This appeared a little while ago.
Medical Journal Of Australia. Volume 210 Issue 6 Supplement
31 March 2019
Expanding the evidence base in digital health
Coordinating editors:
Meredith Makeham and Angela Ryan
Sharing information safely and securely: the foundation of a modern health care system
Med J Aust 2019; 210 (6 Suppl): S3-S4 Open Access
Australia's digital health journey
Med J Aust 2019; 210 (6 Suppl): S5-S6 Open Access
Towards routine use of national electronic health records in Australian emergency departments
Med J Aust 2019; 210 (6 Suppl): S7-S9 Open Access
Digital health benefits evaluation frameworks: building the evidence to support Australia's National Digital Health Strategy
Med J Aust 2019; 210 (6 Suppl): S9-S11 Open Access
Gathering data for decisions: best practice use of primary care electronic records for research
Med J Aust 2019; 210 (6 Suppl): S12-S16 Open Access
Attitudes of health professionals to using routinely collected clinical data for performance feedback and personalised professional development
Med J Aust 2019; 210 (6 Suppl): S17-S21 Open Access
Nudging hospitals towards evidence‐based decision support for medication management
Med J Aust 2019; 210 (6 Suppl): S22-S24 Open Access
Consumer‐directed technologies to improve medication management and safety
Med J Aust 2019; 210 (6 Suppl): S24-S27 Open Access
App utility and adoption in a tertiary children's hospital
Med J Aust 2019; 210 (6 Suppl): S27-S29 Open Access
Preparing Australia for genomic medicine: data, computing and digital health
Med J Aust 2019; 210 (6 Suppl): S30-S32 Open Access
My Health Record implementation in private specialist practice
Med J Aust 2019; 210 (6 Suppl): S32-S34 Open Access
Using My Health Record in a private obstetrics and gynaecology clinic
Med J Aust 2019; 210 (6 Suppl): S35-S36 Open Access
Telehealth a game changer: closing the gap in remote Aboriginal communities
Med J Aust 2019; 210 (6 Suppl): S36-S37 Open Access
Artificial intelligence and the clinical world: a view from the front line
Med J Aust 2019; 210 (6 Suppl): S38-S40 Open Access
----- End Article List.
I have to say it is well worth downloading and reading these papers only so see how little there is in terms of concrete outcomes – rather than suggestions that with further work potential may be realised of outcomes demonstrated.The focus on the myHR in so many of the articles belies the virtually total lack of evidence so far that it is a genuinely useful clinical system. As for comparing its utility with other approaches – this does not seem to have occurred to anyone!
You have to wonder just who paid for all this and how much it cost for what I see as very little new news.
I really love the irony in the fact that the earlier and demonstrably working shared record system in the Northern Territory (the myehr system - https://nt.gov.au/wellbeing/hospitals-health-services/my-ehealth-record ) was closed down to be replaced by the unproven myHR!
Each of these papers says it was commissioned and peer reviewed. I wonder who the reviewers? Years ago I used to review papers for HISA but they lost interest when if kept describing most of the abstracts as “gunna” abstracts. (The authors were going to undertake a study and we were being alerted in advance!) .
It seems, with a couple of exceptions, not much has changed – or am I too hard?
David.
15 comments:
With so many ADHA folks involved and all linked back to the ‘research wing’ this is probably:
1. Meeting some quota regarding published papers to retain some badge
2. Always looks good on LinkedIn
3. If you cannot find evidence to support your claims - write you own evidence
I had a quick look across one and yes does seem to be bias. I was looking for thought leadership or something than expressed ‘and now for something completely different’
For academia it could be better
An ivory tower dug in a ditch. Looking to justify a bad decisions. Australia is in danger of becoming an international laughing stock all thanks to an incompetent department of health.
The introduction to this edition of the Medical Journal has an interesting paragraph:
"Given our use of outdated communication technology, there is a compelling argument that we need to modernise our systems, improve our ability to share health care information and embrace the benefits that digital health systems can offer. We know that Australia delivers a world class health system ranked among the highest globally for efficiency and health outcomes.
Maybe, just maybe the use of "outdated communication technology" is very efficient and effective and is, in part, the reason why "Australia delivers a world class health system ranked among the highest globally for efficiency and health outcomes".
Just because some biased "consultation" that supported the National Digital Health Strategy has come up with "we could do better, that people want access to their own health information and that they want their health care providers to have access to it too" does not mean it will deliver benefits.
Simplistic solutions often do not work as intended. myhr is a simplistic solution with many unintended consequences.
When a snake sheds its skin it changes; when a caterpillar becomes a butterfly, it transforms. We have a bunch of snake oil sale-persons running ADHA when what we need is lepidopterists.
From "Gathering data for decisions: best practice use of primary care electronic records for research" https://www.mja.com.au/journal/2019/210/6/gathering-data-decisions-best-practice-use-primary-care-electronic-records
Australian general practices were early adopters of clinical practice software tools and EMRs.[13] First‐generation general practice software assisted clinicians with drug prescribing, but over time evolved into many clinical patient management software packages. These packages were designed to help GPs manage patient care and referrals, and improve practice efficiency. However, each package has been developed with limited need to comply with clinical coding, interoperability, or national accreditation standards.[14] Because of these limitations, little research and data linkage using EMRs has been conducted in Australia.
#14 refers to Deeble Institute Issues Brief No. 18 https://ahha.asn.au/publication/issue-briefs/deeble-institute-issues-brief-no-18-reality-check-reliable-national-data
The lack of standards are glossed over in the conclusion of the MJA article. Gathering data can result in garbage if the sources of your data are garbage. Best practice use of GP data is of little value without standards applying to all steps in the process.
Have a look at the 9 recommendations from the Deeble brief.
Recommendation 1: That the GP core data set and data model (Simsion Bowles Consulting) is used as the starting point for the development of a minimum data set for general practice.
Recommendation 2: Subsequent to the data model review, measures must be introduced to enforce the implementation of the data model. This could include accreditation of GP EHRs (see Section 7.5).
Recommendation 3: Review all data element labels and their definitions, across all GP EHRs, and where possible standardise them across the system, to ensure that comparable data can be extracted from EHRs. This work must be done in conjunction with the work outlined in Section 7.2.
Recommendation 4: That previous standards work undertaken in this area is used as the basis for the development of a minimum data set specification.
Recommendation 5: Once the EHR data model and the data element labels and definitions are finalised, relevant aspects of this work should be entered into METeOR, the Australian online registry for health metadata.[24]
Recommendation 6: Each of the termsets/terminologies currently used in general practice EHRs should be mapped to SNOMED CT-AU, the Australian national clinical terminology.
Recommendation 7: SNOMED CT-AU should be used for communication to and from general practice (e.g. for referrals and discharge summaries, for transmitting information to the My Health Record).
Recommendation 8: Relevant concepts from SNOMED CT-AU should be classified to ICD10-AM and ICPC-2.
Recommendation 9: All GP EHR software should be required to meet accreditation standards.
~~~~ Mark
David this is paid for supplement. The MJA does a few each year. ADHA paid. It cost a lot - like well over $50k.
10:13 AM This mob?
https://www.tenders.gov.au/?event=public.cn.Amendment.view&CNUUID=0C8094CF-00BD-1EEA-444E7FDF24880BBE
And this $88K contract?
https://www.tenders.gov.au/?event=public.cn.view&CNUUID=02D4B4D5-BF98-3BFB-2DFB92BAD9566F5A
10:13 AM This mob?
https://www.mja.com.au/journal/2018/ampco-and-wiley-announce-new-publishing-partnership
And this $88K contract?
https://www.tenders.gov.au/?event=public.cn.view&CNUUID=02D4B4D5-BF98-3BFB-2DFB92BAD9566F5A
Are MJA supplements peer reviewed?
Or just glorified adverts dressed up as research?
If it keeps the AMA cashed up and people read them (please do not print of fax) then that is good. This is inline with ADHA normal practice, buy your way in and make it look like it is a relevant agency, either through cash or board appointments.
The papers are not bad and the authors are in positions to talk about this. The MHR is going to damage much in the coming years though.
@ 1:36 PM - the latter
I believe it's known as vanity publishing
I don't suppose it's a journalist's strategy is it? It would fit in with the skill set of at least one senior ADHA executive.
Will Amazon’s Alexa be allowed to interface with My Health Record?
https://www.healthdatamanagement.com/news/amazons-alexa-can-now-handle-protected-health-info
Alexa interface? Why not. The more hype the merrier. It acts like a magnet attracting lots of investors.
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