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."

Sunday, April 12, 2020

I Think It Is Really About Time Someone Held The ADHA Spinners To Account For Persistently Delivering “Fake News”!

Yet again we have seen a clearly bored and isolated Media Unit from the ADHA delivering blatant rubbish and ‘fake news’!
This release appeared a few days ago.

Media release - Technology delivers social distancing for healthcare in fight against COVID-19

8 April 2020: Technology is poised to further help Australians during the COVID-19 pandemic through electronic prescriptions that will allow people convenient access to their medicines to people practising social distancing and self-isolation. This new development will complement the My Health Record which is already making critical health information available when it’s most needed.
In Australia, evidence shows there are more than 250,000 hospital admissions annually as a result of medication related problems. Many of these are associated with poor availability of medicines information especially at transitions of care. My Health Record is improving this access to medicines information and is an integrated record of what medicines patients are taking to ensure the most safe and effective care.
The My Health Record system has 1.81 billion documents in it including: prescription and dispense information, Pharmacist Shared Medicines Lists, medical history, allergies, pathology and diagnostic imaging test results and immunisations, as well as hospital discharge summaries.

More technology is on its way. Under the Australian Government’s National Health Plan for COVID-19, electronic prescriptions are now being fast-tracked to allow patients to receive vital healthcare services while maintaining physical distancing and, where necessary, isolation.
Electronic prescriptions are an alternative to paper prescriptions, and the solution being fast-tracked will see a unique QR barcode ‘token’ sent via an app (if they have one), SMS or email to the patient. This will allow people in self-isolation convenient access to their medicines and will lessen the risk of infection being spread in general practice waiting rooms and at community pharmacies.
This initiative is designed to support telehealth and will allow a doctor to generate an electronic prescription that patients can then share with a pharmacy.
A significant amount of work had already been done to ensure that necessary upgrades to both pharmacy and prescriber software can be done quickly and electronic prescriptions are expected to be progressively available from the end of May.
Ms Bettina McMahon interim CEO says, “the use of technology in healthcare has never been more critical, and Australia is in a better position than many other countries when it comes to digital health. Electronic prescriptions are another vital tool that will help to create a connected healthcare system for Australia.
“Australians should take comfort that governments and healthcare providers have made significant investment in healthcare technology over the past 10 years. We are now able to fast-track adoption of this tech to respond to this pandemic in a 21st Century way.”
The Agency is launching a new community communications campaign next week to help people understand the benefits of technology in healthcare and the need to ensure the health system is connected to provide better health outcomes for all Australians.
The campaign features Dr Andrew Rochford, a Medical Practitioner with an Undergraduate Degree in Medical Science, Majoring in Anatomy and Neuroscience, Post Graduate degree from University of Sydney Medical School, Bachelor of Surgery with Honours.
Medically, he’s trained in emergency medicine, having held Registrar positions at major teaching hospitals around Australia, including Royal North Shore Hospital in Sydney, Princess Alexandra Hospital in Brisbane and is currently working at the Northern Beaches Hospital.
Dr Rochford is a digital health expert with his own organisation ‘Docta’ which builds customised mobile smart clinics equipped with telemedicine and digital healthcare technology to improve access to healthcare resources and knowledge for people in remote areas round the world. The campaign will feature in radio, online (including catch up TV) and in social media.
Watch the video here or below.
My Health Record statistics (as at February 2020)
  • Nearly 23 million Australians have a My Health Record
  • More than 90% of pharmacies and GPs are registered and 94% of public hospital beds are connected.
  • More than 112 million medicine documents (prescribe and dispense)
  • Almost 40 million pathology reports
  • More than 6 million diagnostic imaging reports
  • More than 6 million discharge summaries
  • More than 4 million shared health summaries
  • 22.71 million My Health Records
  • 13.6 million records with information in them
ENDS
Here is the link:
What can you say?
Firstly it is important to point out that this is another case where actual delivery (of electronic prescribing) is not yet a reality and all we have at present are regulation modifications to allow prescription barcodes, that have been printed on prescriptions for years, to be photographed and sent to a patient or a pharmacy for dispensing. Sure it may work but can you imagine a more ‘Micky Mouse’ and potentially insecure system. All the work on new electronic standards for secure transmission of prescriptions seemingly just scrapped?
Do you think all this would be happening now, if the properly designed electronic prescribing system really was just a few weeks away. I think not! Note what the release says it that all this will be available ‘progressively’ from the end of May. I wonder how long progressively covers?
Here is a discussion of what is going on:

E-prescriptions fast-tracked amid coronavirus crisis

GPs will be able to generate electronic scripts in a matter of weeks, says the Australian Digital Health Agency
9th April 2020
Electronic prescriptions will be rushed in from as early as next month, as part of the Federal Government’s COVID-19 health plan.
Under the solution being fast-tracked, patients will receive their prescription via a unique QR code sent via an app, or by SMS or email to share with their pharmacy, the Australian Digital Health Agency has announced.
“A significant amount of work had already been done to ensure that necessary upgrades to both pharmacy and prescriber software can be done quickly and electronic prescriptions are expected to be progressively available from the end of May,” it said in a statement.
“This will allow people in self-isolation convenient access to their medicines and will lessen the risk of infection being spread in general practice waiting rooms and at community pharmacies.”

In the interim, special arrangements have been introduced to allow GPs to send a digital image of prescriptions via email, text or fax to the patient or their nominated pharmacy.
However, S8 and S4D prescriptions cannot be sent via a digital image, according to the AMA.
Further, the paper script must be sent to pharmacy within 15 days, it said.
More here:
I imagine having the use snail mail to send in the prescription to the pharmacy will infuriate many GPs.
Additionally spare a thought for the pharmacists trying to check if they have a bit of paper 2 weeks later matching a dispense activity that is already long forgotten!
Other than the nonsense announcements on prescribing we have the usual rubbish talking about all the billions of aged documents (now up to almost 10 years old) that your taxes are paying to keep – despite the fact they are of absolutely no use to anyone! The ADHA media unit really love these big numbers - trying to hide the irrelevant nature of most of the documents.
It is interesting to note that despite the document piles over ½ of the records are empty! What a triumph this system is!
And to cap it all off the ADHA is publicising that the #myHealthRecord and Digital Health is seen by the public as being so valuable that we need some stethoscope wearing doc to chat to us via a new advertising campaign hoping to get us all on board. I wonder why we are paying for this? If what the ADHA was offering was any good would we not seek it out?
I wonder when our mutual pain will stop?
David.

7 comments:

Bernard Robertson-Dunn said...

Everyone selling anything in healthcare is claiming their solution is invaluable in fighting the virus. ADHA is no different - they are selling a product which is worth every cent it costs to buy - nothing.

The reality is that the only thing that is working is social isolation.

Apart from the unfortunate few who need to go into ICU and the even fewer who die most of what's going on to cope with the virus has nothing to do with clinical medical.

Many of the consequences are impacting hospitals, GPs specialists, big pharma, small business, airlines, governments and all the "stay at homers".

Health insurance companies are benefiting because there are fewer people getting treatment for "normal" medical problems and elective surgery.

It would be interesting to see the access statistics for the public portal as well as for provider access for the whole of 2020 (i.e. including the bushfires). Uploads (the usual statistics) are meaningless.

These statistics are probably classified to the same level as the evidence in the Witness K case, all under the category of Don’t Embarrass the Government, sorry, National Security.

Grahame Grieve said...

@Bernard

> Everyone selling anything in healthcare is claiming their solution is invaluable in fighting the virus.

Maybe that's because they believe in it? I sure hope they do, and they're not selling something that they don't believe in. Almost everything is a little useful. But at least some of what is being sold is worth while - so the mere fact it's being sold doesn't make it not useful

> The reality is that the only thing that is working is social isolation.

That is far from the *only* thing that is working. What is working is a package of measures:
* social isolation (not that we're very good at it; given how hard China/Europe/USA has had to work at that, we would be good to be skeptical that it's that big a contributor for us, actually)
* closing the borders - very evidently a big deal, and it does look like the government got the timing pretty right on that (with occasional high profile single event fails)
* Test & Trace & Isolate - I think that this is actually our big win, so far. It's not done in the glare of publicity, so it's easily overlooked
* Surge the hospital capacity - so far, we haven't needed it, but the fact it is going on has given the decision makers confidence to give us lockdown-lite
* the change to telehealth as much as possible - giving us all sorts of change control pain, but a huge win for everybody (and you did probably include it in social isolation but I think it's more than that)
* research - both raw and applied, helping calibrate all the other stuff

Soon one of 2 things will happen: either (a) the virus will prove seasonal and slam us hard in may/june (there's support for this in the raw data, but too many confounding factors for any confidence, but it can't be ruled out) or (b) we'll find that we calibrated our response nicely, and we've beaten the virus

But even for option (b), we then confront the fact that in some important parts of the world, they've lost, and the virus will be endemic. What then?

Any view of the future involves scaling test/trace/isolate + quarantine - and that will need a very solid interoperability backbone to scale. I do not believe we have such a thing, nor do I see any efforts to build it.

Please someone, tell me I'm wrong....

Bernard Robertson-Dunn said...

Grahame

re:
the mere fact it's being sold doesn't make it not useful

neither does it make it useful. Check out what chef Pete Evans is selling.

re:

* social isolation (not that we're very good at it; given how hard China/Europe/USA has had to work at that, we would be good to be skeptical that it's that big a contributor for us, actually)

* closing the borders - very evidently a big deal, and it does look like the government got the timing pretty right on that (with occasional high profile single event fails)

They are part of isolation. One at the personal level, the other at the national level.

* Test & Trace & Isolate - I think that this is actually our big win, so far. It's not done in the glare of publicity, so it's easily overlooked

Testing is less than optimal, the others are part of isolate.

* Surge the hospital capacity - so far, we haven't needed it, but the fact it is going on has given the decision makers confidence to give us lockdown-lite

* the change to telehealth as much as possible - giving us all sorts of change control pain, but a huge win for everybody (and you did probably include it in social isolation but I think it's more than that)

* research - both raw and applied, helping calibrate all the other stuff

The others are still works in progress.

re:

Any view of the future involves scaling test/trace/isolate + quarantine - and that will need a very solid interoperability backbone to scale. I do not believe we have such a thing, nor do I see any efforts to build it.

Totally agree (especially test), but, again, works in progress.

We are getting to the end of the isolation phase, the next phase is much harder.

Long Live T.38 said...

None of what either of you says on the broader subject is incorrect. However, let us not hide the fact that the ADHA has lost its currency, in the game-changing world that Digital Health promises, the ADHA position on the field is 'Left-Right-Out' I am not sure many would trust them to deliver the half-time oranges.
They might be good at storytelling and personalising the narrative towards themselves—a trait some world leader has adopted.
So not fast-tracking anything, more had their agenda reprioritised because they are too focused on a centralised solution, that has never demonstrated capability to address a distributed business model.
It is still difficult to be critical of the ADHA publicly, and I would not expect people to bite a hand.

Anonymous said...

The ADHA, My Health Record and Interoperability are all irrelevant when it comes to COVID-ID.

They are irrelevant when it comes to population health and when it comes to individuals the only things that matter are test results and, if the patient is in ICU, close monitoring and life support.

The ADHA can spin all their little yarns as much as they like, but it's all noise in the background.

Anonymous said...

April 13. 2020 1:43 PM. Agree with 2 out of 3. One item is essential but cannot be established on the back of flimsy businesses cases and bs benefits.

Anonymous said...

Deferring the Budget till Sept/Oct has probably given ADHA a reprieve. They will need to hunker down and shrink to become much smaller and more agile.

Redundancies and terminations should now be management's priority to weather the forthcoming laser-like scrutiny and the inevitability of the razor gangs sharp scalpels. Keksey jumped ship at the right time