I really do despair at the nonsense supposedly well-informed commentators come up on Digital Health.
The following is a real beaut!
Health technology report
April 7 202
Australia needs a new prescription for healthcare – a focus on prevention and wellness, enabled by technology.
To help meet this challenge, the Australian Academy of Technology and Engineering (ATSE) has drawn on expertise from across the nation to prepare a map for step-change, to prepare A New Prescription: preparing for a healthcare transformation.
Download the full report
ATSE-Tech-Readiness-Health_full-report
Download a four page summary
ATSE-Tech-Readiness-Health_report-4-page-summary
For several decades, Australia’s healthcare system has increased life expectancy and improved quality of life.
Now healthcare in Australia is under strain, challenged by an ageing population, chronic illnesses, evolving consumer behaviour, and changes in the type and frequency of
emerging diseases.
The digital revolution has readied Australia for a more rounded approach to wellness, and a radical shift to preventive healthcare. A New Prescription outlines how we can take best advantage of existing and emerging technology, to kick-start that shift.emerging diseases.
In the decade to 2030, we predict:
- paper files will disappear, replaced by secure electronic health records
- health professionals will share patient information through universally accessible software
- big data will enable accurate monitoring and prediction of population health trends
- precision medicine will be more common, with prevention and treatment targeted to individuals
- genetic testing and screening for preventable disease will become affordable
- smart devices, mobile health and telehealth – all linked through a digital health record – will enable a real-time holistic picture of a person’s health.
- technological solutions to the problems of distance and mobility will enable affordable healthcare access for more Australians, when and where we need it.
The Australian Academy of Technology and Engineering is undertaking a major three-year (2018–2020) Australian Research Council Learned Academies Special Projects-funded research project to examine the readiness of different Australian industry sectors to develop, adapt and adopt new and emerging technologies, with a horizon out to 2030.
The health technology sector is the second industry sector to be examined by the project.
Here is the link ( where the reports can be downloaded from):
So what we have here is a Government Funded research report which is utterly confused about who in the health system does what to whom and how information and information flows work in the sector.
Their most critical and first recommendation.
Transition to interoperable electronic health records
All healthcare providers must switch to electronic records as soon as possible. Social licence for this move will fundamentally depend on well-communicated privacy and cybersecurity frameworks.
The most critical priority is the digitisation of health records. Integrated care relies on electronic health records, which are essential for efficient, accurate, timely and patient-centred care. Without a shift to electronic records, the fragmented healthcare system will not cope with increased volumes of data and the emergence of digital technologies, nor with personalised healthcare.
To underpin this transition, ATSE recommends:
- Conversion to electronic health records should be mandatory for all healthcare providers in Australia.
- The Australian Government should lead the development of interoperability standards for digital health.
- A public campaign should be launched to improve take-up and awareness of electronic health records
- Patients should retain the choice to opt out of having their information shared to a personal health record, such as My Health Record
- Creating a national framework to strengthen health data privacy and usage, and build social license for the transition.
We need the support of research and industry to build a future healthcare system based on digital technology, and have identified three critical questions for the next decade:
- How can existing and new technologies be integrated within different health settings or contexts? How do we ‘join up’ the health data ecosystem?
- How can we best build public confidence in digital health technologies?
- How can we shift perspective to value data, rather than regarding it as a burden?
----- End quote.
I cannot really believe just how stupid this is and how it betrays a total lack of understanding of the health system. The top recommendation – “Conversion to electronic health records should be mandatory for all healthcare providers in Australia” – seems not to grasp that the vast majority of GPs already use electronic health records. Are they proposing MANDATORY EHRs for nurses, physios etc. as well or what? Who on earth is going to pay for and support this?
As far as recommendation 2, last I looked the ADHA was a Commonwealth Government Agency that was doing just this – successfully or not is up to you.
I suspect the reason this report is clearly such a load of rubbish is that the beneficiaries of all this disembodied technology (the docs, nurses and patients) were basically not involved.
See here – hardly a clinically aware and connected group.
Project Steering Committee..
• Professor Hugh Bradlow FTSE (ATSE President; former Chief Scientist, Telstra)
• Mr Phil Butler FTSE (Chairman, Textor Technologies)
• Mr Drew Clarke AO PSM FTSE (Chair, AEMO; Director CSIRO & NBN; former Secretary
Energy and Communications Departments); Steering Committee Co-Chair
• Professor Mark Dodgson AO (Professor of Innovation Studies, University of Queensland
/ Imperial College London)
• Mr Michael Edwards FTSE (General Manager, Boeing Research & Technology Australia)
• Ms Kathryn Fagg AO FTSE (Board Member, Boral), Steering Committee Co-Chair
• Dr Erol Harvey FTSE (Head of Strategy and Research Translation, Bionics Institute)
• Mr David Thodey AO FTSE (Chair, CSIRO Board; former CEO, Telstra)
Project Expert Working Group..
• Emeritus Professor Simon Foote FAA FTSE (Emeritus Professor, The John Curtin School of Medical
Research, The Australian National University); Expert Working Group Co-Chair
• Dr Carrie Hillyard AM FTSE (Chairman, Leukaemia Foundation, Director, Fitgenes Australia Ltd)
• Dr Cherrell Hirst AO FTSE (CEO and Deputy Chair, Lifesciences Venture Capital
Fund QIC BioVenture)
• Dr Anna Lavelle FTSE (Chairman, Medicines Australia)
• Ms Sue MacLeman FTSE (Chair and Non-Executive Director, MTPConnect);
Expert Working Group Co-Chair
• Dr George Morstyn FTSE (Director, Actinogen Medical Ltd)
• Dr Tracie Ramsdale FTSE (Director, Anatara Lifesciences)
• Dr John Ramshaw FTSE (The University of Melbourne; former Chief Research Scientist, CSIRO)
• Professor Karen Reynolds FTSE (Professor of Biomedical Engineering, Flinders University)
• Professor John Skerritt FTSE (Deputy Secretary for Health Products, Department of Health)
• Professor Greg Tegart FTSE (Adjunct Professor, Victoria University)
• Professor Alan Trounson FTSE (President, Hudson Institute of Medical Research)
Basically I think we, as taxpayers, should be given our money back!
What a load of misguided technobabble! This is an example of seeking to apply all sorts of technology in a sector in which you are totally clueless! Download and be amazed!
David.
p.s. For rank opportunism the current front page is ripper!
See here:
D.
28 comments:
It does seem to be the same old bullet point objectives that are used by all. Nothing new or exciting I have to say. Perhaps instead of “A New Prescription“ it should read “Another Placebo”
I was invited to participate in one of the round tables.
I suspect my opinions were lost in the noise and prejudices of the researchers who produced the report. The prejudices come from reading similar reports such as Crossing the Quality Chasm: A New Health System for the 21st Century published in 2001 by the Committee on Quality of Health Care in America, Institute of Medicine
There is very little of substance in the ATSE report that is different from the many other similar reports published since 2001.
It is interesting to read what the medical profession thinks the major problems are in clinical medicine. Two of the most frequently mentioned are Diagnostic Errors and the issues of bias and poor specificity in so called Evidence Based Medicine.
Neither of these are raised as issues in the ATSE report, which says, essentially, We Need Better Technology.
IMHO, what we need is better ways to solve longstanding problems, not just different ways to solve old problems.
Clinically, a digital health record is very little different from a paper health record. More data is not necessarily better. Different data, better analysed and used, probably is.
Ever so many apparently highly knowledgeable, important and well-connected people have lent their names to this Report. I wonder why.
Does this Report do them credit? I don't think so, but others may. I find this very sad indeed because there are so many genuine, intelligent and well-meaning individuals associated with this Report. It's clear they don't know that they don't have much understanding of the health industry, its complexities and what is needed to develop a new health service delivery model to address the many complex and wicked problems confronting the health system.
Not knowing what they don't know, whilst promoting technology as the 'solution', is simply repeating the same mistakes of years past thereby perpetuating the damage that the random application of technology has done to fragmenting the delivery of health services. Even more disconcerting is that such reports tend to take on a life of their own and become the basis for attracting funding to establish huge ill-conceived technology projects on a pathway to nowhere.
Why has the Government funded this? Is the intent to provide support for the ADHA or is it to open another way forward for replacing the ADHA under another guise? Is it intended as the first step to creating a new agenda, albeit haphazard and shallow, as the basis for beginning a new project in health and ICT to deliver that which the ADHA has been unable to deliver?
The overriding emphasis throughout the Report "A New Prescription - preparing for a healthcare transformation" is all about 'technology'. It does nothing to analyse or discuss the problems confronting health care service delivery and how to resolve them. This is understandable when one considers that ATSE sees technology as the solution for solving problems.
As a consequence the fundamental steps, of first defining the problem(s) to be solved within the context of data and information workflows, become submerged and relegated to 'insignificance' against the overriding desire to embrace and promote technology as the panacea to the health systems problems.
A huge amount of effort has been invested in preparing this Report which clearly is intended to form the basis for some wide-ranging market research projects, but what exactly is envisaged will be delivered and for what purpose?
I have no idea and there is little to suggest ATSE does either.
The use of Transformation shows there is little appreciation of the contributing factors that go into “transformation” in a system context. Many things need to be addressed before technology. None of which are new.
Perhaps that is the intent, focus on machines that go ping to avoid discussing funding models, value propositions, equity, equality.......
The Report is stuffed full of techno-babble. It's a dreamers' dump of anything and everything related to technology and where it might have some kind of applicability one day in health. But so what?
Is this a New Prescription for transforming healthcare? Definitely not. More than anything else it's a marketing document constructed to convince the gullible reader the future has arrived.
Is it of any use? Perhaps. Much use? Not really, unless it can be used as a Reference Doc to provide some artificial credibility for a variety of purposes.
David, your descriptions "A Huge Collection Of Ignorant Guff On Digital Health" and "A load of misguided technobabble!" nail it. It's nothing more than a technology marketing document for pushing technology into the health sector.
There's nothing new here, it's just a cut and paste consolidation of everything that's been written before.
@12:43 PM Mmm ... ".. nothing new .."? Surely you would agree that this is 'new(s)worthy'
Page 114
ATSE’s research and stakeholder consultations revealed a consistent and common theme: the
current system of healthcare delivery is fragmented, inefficient and unsustainable. We must
use technology to support a shift in focus to a patient-centred, outcomes-focused, value-based
system of healthcare delivery. Supporting the healthcare sector to adopt, adapt or develop
technology solutions will catalyse and accelerate this transition.
Yes - news worthy in about 1980. Has been clear for at least 40 years. Still nothing has really happened!
David.
@1:05 PM I agree with you and all the above commentators. It's interesting to note that a total of 301 references have been cited. Someone, or some organisation has had a DATA FILE DUMP. CSIRO?
I had a (remote) meeting with three senior people in ATSE days prior to this report being issued. The meeting wasn't specifically related to the report but I mentioned it and spoke about some of the impressive work being achieved in the sector, assuming they would share my enthusiasm. Instead, I was surprised that they'd never heard of the MSIA or other organisations or digital health strategies. In my view, ATSE should have closely consulted the experts developing the tech and those who use it. (Sorry Grahame, they hadn't heard of you either, despite the report talking about interoperability.)
Also surprising was when they described the project as just "a report for hire" funded by the federal government. So rather than giving those grant dollars to AIDH or another specialist organisation, the government gave it to one with no apparent passion for just how vital, complex and pioneering the work going on here is. That's presumably why the report says nothing particularly groundbreaking.
@6:26 PM ... just "a report for hire" !!
What exactly does that mean?
As 10:39 PM asked "Why has the Government funded this"?
The only valid conclusion one can reach is that ATSE has done itself a huge disservice undermining it's credibility and that of all those who have put their names to the Report. No doubt they will be very angry when they finally realise how they have been duped.
> Sorry Grahame, they hadn't heard of you either, despite the report talking about interoperability.
Sigh. I will pick up the pieces of my shattered life and try and keep going... :-)
> Also surprising was when they described the project as just "a report for hire" funded by the federal government.
government consulting 101... nothing to see here. (https://healthitnerd.blogspot.com/2008/11/turkey-for-thanksgiving_27.html)
@6:26 PM said "the government gave it to one with no apparent passion for" .....
Are you suggesting here that ATSE actually WROTE! the Report. If so incredible incompetence and naivety, on the other hand if they sub-contracted it out then they should be asking for their money back.
These individuals formed the Project Team who wrote the document:
Ms Jasmine Francis
Ms Riajeet Kaur
Ms Robyn Lawford
Dr Michelle Low
Dr Matt Wenham
Ms Alix Ziebell
Of the four worker bees from the AATE who ran the round table these were their positions:
Policy Analyst and project manager (PhD in geology)
Policy Analyst (Physicist)
Policy Analyst (Chemical Engineer)
STEM Graduate Policy Intern (Applied Science - Biotechnology, currently doing a PhD in nanoparticle-based vaccine delivery systems.)
In introducing myself to them, I included this in an email:
"There are many claims, mostly from vendors and proponents of technology solutions that their approach will transform healthcare. The reality is that these solutions are incremental changes that are little more than new ways of delivering old solutions. Sometimes these solutions deliver some value – these are mostly confined to administrative functions or better communications. In some cases, they are having a detrimental impact on the performance of clinicians.
In my view, what healthcare needs is the genuine transformation of clinical medicine – new ways to solve old problems.
My research has identified that very little work has been conducted to identify what the root problems are with the practice of clinical medicine. My analysis strongly suggests that, as in other transformations, a completely new approach is required to solving these problems."
None of that should come as a surprise to anyone reading David's blog.
This is from one of their emails:
"Your insights into the advancement of clinical medicine, and the transformation of the healthcare sector will be incredibly valuable to the discussion. The final session at the roundtable will focus on identifying key policy actions and research questions that should be addressed over the next decade. We would be very interested in hearing what approach you would recommend, based on your experience and the outcomes of your research."
I don't think they understood a word of what I said to them.
Ms Jasmine Francis
Ms Riajeet Kaur
Dr Michelle Low
were on the roundtable. The Project Manager left the team in November last year
Read this, there will be questions at the end:
Italy during 17th century pandemic lockdown is a lesson for our times
https://www.smh.com.au/culture/books/italy-during-17th-century-pandemic-lockdown-is-a-lesson-for-our-times-20200402-p54ggo.html
Take particular note of:
"Italy was forced to grapple with contagion when the plague hit in 1630
...
In the winter of 1629 plague had been found in the French region of Languedoc on the Provencal coast, so the Tuscan state had banned its inhabitants.
Four months later, when Milan officially declared it was a plague state, Florence banned the entire Milanese Duchy, down to the Bolognese border. The Apennines, to the north and west, were a natural cordon sanitaire so Florence sent mounted troops to patrol the mountain passes.
Five or six soldiers manned posts at halfmile intervals. Travellers without a valid health pass were arrested and imprisoned. If they refused to return to where they came from, the soldiers had permission to shoot them. Hard border, 1630.
...
Each state and city did it their own way. Trespiano quarantine and treatment became the model for Florence. The aim was containment. In Florence,when the Sanita realised the plague could not be contained in Trespiano, private villas and public buildings were commandeered and set up as special plague hospitals called lazaretti.
The sick were treated with compassion and sense. Separate rooms were assigned to men and women, each hospital had its own doctors – often clothed in their extraordinary protective outfits – nurses and cleaners.
Hygiene, often assumed to be a result of the age of bacteriology, was observed to the highest standards: straw mattresses were burned, bedlinen washed or burned, houses of the infected meticulously scrubbed and fumigated with sulphur, and contaminated clothes were ordered to be burned. The clothes, valuable items, proved to be a constant source of petty crime.
Public gatherings, even at church, were forbidden but Church and State were generally in unison. Travelling across the city or into the rural areas was forbidden. Any suitable buildings, regardless of who owned them, could be seized for those in quarantine and recuperating. Stage 2 lockdown, 1630."
Two questions:
1 In terms of our ability to cope with plague/coronavirus, what has changed in 400 odd years?
2 What difference has technology made?
My answer to 1 is: not much.
re 2: it has made things worse. In 1630, the plague was largely limited to parts of Europe. Today it is global. Why? because of the technology of personal travel and global trade.
In both cases, medical care was limited to keeping people alive until their natural ability to develop resistance and immunity kicked in.
I'm not saying that our understanding of medical science hasn't changed. Technology plays an enormous part in testing and the development and use of vaccines, but there are large areas where technology either hasn't helped or has made things worse.
That technology is a two edged sword is not exactly news. Read
Why Things Bite Back: Technology and the Revenge of Unintended Consequences
by Edward Tenner, Steve Kramer, et al.
which was published in 1996.
Check out the section in the ASTE report that discusses unintended consequences, risks and warnings about the use of technology in healthcare.
Good luck, I can't find anything. Maybe you'll have more luck. Let me know if you see anything.
Just so everyone knows I send this to the ASTE a few days ago.
-----
Hi,
I have just has a look at your healthcare report of April 7.
https://www.atse.org.au/research-and-policy/big-issues/helping-australia-get-technology-ready/health-technology-report/
It is a profoundly disappointing and sadly ignorant report that totally fails to appreciate or understand the Healthcare ecosystem it is attempting to make recommendations about. There is no sense the complexity of the issues raised or that in any real way are they understood. Technology is an enabler not a solution to most of the problems mentioned.
The lack of any recognisable Health Informaticians contributing to the report is probably the reason.
Can I suggest you contact the CEO of the Australian Digital Health Institute (Dr Louise Schaper) (e-mail copy to her of this comment) to obtain some expert advice on how this report may be dramatically improved, and possibly made relevant in these difficult times.
Best regards.
David.
---- The silence has been deafening!
David.
There's none so blind as those who will not see...
@April 17, 2020 9:58 AM You should also have sent them your blog entry on this subject and your readers comments.
@11:57 AM As ATSE wrote the report none of your views may ever reach the Board. You should be writing to a few of the Board Members like David Thodey.
ATSE has posted an article on its website about the technology dealing with the pandemic: https://www.atse.org.au/news-and-events/article/using-technology-to-get-through-the-pandemic/
Within it they blithely suggest that all tech is awesome! Like China using a global pandemic to roll out facial recognition! Yay!
Obviously, those of us within the industry think that technology is great within reason. As a think tank, ATSE should preferably take a more responsible line.
@9:58 AM David I doubt the Exec. will be eager to pass your comments upwards to the Project Steering Committee or the Project Expert Working Group or The ATSE Board https://www.atse.org.au/about-us/the-board-and-committees/.
Is that their problem or mine...?
They are clearly a governance free entity who has no accoutability to either the living (or the dead).
What a collection of self important wankers!
David.
Grahame: In addition to your comment making me lol, that link was gold
Thanks! HealthITNerd was funny, but didn't last
@9:15 PM It's not their problem if they don't know they have made a huge stuff-up. On the other hand if the Board becomes aware of the stuff-up maximus they may attempt to do something about it.
It only becomes your problem if you genuinely believe ATSE has made a huge stuff-up and your concerns do not come to the notice of the ATSE Board.
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