In the last week or so we have had the ADHA ramp up its spin supporting the #myHealthRecord.
First we had this:
Media Release: My Health Record sees a 62 per cent increase in general practitioners viewing documents
23 December 2019: According to data released by the Australian Digital Health Agency (the Agency), general practices increasingly lead the way in using My Health Record, with usage (viewing and uploading) rising substantially since March 2019.
In data released in December as part of a refreshed My Health Record statistics dashboard, general practices averaged around 200,000 My Health Record views per month throughout September and October, a 62 per cent increase since March this year.
- Since March, monthly cross-organisation views have increased by 140 per cent.
- General practices are viewing the most documents uploaded by other healthcare providers, and the documents they upload are most frequently viewed by other healthcare providers (including other general practices).
- 90 per cent cent of general practices are registered for My Health Record, with 71 per cent using the system as at November 2019.
- General practices are one of the leading healthcare provider groups in both registration and usage, along with pharmacies (90 per cent registered and 69 per cent using) and public hospitals (94 per cent of beds registered).
- General practices also upload between 2 and 3 million documents to the system every month.
Dr Harry Nespolon, President of the Royal Australian College of General Practitioners, said general practitioners may be more inclined to use My Health Record because of the nature of their work.
“Many general practitioners are treating patients with complex or chronic conditions, so they need to be able to make decisions that are informed by a wider view of a patient’s health.
“Further, general practitioners tend to facilitate patients’ interaction with the health system as a whole, so they may be quicker to look for information from other healthcare professionals,” said Dr Nespolon.
Using My Health Record allows general practitioners to access and contribute to a digital summary of their patients’ previous diagnoses, outcomes, medications, reactions and allergies. But My Health Record can also directly empower health consumers, too.
That was the case for Corey, a 24-year-old man who was once under the care of a pain specialist and was prescribed a complex medication regimen. “I was on a lot of medications, many of which made my memory far more unreliable,” says Corey. “During this time, I used the medications list on My Health Record to help me remember which medications to take and when. There was also a section where you could keep your own notes, which I used to keep questions to ask my doctors.”
Even though Corey is no longer taking medication that impacts his memory, he’s still using My Health Record to take a more active role in managing his health with his regular general practitioner and two specialists.
“I still find the pathology results section useful for getting my results and reviewing them before seeing my doctors, which often helps me to assess and question the information being given to me. After discussion, I sometimes make requests based on what I believe will work best for me. My doctors sometimes accept those requests, other times they’ll recommend alternatives,” Corey said.
The Agency will regularly release statistics offering more detailed insights into how healthcare provider organisations and consumers are engaging with My Health Record.
Professor Meredith Makeham, the Agency’s Chief Medical Adviser, noted “While registration is an important metric for the volume and type of healthcare provider organisations moving toward My Health Record, views and uploads can be better measures for showing how the system is being used meaningfully for patient care.” “These figures demonstrate the way healthcare providers are sharing information and show the increasing value that My Health Record is delivering to practicing clinicians. My Health Record allows us to see important details that we wouldn’t have otherwise had access to view,” Professor Makeham said.
ENDS
Here is the link:
Then this, this week:
Media Release - Increased use of My Health Record by healthcare providers
28 January, 2020: Healthcare providers have uploaded documents to an additional 490,000 My Health Records in one month.
This takes the total in December 2019 to nearly 13 million My Health Records with information in them, up from 12.5 million in November.
Also, between November and December, there was an 11% increase in the volume of medicine documents uploaded by healthcare providers like GPs and pharmacies, to more than 100 million documents and a 13% increase in clinical documents uploaded by healthcare providers like hospitals, pathologists and radiologists.
In December alone, GPs uploaded nearly 3 million documents and their viewing increased 10%.
The total number of documents in the My Health Record system is now 1.7 billion.
These December 2019 My Health Record statistics were published today by the Australian Digital Health Agency (the Agency).
Professor Meredith Makeham, the Agency’s Chief Medical Officer, said “While it was not expected that all My Health Records would have documents uploaded in the first year as not everyone would see a GP or other connected healthcare provider service in that timeframe, we are now seeing significant increases in uploaded clinical documents and My Health Records with valuable clinical information.”
Paul Smith, a pharmacist at Capital Chemist in Huskisson NSW, was able to dispense medications to both locals and visitors trapped in the town by bushfires.
Mr Smith said “In the lead up to New Year’s Eve, Huskisson and surrounding towns in NSW had an unusually large number of travellers and locals seemingly stranded without their prescriptions or regular medications. These medications included your run-of-the-mill blood pressure tablets and the like, but there were patients without their insulin, anti-epileptic medications, anti-depressants, preventative asthma inhalers, and numerous others.”
“Having access to the My Health Record database certainly helped me a great deal during this unprecedented time, as I was able to ensure a continuity of care in a safe and legal fashion.”
“The main hurdle I faced was assisting patients who had chosen to opt out of the My Health Record system. It is an extremely bad situation to be in when there were no local surgeries open, the roads to the closest public hospital were closed, and the person had nothing to show you that they are normally prescribed.”
Key statistics from March 2019 to December 2019:
- 22.68 million My Health Records (an increase of 30,000 in December)
- 12.99 million records with information in them (an increase of 490,000 in December)
- 1.7 billion documents in the system (100 million increase in December)
- 49.3 million clinical documents (5.7 million increase in December)
- 101.4 million medicine documents (9.8 million increase in December)
- Hospitals uploaded 500,000 more documents in December than November
The Agency’s My Health Record statistics are published on the My Health Record website regularly to provide more transparency around how the system is being used by consumers and healthcare providers.
ENDS
Here is the link:
And we had propaganda emissions like this:
Bushfire emergency highlights the importance of updating patient information on My Health Record
29/01/2020
The Shared Health Summary (SHS) represents the patient's health status at a point in time. SHS can be created at any consultation, and may include information about a patient's medical history, including medical conditions, medicines, allergies and adverse reactions and immunisations. This is likely to be the first document accessed by any other healthcare professionals.
In the current state of bushfire emergencies, My Health Record is a potential source of information Healthcare providers may not have otherwise had access to. My Health Record had significant benefits in the 2019 Townsville Floods where access to medicines information became a significant comfort to many displaced people who lacked access not only to their medicines, but to information about them.
The Shared Health Summary (SHS) represents the patient's health status at a point in time. SHS can be created at any consultation, and may include information about a patient's medical history, including medical conditions, medicines, allergies and adverse reactions and immunisations. This is likely to be the first document accessed by any other healthcare professionals.
In the current state of bushfire emergencies, My Health Record is a potential source of information Healthcare providers may not have otherwise had access to. My Health Record had significant benefits in the 2019 Townsville Floods where access to medicines information became a significant comfort to many displaced people who lacked access not only to their medicines, but to information about them.
Here is the link:
Somehow they seem to think, as has been shown to be false, that access to the #myHR can be relied on in emergency situations like flood and bush-fires. Loss of power and the internet make access rather moot.
Also the way these statistics are just run out earlier is amazing.
Also the way these statistics are just run out earlier is amazing.
A claim that ½ the records have some data in them – aged and trivial though much of it my me – does not disguise the fact that the other ½ are totally empty.
This is a good example of a contextless fact, like the claim of holding 2 billion documents. Another is this.
“In data released in December as part of a refreshed My Health Record statistics dashboard, general practices averaged around 200,000 My Health Record views per month throughout September and October, a 62 per cent increase since March this year.”
From this link we know Australian GPs see about 110 patients a week (call is 440 a month).
We also know there are about 35,000 active GPs in Australia. This means there are about 15.4 million patient encounters a month.
Simple division shows that one in 77 encounters involves the #myHR so it is used by the average GP about 6 times a month! Hardly what you would call regular use.
It is interesting to note at the statistics site the GP use of any part of the myHR has risen to 220,000 or a 10% rise. You can see for yourself that to have use say every 5th encounter might happen will need usage to jump hugely – which won’t happen in my lifetime at the present rate of uptak!
Here is the link:
Of course the key statistic regarding upload and look up of Shared Health Summaries has not been available for 6+ months.
The key point in my mind is that the ADHA should be providing full detailed information free of spin. To do less just is not good enough – although with the way we have seen the ‘sports rorts’ handled, I am not sure the ADHA isn’t simply following ‘Government Policy’!
Also of interest is the uncritical way the media just regurgitate the ADHA press releases with absolutely criticism or skepticism. I would be good to see some questioning of the spin!
Also of interest is the uncritical way the media just regurgitate the ADHA press releases with absolutely criticism or skepticism. I would be good to see some questioning of the spin!
What do you think?
In passing does anyone know what the 3 million documents that GPs have uploaded in December actually are? They are not Shared Health Summaries for sure.
David.
Professor Meredith Makeham, the Agency’s Chief Medical Adviser, noted "While registration is an important metric for the volume and type of healthcare provider organisations moving toward My Health Record, views and uploads can be better measures for showing how the system is being used meaningfully for patient care."
ReplyDeleteA better measure is the use to which the information is put. Just viewing is meaningless if you are a GP. A GP is probably checking to see if some numbskull has over-written their summary.
An even better measure is how much the thing has saved the healthcare industry and the government. So far nobody has made any such claim; even a dubious one.
"In passing does anyone know what the 3 million documents that GPs have uploaded in December actually are? They are not Shared Health Summaries for sure."
ReplyDeleteMore to the point what are the 5 million documents pharmacists are supposed to have uploaded?
My guess is that these "documents" are all associated with MBS/PBS transactions and have little to no health care relevance.
Does anyone know if some or all clinical software automatically connects with a patient's myhr when a GP opens a patient's record in their local system?
ReplyDeleteIf so, is it possible that this is being interpreted as a GP "viewing" a patient's myhr?
Great question Bernard.
ReplyDelete@3:15 PM If you are correct it would raise a huge number of questions that from the Morrison Gonernment's perspective would make the 'sports rort' pale into insignificance.
ReplyDeleteHospital systems would, they would do batch uploads. Other CIS type systems probably do at least a lookup to see if you have a record. I know Ramsey Health tell you if you are covered by insurance and have a MyHR.
ReplyDeleteThere is also the yet to be resolved issue where documents are rejected without the sending system being notified
Rather makes mockery of all the statistics. I wonder if any humans actually look at anyone's health record for healthcare purposes. It would appear to be computers talking to computers. A sort of write only memory.
ReplyDeleteMaybe the police are the only humans who access My Health Record, trying to find is someone is dead, or where they live or where they were on a particular date. It's much more useful as a surveillance system than a health record. Peter Dutton and his people probably love it.
Maybe the professor would like to clarify, or the digital visionary they have or perhaps even the national CIO
ReplyDeleteWhat makes you think that anyone at ADHA or Accenture understands the meaning of the stats they gather? If a GP system interacts with MyHR, then it is obvious to management that the GP has viewed the record - because that's what they want to believe. Unfortunately, from "Scotty from Marketing" down, everything about this government is perception and spin.
ReplyDeleteOn ABC Q&A Senator Molan was questioned about climate science.
ReplyDeleteSenator Molan said: "And I respect very much scientific opinion but every day across my desk comes enough information for me to say that there are other opinions."
Asked once again to answer the question and "what is the evidence you are relying on?" by Macdonald, the senator gave an unpopular answer.
"I'm not relying on evidence, Hamish," Senator Molan said, prompting heckles from the crowd, as well as parliamentary peers and commentators on social media.
It would appear that evidence is only acceptable if it agrees with their biased, one eyed opinion.
You can't argue with these people.
A friend in the UK alerted me to this - https://www.hsj.co.uk/comment/how-caredatas-failure-helped-transform-australian-healthcare/7026835.article
ReplyDeleteHow care.data’s failure helped transform Australian healthcare
By Tim Kelsey3 February 2020
Tim Kelsey
Australia has one of the best health services in the world with some of t.......
As you can imagine it is not gone down to well over there. Arrogance is to small a word.
Talk about 'polishing a turd'!
ReplyDeleteDoes anyone have access to the full text?
David.
Australia has one of the best health services in the world with some of the best outcomes.
ReplyDeleteBut it could be better: as many as 250,000 avoidable hospital admissions are reported to occur each year because of medication misadventure; up to 18 per cent of diagnostic tests may be duplicated; it has serious issues with equity of access for those living in remote and rural Australia, particularly among indigenous people whose lifespan is, on average, eight years lower than residents of the more prosperous suburbs on the Eastern seaboard.
I have travelled across this continent on many occasions and the distances are still eye-watering – it can take five hours to fly from Perth to Sydney, longer than from London to Moscow. It is difficult to imagine a better case for the use of basic digital services, like video consultation, to empower people in remote country to speak to a doctor or a nurse quickly and conveniently – but adoption of telehealth has been slow.
For these reasons, the Australian government decided four years ago to put data and technology to work to solve some of these problems and bring an end to the dangerous dependence of Australian medicine on paper and the fax machine.
In 2016, the Australian Digital Health Agency (ADHA) was established to design and implement a new national digital health strategy and I was appointed its inaugural chief executive.
In 2017 that strategy was agreed. At its centre is a set of simple principles: that all clinical information should be shared securely, in real time and with standards that enable common meaning; and that a person should, if they wish, have online access to their key health information and the right to control who else sees it.
The immediate priority was to make people safer: to ensure that key health information, including allergies, medication history, hospital discharge summaries and summary data from general practice is available to all authorised clinicians at point of care, when a person permits it. In 2017, it was announced that My Health Record, the existing online summary health information service, would be expanded to all Australians, unless they chose to opt out.
ReplyDeleteAn individual can remove any information in their My Health Record from the view of one or more of their authorised clinicians. For example, they might choose not to let their physiotherapist access information about their mental health. They also can see who has viewed the record and can subscribe to an SMS or email service that will alert them when it is accessed by a clinician. An individual can also decide to delete their entire record permanently or to allow another person, perhaps their carer, to control it for them.
There was media controversy about the move to opt out amid concerns about the privacy and security of digital health records. The Federal government responded by strengthening the privacy controls even further and to make it illegal for law enforcement agencies to access the record without a court order – a higher standard than for other medical record systems in the country.
Last February the opt out period ended. Just under 10 per cent of the 25m people resident in Australia had chosen to opt out. As people interact with health services, or access it online themselves, My Health Record starts to fill with content. Most healthcare providers are now connected and uploading content, including pharmacies, GPs, hospitals, pathologists and radiologists.
Recently the Australian Auditor General published a review of the My Health Record programme and concluded that implementation was ‘largely effective’. It called out broader concerns about secure management of clinical information by healthcare providers and the ADHA is now working with partners to develop new approaches to standards and compliance.
Lessons from care.data
ReplyDeleteInevitably, the implementation of the My Health Record opt out was influenced by my experience with care.data when I was a National Director at NHS England.
They are very different propositions (My Health Record’s primary purpose is to provide information at point of care; care.data was intended to enable access to de-identified data for analytic purposes). However, there were important lessons to be learned.
One common thread was the need to properly address people’s concerns about the privacy and security of their most confidential clinical information and to ensure they could make an informed decision about the right to opt out – and that it was easy for them to do so.
In the run up to – and during – the opt out period in Australia, there was a major communications campaign. This covered TV and social media, as wells thousands of local events and special programmes for minority and indigenous communities.
A national call centre allowed people to ask questions or opt out. The was also a simple tool if people wanted to opt out online.
The important media debate, which robustly tested the potential benefits of the initiative and investigated the potential risks, also supported widespread public awareness. The ADHA commissioned communication tracking which showed that every Australian had on average 38 opportunities to see or hear about My Health Record within the opt-out period. All general practices and pharmacies received training.
The important media debate, which robustly tested the potential benefits of the initiative and investigated the potential risks, also supported widespread public awareness. The ADHA commissioned communication tracking which showed that every Australian had on average 38 opportunities to see or hear about My Health Record within the opt-out period. All general practices and pharmacies received training.
ReplyDeleteAnother key lesson from care.data was to ensure that a robust statutory framework existed for potential future secondary uses of My Health Record (even though none is currently permitted). In Australia, this was legislated for before the start of the opt out period. It rules out any future uses of de-identified data for any solely commercial purpose, for example, and guarantees that people have the ability to withdraw their consent for secondary uses at any time using a simple consent button on their My Health Record.
The absence of absolutely clear statutory rules for the uses of care.data was one of the reasons that the programme had to be stopped (the law was subsequently amended to clarify permitted uses). Information sharing initiatives in health care, however beneficial, risk the loss of social licence without such statutory frameworks in place.
Will My Health Record realise the benefits anticipated? Will it reduce medication errors because clinicians have access to a person’s recent history, cut avoidable hospital admissions, minimise diagnostic testing, and/or improve patient self-management? Early data is encouraging – the majority of clinicians in one study reported at least one incident of improved clinical decision making after use of My Health Record and the Medical Journal of Australia has highlighted a number of positive case studies.
More time is needed to judge the full impact of My Health Record, but I believe the national strategy of which it is a part represents a significant step forward in the digital maturity of Australian health care and can offer valuable lessons for other countries with the same ambition.
Tim Kelsey was CEO of the Australian Digital Health Agency until January 2020. He is now senior vice president at HIMSS, an international not for profit organisation which promotes digital maturity in healthcare. Before he left for Australia, he was National Director for Patients and Information in NHS England.
Many thanks whoever!
ReplyDeleteDavid.
Tim should have rounded off his little piece of fantasy with:
ReplyDeleteIt cost well over $AUD 2billion and has significant running costs, including reducing the amount of time a GP has available in a standard consultation to attend to patient needs.
So far, after ten years of operation, we have never been able to claim or report on any of the savings that we predicted would accrue from its use.
We are still working on solving one of the major problems that were critical to the operation of the system - interoperability. Because of this failure, we are not able to include any of a patient's history in their health record.
My Health Record was released in July 2012 full of promises and potentials. Those promises and potentials still remain - however none have been delivered.
Meanwhile the ADHA is planning on replatforming My Health Record in an attempt to deliver what was promised. The danger, however is that even the promises and potentials have never been justified and can never be realised.
My Health Record is designed to gather as much data about a patient as possible. We now realise, but would not admit in public, that GPs do not want more data they want better data, better managed and better organised. They want to spend less time uploading data and less effort making sense of the hosepipe of data being thrown at them. My Health Record does nothing to help GPs.
ADHA lives on in hope. That is all they have left.
you forgot to mention that the much touted benefit of MyHR, its use in an emergency, was totally debunked in the recent bushfires when power and internet were disrupted making the thing inaccessible. Oh, and the fact that most MyHRs are empty or very old.
ReplyDeleteIt's about as useful as a chochlate teapot - an analogy the poms would understand.
They have started to say all the right words, like standards, real time and inter-operability, but there is no implementation to back up the words. We need good, tested engineering, not public relations, and I think I have just about given up any hope that anything useful will ever come out of the ADHA. I think even a chocolate teapot is far to technical for them.
ReplyDelete"all the right words, like standards, real time and inter-operability" may be the right words from a technical perspective, but the real words should about the business processes in hospital's, GP's and specialist's environments. What data do they really need, how will they use it, what are the costs and unwanted consequences of gathering it?
ReplyDeleteHealth care is not about health records, it is about the right data used in the right way. ADHA doesn't have a clue about the use of data, apart from "more is better"
Anonymous @9:57am has it right.
ReplyDeleteThere is a fundamental schism between a communications perspective and a data processing perspective.
If we think in terms of information flows to inform, guide, authorize, and enable some care action then the question is: Is it the right information, in-time and on-time and received in the right way to enable said care action?
This is the real interoperability question and one that can only be properly addressed by the clinicians actually delivering the care.
Finally, yes the electronic medical record is important; but it is a static thing. The action is with the clinicians. And for those 'economists' listening this is where the real productivity gains are to be made. Not by some 'technology transformation' paradigm.
@5:39 PM Succinctly expressed John. I hope others who comment here will understand the subtle distinctions you have made about the electronic medical record, and also your observation on the fundamental schism between the two perspectives of communications and data processing.
ReplyDeleteI certainly do, and it would be most reassuring to hear that others do too. Thanks.
In case you missed it
ReplyDeleteNavigating My Health Record one year on
Michael Mackenzie
Life Matters
Wed 5 Feb 2020 09:06am
https://www.abc.net.au/radionational/programs/lifematters/navigating-my-health-record-one-year-on/11929084
Download Navigating My Health Record one year on (20.56 MB)
https://abcmedia.akamaized.net/rn/podcast/2020/02/lms_20200205_0906.mp3
Two of the speakers are ADHA advocates, one a nurse the other a GP. Neither seemed very positive about the system but have to choose their words carefully.
However, they both (and people making comments on-line to the show) made it clear that their patients want and expect a full copy of their medical record to be available on-line automatically.
The presenter went so far as to expect the data to be accurate and up-to-date, without explaining exactly how that could possible happen.
Neither the presenter or the speakers thinks it meets anybody's expectations or had much praise for the system though they did believe that it was a good idea - in theory.
Of the Facebook commenters (29) the ratio of negative to positive is about 10 to 1.
Which is a good time to repeat the second quote at the top of David's blog:
H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."
According to reports today
ReplyDelete"The Morrison government has given the states until the end of the year to connect to a national monitoring system for powerful painkilling drugs in a bid to reduce the death rate from overdoses and avoid a US-style opioid crisis.
Declaring he is 'passionate' about reducing opioid-related harm, Health Minister Greg Hunt has moved to fast-track plans that would give GPs and pharmacists immediate information about a patient’s use of addictive medication."
But doesn't everyone have a My Health Record with all their prescriptions in it?
Why build yet another system that further increases data fragmentation?
Oh, that's right. My Health Record isn't real time. People can opt-out of My Health Record. People can hide data in My Health Record.
Once again My Health Record proves to be white elephant.
And saying you are 'passionate' about something means you've run out of useful things to say so you say something meaningless.
Personally, I'd rather someone was 'competent and effective' rather than 'passionate'.
Fat chance.