This appeared last week.
Key lessons from bushfire failures
May 4, 2020
When devastating bushfires hit Australia over summer, our fixed line and mobile phone networks came under great pressure.
At the peak in early January, some 150 mobile base stations across New South Wales, Victoria and South Australia were off the air – and over 20,000 NBN services were down.
The failures were very visible. When busy holiday towns on the NSW south coast and eastern Victoria lost mobile service, it made a bad situation worse.
Locals and tourists lost contact with friends and family. When EFTPOS terminals (many of which run over mobile networks) went down, people could not buy food or fuel.
Many of these problems were fixed quickly – with staff at Australia’s big telcos like NBN Co, Telstra, Optus, Vodafone and TPG, working intensely to get networks restored.
But we need to know exactly what happened – and what we can do to respond better in future.
In January I convened a round table of our telcos – attended by the CEOs of Telstra, Optus, Vodafone, NBN Co and TPG and many other senior leaders from the sector.
Companies reported on some of the issues they had faced – including direct fire damage to base stations and exchanges, loss of power, and difficulties in accessing base stations and exchanges once a fire had passed through.
We agreed that the Australian Communications and Media Authority, working with industry peak bodies Communications Alliance and the Australian Mobile Telecommunications Authority, would conduct an investigation and prepare a report on what happened.
That report has now been submitted to me – and I am releasing it publicly.
It is a valuable fact base – about what happened to telecommunications networks during and after the fires, and how the telcos responded.
One encouraging finding was that most network outages were restored quickly, on average within 3.5 days.
But the report also highlights the scale of what happened. A total of 1,390 facilities were impacted by the bushfires in December 2019 and January 2020.
This includes exchanges, mobile phone base stations, equipment shelters, cables and other parts of the telcos’ networks.
In the great majority of cases, the cause of the impact was a loss of mains power.
It is natural for us to envisage base stations damaged by fire – and certainly there were cases where this happened. I saw a sobering example at Malua Bay on the NSW South Coast, where a mobile base station was left scorched and partially melted after a fire went through.
But according to the ACMA report, this was in fact very unusual. There were 888 separate outage incidents. Of these, only 11 were caused directly by fire damage – while 779 were caused by a loss of power.
These are important facts as we work out how to better prepare networks for future bushfires.
More here:
So it seems that loss of power to internet access points was the key problem for those in the fire zones. The obvious solution of providing internet access via satellite is thus only a very partial solution given internet access is not much use if you phone / laptop has exhausted their batteries. Either way the #myHealthRecord is not a reliable emergency health record – even ignoring is regular planned outages and ignoring how it is often or out of date!
Real emergencies are best prepared for by having a small regularly updated card in the purse / wallet containing the life-saving information you want to be available! This plan is also pretty cheap to implement!
Utility in major national disasters is not a use case for the #myHealthRecord despite the claims (floods and earthquakes also take power down)!
David.
Soooo, what should be done about My Health Record? It's clear government and the Department are continuing to fund it. It clearly isn't being allowed to whither and die. Ignoring it just perpetuates the status quo. Retyrn to beginning..... Soooo .... what should be done? Nothing is not an answer.
ReplyDeleteThe answer might be to start integrating it with other systems. Could start with Age care, child health records etc.. it is obvious that attempts to joking state and territory systems failed as the MyHR cannot keep pace nor offer addition value or service offerings. Could be used to latch other half baked failures onto such as Covid safe and the new myGov Facebook
ReplyDeleteDoes anyone know what happened to the "My Health Record in emergency departments" project?
ReplyDeleteThere was an interim report on the methodology and project design which was presented to the Board:
https://www.digitalhealth.gov.au/about-the-agency/australian-digital-health-agency-board/board-papers/Item%2016%20-%20My%20Health%20Record%20in%20Emergency%20Departments%20-%20project%20update.pdf
There are a few references to the project
https://www.safetyandquality.gov.au/our-work/e-health-safety/my-health-record-emergency-departments-project
and a paper published by the MJA
Towards routine use of national electronic health records in Australian emergency departments
Paul Miles, Andrew Hugman, Angela Ryan, Fiona Landgren and Grace Liong
Med J Aust 2019; 210 (6): S7-S9. || doi: 10.5694/mja2.50033
Published online: 31 March 2019
https://www.mja.com.au/journal/2019/210/6/towards-routine-use-national-electronic-health-records-australian-emergency
The MJA paper conflates access to full eHealth Records and the MyHR which is only a summary system
The paper says:
"The project consists of an observational study across four sites from early 2019, in alignment with the My Health Record opt‐out period, which concluded on 31 January 2019."
There was no project timeline and I can find no report or media release.
Maybe there is something in the Board papers that have not been published since 6 December 2018 which was when the project update was tabled.
Maybe they are still looking. It's not as though there haven't been any significant emergencies when the use of MyHR could be correlated with obvious need.
Sounds like an Agency success story to me Bernard.
ReplyDeleteGeneric Methodology published - Tick
Referencing mentions In other government entities - Tick
Academic paper published Agency collaboration and career KPI - Tick
Like the Chief Medical Officer and all other medical folk this illusion has passed its usefulness.
@ADHA Staffer
ReplyDelete"Sounds like an Agency success story to me"
You're quite right - at least that's what the Agency intended.
The "project" is not research but is an attempt to justify existing biases. All you have to do is look at the last few paragraphs:
"The study will examine all aspects of My Health Record use, including training, awareness, viewing platform integration, workflow integration and how staff are able to best access My Health Record.
An additional component of the pilot site study phase will be the testing of metrics that demonstrate the expected benefits of the My Health Record expansion and, subsequently, any barriers. The expected EHR benefits that will be measured include a reduced ED length of stay,1 the avoided duplication of pathology and diagnostic imaging,1 and a reduced ED admission (and readmission) rate.1,5,13,16 In addition to examining benefits realisation, the project measures may support hospitals in demonstrating achievement against My Health Record‐related criteria in the National Safety and Quality Health Service Standards.
Conclusion
My Health Record has the potential to support health care providers in EDs by providing timely and secure access to a patient's clinical history. Moreover, the My Health Record in ED project is likely scalable for use in other clinical disciplines in the acute setting, as a number of the barriers and enablers of EHR use experienced by ED clinicians are common to other health care providers."
IMHO, the best word that describes this project is "fraud"
The fact that nothing has been reported strongly suggests that it is actually a failure.
I expect David will include this in his round-up but it's worth a read now.
ReplyDeleteWhat happened to our dysfunctional innovation-killing health bureaucracies?
http://medicalrepublic.com.au/what-happened-to-our-dysfunctional-innovation-killing-health-bureaucracies/28968
Tl:dr
Grahame Grieve gets a well deserved rap.
Telehealth is a WIP
Cloud is acceptable
ADHA's electronic script transfer has made some progress but has a way to go
My Health Record. It does feel like it went seriously MIA during our biggest health crisis in a generation
Surely to goodness I must be living on another planet. Has the ADHA really made such a major contribution, as Jeremy Knibbs would have is believe, to getting electronic script transfers up-and-running.
ReplyDeleteI stand to be corrected by all means but really, does anyone else believe what Jeremy has written here below (re electronic script writing) in his Medical Republic article:
"The Australian Digital Health Agency (ADHA), which has come in for so much flack over the years for its dysfunction was already doing a a good job pre COVID-19 on the electronic script writing project. It was one of the few projects that was making good progress against the many goals the agency had set itself.
But when COVID-19 hit, it wasn’t actually near ready. While the pharmacy vendors had a system they could roll out, and the script exchanges were ready to play ball, the GP PMS system vendors had other priorities and issues. The timeline expected to a reasonable implementation was estimated by one expert in the know in February at the HL-7 Congress in Sydney at 6-12 months at least.
We aren’t saying it’s done and dusted, but late last week the ADHA announced that they had successfully achieved electronic script transfer No 1. So maybe 8 months is going to become something like 8-10 weeks in the face of need? That’s an impressive job."
So they managed to send an image of a document over the wire using specification that have changed little in 7 years? At best this means 5-6 people out of over 400 got lucky? Not sure I would be reaching for the champagne just yet.
ReplyDeleteAs for the small band of merry APS staff that are allowed to produce a few outputs, they will be reigned in soon enough and things will return to as they were. It is good to dream but seriously you really think the machine of government will change, and should we let it?
May 16, 2020 11:20 PM. You certainly know how to throw a bucket of cold water on overhyped success. It really does not paint a good picture for ADHA. Still onwards and upwards I am sure this Digital Officer Chappy has some super duper innovations to announce.
ReplyDeleteThe Australian Digital Health Agency has launched a new website providing advice to consumers on how to navigate the health system using digital tools during the pandemic.
ReplyDeleteOh goody just what the doctor ordered. So our national digital health agency will all its resources delivers what? Yes a website. Just like its MyHR it is compiled of second hand information thrown into a blender and regurgitated for your pleasure. Surely this is the domain of the Consumer Health Forum?
"how to navigate the health system using digital tools during the pandemic." Is that what Digital Health is? Nothing to do with actual healthcare, just an info site?
ReplyDeleteThe Agency’s Chief Digital Officer, Steven Issa said, ‘A recently coined term, infodemic, has been used to describe the oversupply of information that confuses rather than clarifies. Digital health solutions are key to the national response to COVID-19 and the Agency has developed this online guide to give Australians clear advice on how to navigate the health system during this global infodemic’. ‘This guide aims to support Australians throughout their health journey and encourages Australians not to put their health on hold’.
ReplyDeleteA noble gesture, however, did it not dawn on them that yet another non-medical institute putting out more random advice is simply adding to this ‘infodemic’. Surely ADHA CHF DOHAS DUMBASS and others could simply contribute and allow more recognised and reputable institutions to provide guidance. Would make content and messaging management a lot simpler surely?
Glad to see the buzzword bingo team has been busy during this time.
"Digital health solutions are key to the national response to COVID-19"
ReplyDeleteIn the footsteps of Scotty from Marketing - an unproven, exaggerated, self-serving sales pitch.
Every technology vendor is pivoting around the coronavirus pandemic claiming they have the answer to today's problem. All that's changed is the sales message, not the product.
Just looking at the "online guide" shows how little thought has gone into this sales pitch.
If you click on "I have COVID-19"
https://covid-19.digitalhealth.gov.au/i-have-covid
The first thing it tells you are the symptoms to look out for i.e. "Red Flags"
That's a lot of use when you know you've already got it.
Try "I need medication". That tells you to call your GP or medical professional.
How do you know you need medication? If it's because you have been told by your GP or medical professional then why go and see them again? If you haven't then you are self medicating which is as stupid as POTUS taking hydroxychloroquine. After all, what have you got to lose? Oh, that's right, your life.
The only thing Issa said that makes any sense is "infodemic .... an oversupply of information that confuses rather than clarifies"
As anon 2:13 PM points out "another non-medical institute putting out more random advice is simply adding to this 'infodemic'"
The ADHA guide is as medically useful as snake oil.
Digital health solutions are key to the national response to COVID-19
ReplyDeleteHad to laugh today we after a telephone consult in the morning my GP renewed a prescription and said I could pick it up at the chemist. In the afternoon I walked down to the local chemist. The prescription was not waiting, they made a call and ten minutes latter the practice manager turned up with a pile of prescriptions, there seemed a process of chatting and clarifying for a few minutes and everyone seemed happy and smiling. Seems prescribing still largely results in a GP printing and then someone walking a batch down to the chemist.
Wonder which approach enables improved communication and relationship management between my clinic and chemist?
If Digital Solutions are so important to national response to Covid-19, then I wonder why the Australian Digital Health Agency have not created and implemented Australia's Covid Safe app? Instead it seems to be the Digital Transformation Agency that has done this. Are these two Commonwealth agencies competing with each other? Perhaps we only need one of them...
ReplyDeleteOr neither, seems we lack guidance is quality and standardisation to support policy and regulation. If government could express it requirements and valid through testing in a collaborative way than we would need very different folks and allow enterprise to provide solutions
ReplyDeleteDoes this sound familiar?
ReplyDelete"Calling all Australian researchers, innovators, entrepreneurs and innovative businesses!
Come up with the next new idea to help future proof Australian biosecurity and you could receive up to $50,000 in funding through the Biosecurity Innovation Program and a 12-week incubation program to make it happen!"
Run by Canberra Innovation Network and the Department of Agriculture, Water and Environment’s (DAWE) Biosecurity Innovation Program Team to support delivery of the 2020 Biosecurity Industry Innovation Challenge
The language has much in common with ADHA's little initiative. It may be the same thing or in addition. I wonder if anyone is coordinating these?
Wonder if New Zealand is considering the massive bio security risk Australia presents when thinking about this travel bubble? I would expect them to be not far behind Chinia in the line to discuss terms over a barrel with Scotty from Marketing and his ever so tactful foreign minister.
ReplyDeleteI wonder how vulnerable MyHR is to hacking attempts coming through hospital systems?
ReplyDeleteCoronavirus cyber attackers going after hospitals
https://www.smh.com.au/politics/federal/coronavirus-cyber-attackers-going-after-hospitals-20200520-p54uq3.html
re: Does anyone know what happened to the "My Health Record in emergency departments" project?
ReplyDeleteMaybe something like this:
TIL A Group Of Flat Earthers Spend $20,000 Trying To Prove Earth Is Flat, Accidentally Prove It's Round
https://www.reddit.com/r/todayilearned/comments/gqj5zk/til_a_group_of_flat_earthers_spend_20000_trying/
It's quite possible the ADHA's project proved the opposite of what they wanted to prove. It does happen, especially if you are a believer with no evidence to back your beliefs
Someone should make a documentary about My Health Record