Here are the results of the poll.
Do You Believe The #MyHealthRecord Is A System Solution That Facilitates Improved GP Workflow And Improved GP Efficiency And Care Quality?
Yes 4% (4)
No 96% (106)
I Have No Idea 0% (0)
Total votes: 110
Well that was pretty clear. The ADHA's #myhealthrecord is simply not a system that supports GPs in delivering quality care according to most who read this blog!
Any insights on the poll welcome as a comment, as usual.
A very reasonable turn out of votes.
It must have been a very,very easy question as only 0/110 readers were not sure what to respond.
Again, many, many thanks to all those that voted!
David.
ps. I do realise there is a typo in this week's question - but too many votes to start again!
D.
There may be a few questions that need answering. Are ADHA and related factions looking through a workflow lens or a process lens? Does it matter either way as they do not seem to take a whole-of-system view. I put forward the argument the healthcare is a system-of-systems
ReplyDeleteThere are various explanations of the term ‘Workflow’ in existence.
Workflow Management Coalition (WfMC) defines the term Workflow as:
“An automation of a business process, in whole or part, during which documents, information or tasks are passed from one participant to another for action, according to a set of procedural rules.”
It also states that the terms Workflow and Workflow Management are synonyms.
In contrast, WfMC defines the term Business Process as:
“a set of one or more linked procedures or activities which collectively realize a business objective or policy goal, normally within the context of an organizational structure defining functional roles and relationships.”
A Business Process has even a more generic term – a process, which can apply to any kind of a process (e.g. physical or biological process).
Can the ADHA and its coalition of the woeful dictate digital health through forced use of technologies when it does not appreciate the business process management aspects?
The technology in question has demonstrated its inability to evolve. Even the fax industry has out-innovated Timmy.
AFAIK NEHTA never looked at clinical workflow. There were some documents that defined the processes for adding data etc, but not what you could call business processes.
ReplyDeleteThe PCEHR was always just a database of health data. Originally it was supposed to be a virtual record by accessing existing data repositories and having a small central database for some summary data.
The "accessing existing data repositories" bit required them to solve the interoperability problem - which still hasn't happened, so all that is left is the central database with no access to existing data.
The PCEHR was never designed to fit in with clinical workflow which is why GPs don't see any value in it for them.
If NEHTA had built the virtual record, it would have automatically joined up a lot of existing data. It could be argued that access to such data has limited value (old, incomplete, overwhelming in detail, etc) but it would not have required manula input of most health data. Pathology results, which would have gone straight into the data repositories and hence be associated with existing contexts, now just sit in the MyHR as isolated data points.
So, the original design was not integrated into clinical workflow. What was built is even less useful and presents an additional workflow overhead that was never intended.
All we have now is a technological boat anchor that is being sold as something it isn't, and can never be.
As 8:34 AM succinctly said “healthcare is a system-of-systems”
ReplyDeleteUnderstanding, analysing and documenting clinical workflow and business processes at the numerous touchpoints to facilitate speedy, accurate, secure, interchange of clinical data into and out of the integrated health record was a vague aspirational dream for NEHTA.
Political and commercial pressures, driven by an unrealistic sense of urgency and hyped-up market rhetoric, sabotaged various attempts to work step-by-step towards achieving the vision, module by module, domain by domain.
ADHA has persisted with perpetuating the PCEHR ideology, all the while exacerbating NEHTAs failures.
I am reminded of my 5 April 2006 comment on this blog, paraphrased below:
"NEHTA appears to be evolving into the nation's leading R&D organisation focussed on HealthICT. If this assumption is correct it will probably be many years before the marketplace and indeed industry will be able to avail themselves of the benefits which may flow from NEHTAs R&D. In that role NEHTA has many complex problems to solve; problems that the rest of the world has wrestled with well before NEHTA was born and will continue to wrestle with well into the future.
Jurisdictions and potential end-users should not allow themselves to be seduced into thinking NEHTA will deliver solutions to all their problems - this year, next year or five to ten years hence.
NEHTA should be viewed as an R&D organisation which one day might provide some practical answers which industry may be able to embrace in a commercially pragmatic way."
13 years later - NEHTA has been replaced by the ADHA. Not much else has changed. Genuine authentic R&D hasn’t even started!