Wednesday, April 03, 2019

A Virtually Total Clean Out Of The ADHA Board Says Something I Believe!

This release has just appeared:


APPOINTMENTS TO THE AUSTRALIAN DIGITAL HEALTH AGENCY BOARD

3 April 2019: The Australian Government has re-appointed Dr Elizabeth Deveny to the Australian Digital Health Agency Board. Ms Deveny succeeds Mr Jim Birch AM as Chair of the Board. Dr Bennie Ng and Ms Lyn McGrath have also been re appointed to the Board providing continuity in leadership for the Agency.
The Government has also appointed Ms Emma Hossack, Professor Learne Durrington, Professor Mike Woods, Professor Kylie Ward and Dr Samuel Heard to the Board, adding invaluable expertise and understanding of health. These appointments are effective from 20 April 2019.
They join ongoing members, Mr Michael Walsh, Dr Zoran Bolevich and Ms Glenys Beauchamp PSM as the Agency delivers on its important work progressing key priorities under Australia’s National Digital Health Strategy – Safe, Seamless and Secure.
Mr Jim Birch AM, Professor Johanna Westbook, Dr Eleanor Chew OAM, Ms Stephanie Newell and Mr Robert Bransby will conclude their terms on 19 April 2019.
Under the current Board’s leadership, the Agency has delivered the My Health Record expansion program, significantly increasing the benefits available through this initiative to all Australians.
ENDS
Media contact
Department of Health
Mobile: 0466 533 960 Email: news@health.gov.au

------ End Release.

It seems this was needed to apologise for the stuff up that has been opt-out?

Do you think the ADHA will lift their game now with the new members or will management capture these Board Members as well?

Of course we also have an election to maybe explain the sudden changes?

Comments welcome and desired!

David. 

26 comments:

  1. They need a few changes further down the line IMHO.

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  2. Dr Ian ColcloughApril 03, 2019 6:24 PM

    Does this mean there are some new cooks stirring the old broth?

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  3. Digital Health CRC is new. Looks like its only connection to MyHR is through Steve Hambleton's experience. From their White Paper -
    An important starting point is the information needed for planning and delivering services personalised to individual needs across the health care continuum. As discussed in the Introduction, much of the data that are routinely collected in health care settings are collected at the treatment stage relating to a person’s direct use of health services across primary care, specialists, emergency departments and hospitals. Information on signs, symptoms and diagnosis of disease are often directly recorded (or automatically populated from diagnostic tools) within the electronic medical record (EMR) at the point of health care delivery.

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  4. Well done Tim, nicely manoeuvred, not only did you kill off those who would dispose of you for your charade but you have also managed to make MSIA and wing of the Government just like to CHF.

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  5. ... has delivered the My Health Record expansion program, significantly increasing the benefits available through this initiative to all Australians.

    the only "benefit" that's been delivered is that more people have been registered. No health benefits have ever been claimed or delivered.

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  6. How does the Agency negotiate with the MSIA now?

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  7. In an open transparent and ethical way based on mutual interests and respect, co-creating value for their customers and citizens of Australia, oh wait April 1 has passed.

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  8. April 03, 2019 9:54 PM. You raise a very valid point. Health or at least Digital Health is infected with conflicts or interest and some very questionable dealings. This is evident in public record.

    With E Hossack now a more permanent fixture of MSIA (CEO rather than the previous temporary role) it is hard to see how the MSIA can be independent, something that must be retained to keep ADHA in check. MSIA has the potential to become just another so called independent body like the Consumer Health Forum. Neither truly represents the whole and mostly speaks on behalf of its major shareholder.

    That aside, I will the new board members well, I hope they realise that history shows the PCEHR/MYHR destroys careers and reputations. Few survive.

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  9. April 03, 2019 7:36 PM - Said "Well done Tim, nicely manoeuvred, not only did you kill off those who would dispose of you for your charade"

    It was the board that appointed him (not saying they necessarily selected him). THe new board will most likely want to see some changes at the top executive level. Why risk having to deal with entrenched behaviours and fiefdoms, better to start afresh.

    On starting afresh, there certainly seems to be some important director roles being advertised at ADHA. Guess there was a bit of spike in staff turn-over.

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  10. if ADHA employees and contractors are not aware of this blog and the opinions expressed, then they deserve everything they get. If they are, and they don't read the tea leaves, they deserve everything they get.

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  11. @2:03 PM. They will find it difficult to explore new opportunities. I was only there for a year and it was a bit of a black mark on my resume.

    Many I worked with do not deserve this, many who do deserve this are already fully engaged in the Bull**** game and will successfully move into another role where they can degrade people with values.

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  12. @2:25 PM

    I know what you mean. In my early days I used to move jobs frequently. It was easy to find jobs with some companies. It took me a while to realise that was because they were not very good companies and their staff turnover was rather high - hence the continuous need for new staff.

    I eventually got into one of the good companies. I changed jobs less frequently after then. It was not particularly difficult as I had a much better resume. I was eventually able to drop off the older "bad" companies.

    I also noticed that in any company under stress, it was always the good ones who moved on quickly and the less able stayed. Half didn't realise they were in trouble the other half found it hard to get a new job.

    Congratulations on moving on and sharing your experiences with us.

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  13. I here rumours of one or more Executives are also to vacate the ADOHA. Anyone know any more?

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  14. Perhaps the MSIA is looking to use the ADOHA leverage to take on the TGA attempts to better regulate Software-as-a-medical-device? Or perhaps the ADOHA will look to use the MSIA as a shield against TGA in defining if the My Health Record falls under SaMD?

    A longbow you ask? Well yes and no. The ADOHA certainly pushes the My Health Record such that it could fall into the broad definition of SaMD?

    Should prove interesting for the ADHA as they champion clinical safety.

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  15. If today's software delivered major medical benefits it would need to be regulated. The fact that the MSIA doesn't want its software to be regulated, says a lot about the state of medical software in Australia.

    Compare medical software to avionics software that does impact flight safety.

    And the thought that anyone could claim that the toy that is my health record has any effect on medical treatment displays a staggering ignorance.

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  16. The new ADHA Board has one major challenge ahead - There’s No Brain Trust. Wonder if they will be able to repair all that damage and broken relationships? As a Federal Agency I think they will struggle.

    Take no offence those at ADHA, I know there are some clever and talented people scattered about like drops of water in a sieve.

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  17. > If today's software delivered major medical benefits it would need to be regulated. The fact that the MSIA doesn't want its software to be regulated, says a lot about the state of medical software in Australia

    Actually, the MSIA is completely in favor of software running in a device that makes treatment decisions directly without human review. We (in as much as i can speak for MSIA) recognise that this is important and necessary. And we also recognise that it's *extremely* costly. TGA practices - rightly - a sliding scale of costliness based on both size and breadth of the risk, so that lower risk devices can be subject to less costly processes. But it's still *costly*.

    The problem is around the definition of a device. TGA is clarifying the definition in a way that considerably extends it's reach - any software that makes any diagnostic recommendation, whether subject to further human review or not - is subject to the TGA risk based process. The problem is that typical software systems sold by MSIA members are vast sprawling pieces of software that are loaded with administrivia, and that are upgraded and further develop on an ongoing basis, where a small part of what they do is making recommandeations. Trying to apply a device framework to enterprise software is just stupid.

    I think that MSIA would be strongly in favor of a framework around health management software risk and quality management that made sense and didn't try to pretend that a device framework make sense.

    From my pov, a bigger problem is how this will apply to health software in the app stores. it would appear, based on their proposed framework that most of the health apps will disappear from the Australian app stores unless they come from Australian companies who have the funding to go through the process. Sounds like regulatory capture to me.

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  18. Thank you Grahame the TGA journey will be an interesting one not unlike the FDA in the US. The costs might be high but if these processes keep the competition lean then you could argue the rewards for those who diligently succeed is high. How all this plays out for those wanting to sell internationally will be tricky, passing through FDA may not get you past the TGA etc…..

    I am not expert and this is not intended as advice but it would seem prudent that investor in and buyers of health-tech might be wise to be conscious of these regulatory pitfalls in connection with financings and acquisitions.
    Due diligence (something in short supply in Aussie digital health) should identify whether the target company has obtained all necessary authorisations and approvals to operate its technology. This may require a more detailed and deeper review than is typical for technology investors. (Increased cost)

    It may also be important to review the vendors policies and procedures on effectiveness to ensure that they comply with norms within the healthcare industry, as well as with government regulations and legal requirements.

    It may also be prudent to review any potential red flags, like product-liability concerns or fraudulent business practices (last, present or emergent) and in certain circumstances, be extended to third parties with whom the seller or target has contractual relationships.

    Digital health comes with a number of constraints, these need factoring in and financed. I know that in Silicon Valley some have a third or so of their workforce dedicated solely to regulatory compliance.

    How we deal with software and the speed of change we test even the most patient of negotiators. Ever wonder why the stethoscope has change little.

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  19. Bernard Robertson-DunnApril 05, 2019 2:10 PM

    I wonder if the new ADHA board will do something about the supposed "weekly" statistics that were last published on 13 January. There was a snapshot "dashboard" issued mid-Feb but nothing since.

    It's notable that the "dashboard", while being similar to the weekly statistics did not include the number of registrations but only had a participation rate (90.1%)

    One reason might be because ADHA has always reported on the cumulative number of registrations (including deleted records, and those of people who have died) , not the number of current "live" registrations. They do the same with Shared Health Summaries etc.

    My guess is that if they were to carry on publicising total, cumulative registrations it would look as though the participation rate was much higher than it actually is. And that would be a lie, and we can't have that, can we?

    @MyHealthRec the official handle of myhealthrecord.gov.au tweeted yesterday:

    "Less than 15% of Australians have their preferences recorded in an advance care directive. Learn how you can add one to your #MyHealthRecord this National Advance Care Planning week:"

    The sad reality is that the "dashboard" statistics showed that only 3959 advance care planning documents have ever been uploaded. Ever. Since July 2012.

    While it is correct to say that fewer than 15% of Australians have their preferences recorded, it would be more correct to say that fewer than 0.001% have them recorded.

    There is a big difference between being technically correct and being accurate.

    I doubt we'll see any more statistics until well after the election. They probably don't want to draw too much attention to the glorious success that is the myhr.

    Surprising really, I would have thought they would be proud of their achievements.

    Apparently not. Maybe someone has hit them with a clue stick.

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  20. Bernard I think you have less the 99.9% chance of the new ADHA board doing much about anything. It is one of those boards you sit on to bulk up you BIO and cement a few relationships, it has nothing to do with the organisation or it’s people or even healthcare.

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  21. MSIA management have been in cahoots with them for a while now. The board appointment was entirely predictable. Previous board thought adha were doing a marvelous job. Hardly a surprise since the exec cherry pick what they are told and the members didn't know how to ask the right questions. The state reps know better but tow the party line because it suits them. If change is going to come it will come from the department and I hear they are not happy at the moment...

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  22. All seems fine and above board. I look forward to the MyHR being shifted onto an openEHR platform.

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  23. Bit hard to tell what's been going on with the board... it's latest published minutes are from the August meeting.
    That's more than 7 months ago - and what a busy 7 months they were!
    Surely the board had plenty to meet and discuss?
    No lessons from the debacle?
    Can hardly expect the new board to come in and make tough decisions when the last mob obviously never bothered with anything more taxing than the luncheon menu

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  24. 9.50 am above said:
    'I look forward to the MyHR being shifted onto an openEHR platform.'

    Yes indeed, with Sam Heard on the board (one of the pioneers of openEHR), and the CEO of Extensia, which sprung out of the Government's Heatlhconnect trials in the early 2000s, built on a shared care system based on the openEHR architecture.

    Seems it is finally time to head for the openEHR, perhaps even have a bon-FHIR of the faxes (or at least of the vanities.)

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  25. Or Pom-fire of the mendax

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  26. Oh! Someone's woken up after yesterday's comment here re board minutes, a number of the December papers have been put up... looks like they warrant close reading. https://digitalhealth.gov.au/about-the-agency/australian-digital-health-agency-board/board-papers

    But oddly there is no longer a copy of the Organisational Chart, which formerly put names to people in their respective positions.

    Oddly, because the chart is supposed to be one of the things the agency publishes, as mandated under its Information Publication plan. Looks like there may be a few other things missing as well

    https://digitalhealth.gov.au/about-the-agency/freedom-of-information-foi/agency-plan

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