (that people are unique) is at the heart of Patient Centric medicine. Much of what passes for today's clinical medicine is based upon group think, pattern recognition (matching symptoms with risk factors) and risk reduction.

    A patient wants to know what's wrong with them not how they can maybe reduce the risk of something by taking some medication that may be useless for them and have major side effects.

    The answer is not to be found in large amounts of historical data but in assessing the patient at the time and place of care. Then treating that patient in a way that addresses the cause not some correlated symptom.

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  5. In the private sector it's said that CEOs are paid to take risks. If a corporation outlaid tens of millions on a new venture, but came to learn that, not only was the new thing incapable of bringing in profits, but it was costing a million or so per year to maintain, it would be killed off. CEOs and Board may then be rewarded by shareholders. But, if the company is punished for its adventure, that CEO is now psychologically harmed and may no longer want to take the kinds of risks expected. A smart CEO in that situation will leave, on good terms.
    Since none of that applies in Govt services, different tactics are needed to kill off a dud project. That is, outsiders must be able to extract verifiable information that can be presented either to the public via the press, or to a high-level agency of audit or inquiry.
    So, I wonder if anyone can say how much of the ADHA (and its associated agencies) is composed of workers on visas who are dependent on their employment for residency.

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  6. The “how to radically renovate the GovHR” does touch on an important subject - interoperability as a property. The ADHA in it narrow view of the world will not be able to contemplate the magnitude of IaaP, this is evident from their approach to requirements and standards and even that goals they list under the 2019 work plan.

    https://www.sciencedirect.com/science/article/pii/S1474667016428491

    This is a reasonable article to explain IaaS.

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  7. On this week's Health Report:

    Scribes help doctors see more patients
    https://www.abc.net.au/radionational/programs/healthreport/scribes-help-doctors-see-more-patients/10776540

    "Doctors can spend up to half their time taking notes about patients — and that prevents them from actually providing face-to-face care.

    A trial in several hospitals has found the use of scribes, to take notes for a doctor, increases productivity and the number of patients a doctor gets to see."

    It's worth listening to the audio as it describes the mess electronic record keeping is creating.

    The research they talk about is here:
    Impact of scribes on emergency medicine doctors’ productivity and patient throughput: multicentre randomised trial

    https://www.bmj.com/content/364/bmj.l121

    The paper is worth reading as it has a long list of things a scribe could do which, if the scribe doesn't do it, somebody else (doctors? nurses? i.e. health carers) has to.

    electronic medical record systems are having a devastating impact on doctor productivity. It's an example of bad automation - it reduces efficiency and/or increases costs (the need to employ scribes)

    And the government wants to add another record keeping system? At least with hospital and GP systems, the people with the costs get the benefits.

    myhr, by definition delivers no benefits to those who incur the costs.

    And the irony is that Dr Swan is in favour of myhr. He may know about medicine, but he's out of his depth when it comes to medical information systems. And he has a vested interest.

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  8. Norman Swann is cofounder of Tonic Health Media which distributes health education information targeted at patients and people in their home and in the clinic waiting areas. Why are you concerned about that?

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  9. AFAIK, Norman Swan, via Tonic, gets paid to promote myhr.

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  10. @9.11 AM "myhr, by definition delivers no benefits to those who incur the costs. And the irony is that Dr Swann is in favour of myhr. He may know about medicine, but he's out of his depth when it comes to medical information systems. And he has a vested interest."

    All true. However, in his capacity as a media presenter it is not unreasonable for him to be reporting on MyHR nor is it unreasonable for him to be providing educational material about it in medical practice reception areas. His job, in that role, is to push the message not to be judgmental about the merits or otherwise of the system. If that is misleading to the target audience the fault lies with the ADHA which have chosen to promote a flawed system, in which they believe, onto a gullible populace according the wishes of their masters - the Health Department and the Government. Credibility is lent to this approach by the peak medical bodies. Because they all receive money or doing so they can rationalise their justification. Norman Swann is simply playing the game and making a living. Irony indeed.

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  11. What might this mean for the My Health Record?

    ABS RESEARCH: 46% OF AUSTRALIAN ADULTS AGED 16-70 ARE ILLITERATE.
    The Australian Bureau of Statistics runs a survey called "Literacy and Life Skills". The research shows that an amazing 46% of adult Australians lack the literacy and numeracy to perform simple workplace skills.
    http://vocationalliteracy.com.au/research-into-adult-literacy-in-australia/

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  12. I think it makes a mockery of opt-out. I doubt that an illiterate person would be able to comprehend their My Health Record and more than likely be unable to access it anyway. On the other hand, if they are unable to read and write they wouldn't enrol to have a MyHR if it was opt-in. Therefore opt-out, being the default state, is the only way to boost registrations.

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