Wednesday, October 02, 2019

The ADHA Are Really High Class Spinners When It Comes To Describing The #myHealthRecord.

This is really a description of the #myHR for the ages.
It is a direct quote from RFIDH2298 that was issued a day or so ago. (p28)

4. My Health Record

Australia’s My Health Record system was purpose built just over six years ago. To date, more than 90.1% of Australians have a My Health Record. The My Health Record is internationally recognised for its consumer protections and the choice and control Australians enjoy over their information.
The MHR system is underpinned by two key pieces of legislation: the Healthcare Identifiers Act 2010 (HI Act) and the My Health Records Act 2012 (MHR Act). The MHR Act established the MHR system. It provides a regulatory framework, delineates roles and responsibilities for operation of the system and provides a privacy regime specific to the system that generally operates concurrently with Commonwealth, and state and territory privacy laws.
The My Health Record system was developed through extensive consultation with clinical, consumer and technology experts. It was designed to be implemented incrementally and since it was established, the My Health Record has continued to grow in its capability, usability and integration with clinical information systems across the health sector.
Software organisations have made significant advances to make it easier to find documents and access medicines information, as well as pathology and diagnostic imaging results through new views recently added to My Health Record. For instance, the “Medicines View” is a recent addition that has been applauded by clinicians using My Health Record. It provides a consolidated summary of the most recent medicines information from notes entered by GPs, hospitals, pharmacies and consumers, allowing previously siloed medicines information to be brought together into a single view.
In addition to improvements in the features of My Health Record for people and clinicians, the system has undergone a significant transformation in terms of the richness of its clinical content. Public and private pathology and imaging providers are now connecting to the system, and there has been a vast increase in connected pharmacy systems as well as hospitals around the country. The addition of this valuable clinical content will accelerate the realisation of benefits as clinicians find that they now have access to a more comprehensive source of information within the My Health Record system.
The Agency is constantly evolving and improving the system to keep pace with technology and always placing the privacy and security of Australia’s health information first.
Changes to the system also keep pace with new, proven health technology. For example, the Agency’s mobile developer program uses Fast Healthcare Interoperability Resources (FHIR APIs), the latest in interoperable health standards.
The system was designed around privacy, security and consumer choice. It has been assessed by Australia’s leading cyber security agency, the Australian Signals Directorate, which found the system has world leading consumer control. A recent international comparison review of digital health record systems showed My Health Record consumers, in Australia, have more ability to personally control their digital health information than in similar countries, worldwide. Out of the 50 countries surveyed, only digital health systems in Australia and France allow individuals to edit or author parts of their record, demonstrating My Health Record’s advanced technology and offering to users.
My Health Record includes a variety of rich clinical and administrative information from sources including:
·         the Australian Immunisation Register (operated by Medicare);
·         the Australian Organ Donor Register (operated by the Department of Human Services);
·         the Medicare Benefits Schedule and Pharmaceutical Benefits Scheme (operated by Medicare):
·         discharge summaries from connected hospitals;
·         shared health summaries from GPs; and
·         medical documents from specialists, pathology and radiology clinical settings.

Over 98% of documents in My Health Record are computer (machine) readable. Only 1-2% of the content in My Health Record is in the form of PDF documents, and of these many are computer readable.
The system is developed in consultation with clinical experts, including the Agency’s Clinical Reference Group (CRG). The clinicians are users of the system who ensure the Agency’s digital health systems, products, services and programs are quality assured and user-friendly, clinically safe and providing what users and patients need.
More information about the My Health Record system can be found here:

https://www.myhealthrecord.gov.au/

This is the link:

A quick list of what is missing from their comments.

1. No mention that people have been enrolled into the on Government whim with opt-out implemented.

2. After 6 years no real evidence that the system is actually helping clinically or financially.

3. Claims of detailed consultation during development of the PCEHR are really not true. It was a rushed politically driven job.

4. In a great blog Grahame Grieve agrees the #myHR is mostly a collection of CDA documents that work like .pdfs – to quote
“I’ve given up trying to dispute the language – programmers and analysts working directly with the system know better, but since the system mostly functions like a repository of PDF documents, I think there’s bigger things to focus on. 
But if you like precision in your language… the MyHR is a CDA based system, not a PDF based system.”
Here is the link:

5. I look closely and I can see little international recognition and a fair bit of laughter.

6. The so called “constantly evolving” #myHR is recognised as being obsolete and in need of a major tech refresh!

7. The level of disinterest in the system from medical practitioners – despite financial incentives etc. signals the system does not provide what is needed – as does the rush to sign up pharmacists.

8. That 48/50 countries don’t allow patient editing or suppression of clinical records probably tells you something.

I will leave the reader to find all the other little distortions and part truths in the document.

David.

7 comments:

  1. David.

    I think you are looking at fake news.

    This ADHA page
    https://www.digitalhealth.gov.au/about-the-agency/tenders-and-offers

    says:

    Tenders and Offers

    We do not have any current tenders and offers - keep an eye out for updated information.

    ReplyDelete
  2. That the clinical leads walked out in 2012

    That it is closer to 10 years old

    That unlike the fax and encrypted email the system has not evolved to meet the changing world

    Any experts are now no longer involved and the ADHA is an empty think tank

    ReplyDelete
  3. Anonymous at 4:22pm

    It's not fake news. As David says, it's here: https://www.tenders.gov.au/Atm/Show/c120551a-5788-49ac-bae4-7ef26e867c07

    As we can see, the ADHA is asking the industry to advise it on how to do its job.

    ReplyDelete
  4. Dr Ian ColcloughOctober 03, 2019 6:51 AM

    It is more than reasonable for ADHA to "ask industry". The problem lies in HOW it asks and HOW it responds to the feedback it receives and HOW it relates to the industry. On all three counts it has no idea and therefore ADHA fails completely.

    ReplyDelete
  5. @10:13 PM

    If it isn't fake news (and I was being sarcastic) it's incompetence on ADHA's part.

    ReplyDelete
  6. Dr Ian ColcloughOctober 03, 2019 8:07 AM

    .... and also HOW it perceives industry, which includes technology and health service delivery.

    ReplyDelete
  7. If you ask industry you are going to get very biased results, based on self interest and industry, for example, knows it would cost a lot of $$ to make their software compliant so they will say compliance is not an issue. The ADHA should really have a good understanding of all the issues and they do not. This is why good governance should be directed at not inventing standards, but simply saying that is you use a standard you have an obligation to be compliant for the sake of patient safety. Every vendor has the opportunity to participate in the standards process so this gives them the ability to ensure the standards are sensible. Currently they just ignore standards and say things like "We have been doing (This non-compliant thing) for 15 years and don't see a reason to fix it"

    ReplyDelete