Quote Of The Year

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


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Thursday, June 27, 2019

The ACT Says That The #myHealthRecord Is Not Good Enough And Plans To Do Better. Is It Smart And Will It Work?

This appeared last week:

Digital Health Record to change the lives of those with a chronic illness in Canberra

Posted Sun 16 June, 2019 at 8:27am
When Jen Sutherland winds up in the emergency department in debilitating pain, she is often forced to relay to the staff a decade of complicated medical history before she can be treated.

Key points:

  • The ACT plans to introduce a new single electronic system for patients
  • $70 million has been set aside to build and implement the system over the next four years
  • Chronic illness sufferers have welcomed the decision
The 27-year-old Canberran lives with Type 1 diabetes and endometriosis, juggling multiple medications, specialist appointments and tests each month.
And because Canberra's public health system uses a complex combination of digital systems and paper records, it can be difficult for clinical staff to access patients' medical information.
The burden is inevitably placed on the patient to keep track of their history.
Lots omitted ……

New system places responsibility on healthcare system

But this record-keeping tradition could become redundant under the ACT's plans to introduce a new single electronic system for patients, to be known as the Digital Health Record.
It would record all patient interactions, referrals, clinical observations and test results across the public health system.
The ACT Government has set aside $70 million over four years to build and implement the system, with another $35 million expected the following four years.
Denise said the move was long overdue.
"At the moment the onus is very much often on the patient to be managing their health information," she said.
"If you're really unwell, remembering things and staying on top of information like that is actually quite a bit ask and it adds a lot of stress to the job that is already a job of being chronically ill."
The disjointed system also presents challenges for doctors.
Matthew Cook, director of immunology at Canberra Hospital, said the new system would improve accuracy and efficiency.
"This is no one's fault at the moment but there are delays, there is missing information and there is redundancy," Professor Cook said.
"Sometimes test results aren't available and they're repeated because that's the only way to achieve those results."
Professor Cook said it was unreasonable to expect patients to provide details of their medical records.
"We would like to focus on the patient's experience of the illness and that's what we will be able to do more when we have more efficient and complete medical records," he said.

Digital database will contain more detail than My Health Record

The digital health record would not be opt-in, so any person who uses the public health system will have one.
Peter O'Halloran, ACT Health's chief information officer, said patients cannot currently opt out of having paper records either.
"We already have a medical record for every patient," he said.
"This is simply taking those records from a variety of digital systems and paper systems into one single digital system."
It would contain more detailed information than the federally run My Health Record, which has prompted backlash over privacy concerns.
However, the digital health record would incorporate My Health information.
Mr O'Halloran said the Government was mindful of privacy concerns.
"We have designed the Digital Health Record from the ground up with privacy in mind," he said.
The new record would bring information from more than 250 IT systems and paper records into one place and would be the "biggest transformation of healthcare in 30 years in the territory", he said.
He said the Government had looked at challenges and successes of similar systems across the country and overseas to design the project.
The rollout of Queensland's system has faced delays and concerns over patient safety.
It's not yet known which company will design the ACT's system, with the project going out for procurement in the coming weeks.
It is expected to be operational in about three years.
The complete article is here:
At first reading it looks like ACT Health is planning a #myHR on steroids with many of the downsides of the current manifestation – honey pot effect, widespread access and worse almost everyone included. There also does not seem to be any opt-out!
I am not sure this has been fully thought through. What do others think?


Bernard Robertson-Dunn said...

A triumph of hope over experience.

Build a new IT system and expect it to transform healthcare?

A wealth of experience: says re-design the healthcare system first then automate to support/implement the new design.

The ACT's Digital Health Strategy is full of themes and strategic priorities all driven by technology. No details, no mechanisms just blind hope.


IMHO, it's backwards. Technology is the outcome from solving problems; technology does not solve problems.

A simple way to analyse the strategy is to look at the number of problems that are identified. A problem has to be expressed as a question. e.g. safety is not a problem it is a thing.

A search for "?" returns zero. A search for "question" returns zero. A search for "problem" returns 2 results, neither relevant to the strategy itself.

If you don't know the question, any answer will do.

It's yet another cargo cult.

Anonymous said...

I think they want to spend money to feed their egos.

I think they don't know what they want to do but they think that's better than doing nothing.

I think they had a great trip travelling around the world to convince themselves that there is plenty of hype and plenty of others who don't know what to do or how to do it.

I think it is clear they will abrogate complete responsibility to a large consulting firm which can convince them it's not that hard!!!!

Anonymous said...

Or, on their travels, did they see a system that works, such as in a number of the Scandinavian countries, and see that it is achievable?

Anonymous said...

How many Scandinavian countries have a population of 400,000 and only two public hospitals? These things don't scale easily - just ask the USA's DVA.

Long Live T.38 said...

They might have, but did they understand it was simply a system within a system-of-systems, those systems being social, economic, political, legislative, clinical care, etc.... then all the way out to information systems