Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Sunday, June 30, 2019

AusHealthIT Poll Number 481 – Results – 30th June, 2019.

Here are the results of the poll.

Should The Government Prioritise Safe, Effective, Accessible, Technology-Enabled and Convenient Pharmacy Services For The Public Over The Financial Interests Of Members Of The Pharmacy Guild?

Yes 92% (99)

No 5% (5)

I Have No Idea 4% (4)

Total votes: 108

Well that was pretty clear. We are all being grossly inconvenienced by a few greedy pharmacists.

Any insights on the poll welcome as a comment, as usual.

A great turn out of votes.

It must have been a slightly hard question as 4 /108 readers were not sure what the appropriate answer was.

Again, many, many thanks to all those that voted!

David.

13 comments:

Anonymous said...

It would be my preference that the pharmacist is part of the GP practice. Other than promoting a closure working relationship and care team. I am sure it would introduce efficiencies leading to cost savings and better health outcomes.

Anonymous said...

8:11 AM. Are you suggesting redrawing of entrenched business models, process and clinical care dynamics, to what end? To optimise? Then what? automate where safe to do so? And allow boundaries to be such that and under ideals care can expand and contract as necessary?

Would take leadership, a strong will and at least one innovation gene for that kind of thinking to be given oxygen, Hunt and Kelsey are disciples of imitation.

Bernard Robertson-Dunn said...

Most of today's healthcare is structured the way it is because of constraints, eg regulations (professional training/accreditation etc, device/treatment safety) and funding models

All of these have the power of the law behind them.

These constraints have created vested interests.

The greatest impediment to achieving major changes in healthcare is the body politic, mostly driven by the vested interests

The evidence is overwhelming, you just have to look at the UK, USA and Australia.

It is quite likely that all supposed advances in healthcare entrench the current paradigm. It is also possible that true transformation that changes the current paradigm to make healthcare radically more effective and efficient will not be supported such that it cannot happen.

My guess is that transformation of healthcare will come from outside existing medical science and outside the large democracies. It will also happen bottom up, eating away at current practice, fuelled by obvious and demonstrable successes. None of this waffle about "promises and potential"

Dr Ian Colclough said...

@11.36 AM.
"... true transformation that changes the current paradigm to make healthcare radically more effective and efficient will not be supported such that it cannot happen."

What you say is true.

So to make this happen you are saying that it must be without the support of the vested interests, and it must find a way round the constraints, eg regulations (professional training/accreditation etc, device/treatment safety) and funding models ..... all of these have the power of the law behind them.... and it must also find a way around the body politic which is the greatest impediment to change being driven by vested interests.

What are the chances of achieving any transformation when confronted with such obstacles?

Aren't you being a 'tad' unrealistic?

Given the size, scope and complexity of the healthcare system and the vested interests operating therein do you really believe anyone can transform the system from outside and the bottom up?

Where would you start?
How long would it take?
What resources would be required?

Bernard Robertson-Dunn said...

@Ian

"Given the size, scope and complexity of the healthcare system and the vested interests operating therein do you really believe anyone can transform the system from outside and the bottom up?"

If you look at the English Industrial Revolution, the development of computers after WWII, the demise of IBM and the mainframe, the demise of Microsoft and the PC, the rise of FAANG, there are lessons to be learned.

Where would you start?
I started researching clinical medicine years ago and have a pretty good handle on its fundamental problems and what needs to be done.

How long would it take?
Years, probably decades for substantial transformation to happen. The main problem being people. There needs to be new technology that solves the problems of clinical medicine in fundamentally different ways. Then the people who do clinical medicine need to change. Neither can happen quickly, it will be done gradually and safely.
There are two stages. 1. realising what needs to be done 2) doing it.

What resources would be required?
For 1. not a lot. Most of it’s been done. The hard part is communicating it.
2. A lot.
Research (university or private)
Entrepreneurs.
Mostly electronic/biomedical engineering R&D that can develop better ways to acquire patient data at the time and place of care, better diagnostic models, better treatment models and delivery systems. (Have a look at the artificial pancreas as an example of future delivery systems. It's an example a feedback control system that responds to the patient's needs)

If your expensive, complex electronic device starts misbehaving, you take it to someone who knows how to diagnose and repair it. Do they ask for a log book or the equivalent of a health record? Of course not, they test the thing and find out exactly what’s wrong and fix it. There are differences between electronic devices and humans, but the concept is the same.

Anonymous said...

Sounds like short-termism versus long-termism. In today's world who has the time, patience and money to commit to long-termism?

Dr Ian Colclough said...

@Bernard,

"If you look at the English Industrial Revolution, the development of computers after WWII, the demise of IBM and the mainframe, the demise of Microsoft and the PC, the rise of FAANG, there are lessons to be learned."

Perfect examples supporting the case for what should be possible.

Clearly the first stage "realising what needs to be done" is the vital first step.

All to often this 'step' seems to get distorted by enthusiasts, irrational exuberance, vested interests, and the body politic, which together create an artificial sense of urgency that leads to governments injecting huge funds (far too much money) into poorly defined projects which, once they get started, take on a life of their own with little to no accountability.

Anonymous said...

short-termism versus long-termism

like climate change?

The muppets in this government can't see past the next vote. As long as they can claim to be doing something, even if it's the wrong thing, they will defend it to the death, even if it's our death.

This government will continue with My Health Record and claim it is world leading until the hardheaded economists in treasury get fed up pumping money into it for no reduction in health care costs. Money trumps everything in government.

Anonymous said...

The “money” you speak of is small change. The shear amount of waste and over-spend the occurs will mean the MyHR ‘platform’ and BSaaS will continue unnoticed and will eventually result in harm.

Anonymous said...

BS-as-a-Service, love it 7:12 AM. Along with lip-service the ADHA is shaping up as a service provider.

Anonymous said...

Talking of BS, there are some amazing parallels between POTUS and Mini-Me Tim.

Have a look at this:
https://www.theatlantic.com/ideas/archive/2019/07/on-trumps-bullshit/593062/

Someone who lies and someone who tells the truth are playing on opposite sides, so to speak, in the same game. Each responds to the facts as he understands them, although the response of the one is guided by the authority of the truth, while the response of the other defies that authority and refuses to meet its demands. The bullshitter ignores these demands altogether. He does not reject the authority of the truth, as the liar does, and oppose himself to it. He pays no attention to it at all. By virtue of this, bullshit is a greater enemy of the truth than lies are.


There's more truth on this blog than there ever will be from the depths of ADHA.

Nice but dim said...

Yes ADHA does appear to be the Ivanka of digital health

Anonymous said...

From the depths of ADHA! Not sure there is that much depth to ADHA. Something needs to be done. A quick glance at the twitter account is would seem no one is listening or engaged. This is reinforced by the photos they post, even inner Sydney PHN can not raise more that half a dozen people.

The CEO and COO just do not cut the mustard.