Quote Of The Year

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

or

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

Wednesday, June 26, 2019

This Smacks Of Huge Ignorance Of The Truths Of Urgent Cardiac Care On The Part Of The ADHA.

This release appeared last week:

My Health Record launches Rapid Access Cardiology Clinic testing

19 June, 2019 - 9:00
The Australian Digital Health Agency, in partnership with the University of Sydney, is pleased to launch a study into the use of My Health Record in Rapid Access Cardiology care.
The Agency and the University of Sydney have launched the pilot to investigate how My Health Record can support the management of low to intermediate risk chest pain patients through the Rapid Access Cardiology Clinic (RACC) model, initially based at Westmead Hospital.
The pilot aims to enhance the quality, safety and efficiency of cardiology services, and if successful, may be scaled up to roll out across the country. It is expected that this study will yield lower rates of hospital readmissions and avoid a rise in major adverse cardiac events, such as heart attacks. Furthermore, the pilot, may also help to develop targeted cardiovascular disease prevention programs including lifestyle modifications to address common risk factors such as high blood pressure.
During the pilot, clinicians will access a person’s My Health Record when they present to the Rapid Access Cardiology Clinic at Westmead Hospital and draw on the information within the record to make quicker diagnoses and treatment decisions.
“Our study aims to provide greater accessibility to the information needed to better treat all Australians suffering chest pain, and to safely divert people with non‐acute chest pain from being admitted to hospital,” says Professor Clara Chow, Professor of Medicine, Academic Director, Westmead Applied Research Centre, at University of Sydney.
“Australia’s Health 2018 report revealed heart disease was the single leading cause of death in 2018 with 170 Australians aged 25 years and over having a heart attack every day. Last month we discovered more than two-thirds of Australian adults have risk factors for heart disease. Statistics like these remind us of the importance of looking after our heart health and My Health Record provides Australians with a place to store all-important records regarding your heart history and preferred treatment methods,” says Heart Foundation’s General Manager of Heart Health and Research, Bill Stavreski.
RACCs are outpatient clinics, located within hospitals, that provide prompt assessment and management of chest pain. Led by cardiologists, the clinics function to reduce the sizeable number of patients experiencing chest pain attending NSW hospitals.
Consumer Simone Marschner says, “I walked out of the Rapid Access Cardiology Clinic satisfied that I’d had a thorough health assessment and equipped with advice about how to reduce my risks at home. The clinic was not just easy to access, it kept me out of hospital. Now, the peace of mind that comes with knowing that my test results and management care plan are available at a glance on My Health Record, so I do not have to remember or repeat details to my GP later on, is invaluable.”
The test bed will explore how My Health Record can support risk stratification of patients referred to the RACC, reduce duplicate testing, and support communication among healthcare providers via the system’s shared healthy summary function. The study will attempt to understand and address existing barriers to the seamless flow of information along the patient journey and among healthcare providers. The results will be used to scope the feasibility of an innovative, cardiology-specific application that is populated with information from My Health Record to optimise patient care.
“We need all Australians to be aware of the prevalence of heart disease and the work left to do in improving our heart health. This program is a great example of how we can use digital technologies to meet this goal and deliver better health outcomes to all Australians,” says Agency CEO Tim Kelsey.
When appropriate, patients who attend a RACC may be given a management plan and allowed to go home without having to enter the hospital, saving emergency medical staff from admitting patients, organising urgent cardiologist assessments in the community and referring to GPs.
Not only will hospital staff benefit from the reduced burden of chest pain care but patients now have an alternative option to heading straight into emergency departments and prolonged hospital stays depending on their condition.
Further study into the effectiveness and safety of the RACC model of care is underway to reduce the burden of chest pain on NSW hospital emergency departments.
Here is the link to the release:
If I grasp what is planned here it is that someone who presents with chest pain to an Emergency Unit are going to be treated as they always would have been initially.
This will typically involve and clinical assessment and diagnostic testing (blood, X-Ray, ECG and so on) to stratify the patient as to the likelihood of a cardiac ischaemic event and the need for urgent inpatient treatment and investigation.
The test that is most used to decide this is a blood test that looks for any evidence of damage to the heart muscle recently (it is called a High Sensitivity Troponin Test). If it is abnormal you are admitted, investigated and treated to prevent recurrence.
If it is negative and there are no other worrying issues (high blood pressure, cholesterol, diabetes etc.) and the patient seems well you to go to one of these RACC to be more fully worked up and an advice and treatment plan developed promptly. (Note: you always err on the side of caution!)
Given your very recent Emergency Dept. visit in which this work up was done to decide if you should be admitted or go to the RACC for additional advice and treatment it seems very hard to figure out just what the #myHR is going to add other than maybe containing a record of the Emergency visit – which presumably is also available on the hospital’s system?
It is hard to work out what this trial is intending to show as for both encounters the patient is properly assessed and worked up. May be the myHR will, if it has any useful information and is active, will show the odd prescription the patient may have forgotten that will make little difference.  Anything important will have been noted long before the RACC visit I believe and basically the myHR is irrelevant to what should be done on either a RACC visit or discharge. In both cases good treatment and advice and back to the GP with a detailed letter!
My view is that this is a needless make-work and another example of a hammer desperately seeking a nail.
What do you think?
David.

10 comments:

Anonymous said...

I think the ADHA is desperately casting around for any kind of project which it can attach itself to so that it can generate publicity and make false claims in order to give the My Health Record a semblance of being useful in some indirect way. In short the ADHA is busy, busy, promulgating false news.

It's a pathetic, immoral, and dare I say corrupt practice, intended to deceive the politicians who allocate the hundreds of millions of dollars to keep the ADHA alive.

Long Live T.38 said...

5:26 PM. Sounds like you sat through the ADHA COO’s speech at Wild Health.

Nice but Dim said...

@5:26 PM. Very well put. If this Tim Kelsey had any real insight into ‘digital’ technology as a useful tool in medicine then he would be honest enough to fathom it is the diagnostic and monitoring tools that are making the difference not some far flung document repository owned and operated by an erratic, ill-disciplined forth rate federal agency.

Oliver Frank said...

"Consumer Simone Marschner says, “(...) the peace of mind that comes with knowing that my test results and management care plan are available at a glance on My Health Record, so I do not have to remember or repeat details to my GP later on, is invaluable.”

Does this mean that the Rapid Access Clinic is not going to write directly (preferably using secure messaging)to the patient's usual GP?

Anonymous said...

ADHA's strategy - say anything, do anything, promise everything to convince the ignorant to keep paying us. They must be dreading the first data breach or death/harm associated with crap data in My Health Record.

Anonymous said...

We are just leaderless at ADHA. We lost the only two executives that made any sense. Everyone is running around making things up, in more than a few cases teams are working on the same things under different projects for different managers. After two years the decline is a constant, when we lost the innovation executive I hope it would get sensible and grown up, sadly that is not the case.

Anonymous said...

1:18 PM reiterates a common theme that has plagued the ADHA. Could have been an opportunity for all ended up another dropped ball.

Anonymous said...

Tarnishing many a good persons reputation along the way.

Anonymous said...

Dr Danny Byrne shows us his "fax cupboard" (which he'd like to get rid of one day), during a recent visit by the Chief Medical Advisor @MeredithMakeham at Chandlers Hill Surgery practice in Adelaide #AxeTheFax

With respect Dr Danny Byrne, you have the hallmarks of a closet hoarder. You do not need my tax dollars and ten years to solve your laziness. Redirect your phone line to your computer or spent a few dollars on a fax server service and store you crap digitally.

If you are serious about reducing paper, trash your printer

Andrew McIntyre said...

Someone who works at ADHA is feeding Scott Adams material for the Dilbert Cartoons...
What about Tiger Teams?