Here are the results of the poll.
Do Electronic Health Records Need A Fundamental Re-think In The Light Of The Range Of Problems That Have Now Become Apparent In Their Implementation And Use?
Yes 96% (138)No 3% (5)
I Have No Idea 1% (1)
Total votes: 144
What an clear-cut poll again. Most seem to think the EHR needs much more work to make it more useful for clinicians and patients.
Any insights on the poll welcome as a comment, as usual.
A more than reasonable turnout of votes!
It must have been a fairly easy question as just 1/144 readers were not sure what the appropriate answer was.
Again, many, many thanks to all those that voted!
David.
5 comments:
Could someone please explain to me why any government or healthcare service provider would think that myhr is a better solution than this:
http://www.isahealthcare.com/Products/MMEx.aspx
myhr is competing with the market. If it going to compete it should either deliver a significantly better solution or, if it can't, it should get the heck out of the way.
According to this:
https://dataportal.arc.gov.au/EI/Web/Impact/ImpactStudy/627
mmex came out of university research in 2008 and
"MMEx has been rolled out to Medicare Locals as part of the Australian Department of Health’s 2015 Care Coordination and Supplementary Services Program to support activities to improve the prevention, detection, and management of chronic disease in Aboriginal and Torres Strait Islander people."
I really don't understand wtf is going on.
If the government was/is really serious about advancing patient healthcare through better electronic health records why did it not just buy the thing?
I probably know the answer: - it would have put the vendors of other similar systems out of business.
So we are stuck with the myhr that cannot compete with commercial systems and which will become redundant when secure messaging and the interoperability problem are solved. Don't be surprised if ADHA cannot deliver either, it is not in their best interest.
The ADHA sees this in an old world transactional view. Supplier delivers product and provides a warranty based on performance metrics (uptime etc..) it measures it perceived value based on transactional metrics - number of uploads.
They talk about co-design and co-development but they miss the co-important bit, which is why I believe they cannot see health as delivery services and working to co-create value through a value system.
I ask anyone who uses or has used the Government HR system if it has delivered you actual true value and has this been expressed as a value measure by ADOHA?
I am a bit confused here. The ADHA reports that the secure messaging trails are a success! The current funding is to support vendors make the modifications is it not?
So if the national entity governing all this has proven the implementation, which by all accounts was ‘co-designed and developed with industry and the MSIA what is the problem seems like a majority call?
The same governing entity has put a fair sum of funding on the table to make these modification happen.
Can someone explain who is pulling what wool over whose eyes please as it seems someone is lying or overstating success
> April 01, 2019 8:02 AM
Its April fools day so replying is fraught with double meanings...
Success depends on how you measure it, yes under highly constrained conditions messaging companies can exchange messages, which is hardly news, as we have demonstrated this years ago.
However the constraints are messages with just pdf content, and manually setup PKI which is not real world and excludes pathology/radiology and clinical messages with atomic data.
The trial exposed compliance issues and ADHAs response was that they had announced in a press release that it would be working in a time frame so everything had to be dumbed down to a point that it would work. It won't work in the real world where multiple radiology and pathology companies along with multiple clinical systems want to send messages. The trial only included a couple of systems and the advice from the few cis vendors involved was that it would take much longer for them to implement support for the standards, so that was rejected because the ADHA had already announced the end date.
At some point supporting the actual messages that get transmitted will emerge as the first step in inter-operability. The lesson from the web landscape of the 90s is that standards compliance with the core underlying formats is critical to growing the network, but thats geeky stuff like html, css and javascript. Even formats like pdf and rtf are not inter-operable to the safety level required for healthcare and they preclude transmission of atomic data to enable decision support. Messaging between tens of thousands of providers, using >30 applications cannot work unless standards compliance and scaleable PKI is firmly in place. The ADHA trial should have taught them that there is low level work to be done, but the PR department rejected that conclusion and went with spin. Even the $$$ on offer has to be spent by 30 June and what they are supposed to implement wrt the FHIR component is yet to be fully standardized!
Thanks Andrew, for the update and decency to be honest with the current state. It is harder and harder to think of excuses for ADHA.
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