This appeared last week:
https://www.digitalhealth.gov.au/news-and-events/news/media-release-international-collaboration-on-digital-health-best-practice-supports-global-response-to-covid-19-pandemic
Media release - International collaboration on digital health best practice supports global response to COVID-19 pandemic
23 July, 2020: Four reports – White Papers – have been published by the Global Digital Health Partnership (GDHP) of over 30 nations including Australia detailing what GDHP member countries are doing to deliver digital health services and improve patient health outcomes.
The GDHP is currently chaired by India. Mr Lav Agarwal, Joint Secretary, Ministry of Health and Family Welfare, Government of India is the GDHP Secretariat Lead.
Mr Agarwal said “Sharing digital health information is now more important than ever as individual nations and the global community respond to the challenges of the COVID-19 pandemic.”
“These White Papers will provide both participant and non-participant countries and territories with guidance on the key digital health enablers that can lead in improving the health and well-being of citizens at national and sub-national levels through the best use of evidence-based digital technologies.”
The reports provide insights, guidance and information on cutting edge digital innovation for digital health workers, governments and organisations providing digital health services, and the communities they serve across the globe.
They are a valuable source of information that provide a catalyst for positive change, with insights and international comparisons of our digital health systems with countries around the world.
One key trend of GDHP members’ digital health systems are efforts to empower citizens to have greater involvement in the management of their own healthcare. This is evidenced in Australia in statistics published by the Australian Digital Health Agency which show consumers are uploading and viewing more of their My Health Record documents.
Chief Medical Adviser at the Agency and Chair of the Evidence and Evaluation work stream for the GDHP, Clinical Professor Meredith Makeham, said the Agency had supported and led the development of the White Papers over the past year, working with more than 30 countries from around the world.
“International collaboration is critical to improving health outcomes for all,” she said.
“Many countries and territories are still at the beginning of their digital health journey, so providing insights in key areas of common interest through our GDHP participation is fundamentally beneficial and supports our goals to improve health and well-being for people.”
“Our experiences with the COVID-19 pandemic have highlighted the importance of international engagement, and the critical role that digital health technologies play in ensuring that people have access to their healthcare providers and services. Digital health has never been more important.”
“I want to highlight the role Australia has played in establishing the GDHP as the inaugural Chair of the partnership and host of its first summit in early 2018. Since then we’ve benefitted from the opportunity to share valuable insights on digital health service delivery for our citizens that have been informed by the cutting-edge work of GDHP participants around the world,” she said.
Comments from other GDHP Work Stream Chairs:
Dr Don Rucker, National Coordinator for Health IT, US Department of Health and
Human Services said “Sharing information using health data standards for
interoperability is necessary to advance public health reporting and research
which are key parts of an evidence-driven response to pandemics. Now, more than
ever, increasing collaboration and sharing best practices around the world, not
just within countries and territories, is critical to advance interoperability
together globally.”
Shelagh Maloney, Executive Vice President, Engagement and Marketing, Canada Health Infoway and Chair Clinical and Consumer Engagement work stream said “Over the last decade there has been a universal shift in thinking; one where there was little to no support for providing citizens with access to their information, to present day, where we are accelerating efforts to provide citizens access to information in an equitable and secure manner. As governments around the world grapple with this new reality, and citizens in many jurisdictions are asked to remain home for public health, it has never been more critical for citizens to access their health information remotely: wherever and whenever it’s needed.”
The four GDHP White Papers are:
- Advancing Interoperability Together Globally
- Citizen Access to Digital Health
- Benefits Realisation: Sharing insights
- Foundational Capabilities Framework & Assessment
I have had a read through these and they
are worthwhile, albeit at a rather high level. They are, however useful as starting points for addressing the domains
discussed. They are well worth a download and read!
In that regard we are again reminded, as we read, just how hard these areas are and how genuine clear-cut progress can be pretty hard won.
I was disappointed that in an otherwise fairly factual release we found this piece of gratuitous ADHA propaganda.
“One key trend of GDHP members’ digital health systems are efforts to empower citizens to have greater involvement in the management of their own healthcare. This is evidenced in Australia in statistics published by the Australian Digital Health Agency which show consumers are uploading and viewing more of their My Health Record documents.”
That second sentence is utterly out of place in an otherwise useful effort. What a pity!
David.
28 comments:
".... starting points for addressing the domains discussed"
Reviews, categories for further work, vague claims that people want access to their health information, etc etc.
What a waste of time and effort. It reminds me of the old saying "Its like wetting your pants in a dark suit, you get a warm feeling but no one else notices"
Dr Steve Hambleton appointed as independent clinical advisor (to ADHA)
https://www.miragenews.com/dr-steve-hambleton-appointed-as-independent-clinical-advisor/
Looks as though the only people they can get to join the ADHA are those who drank the Kool-Aid years ago.
No doubt he finds the financial incentives seductively enticing. Perhaps he is trying to position for the CEOs job.
Been there done that or at least as Chair. To smart to take the CEO role. Bettina is there simply to close shop and move assets under Commonwealth care. Everything else is just done for effect and perception. The recent Standards webinar made this very evident.
If Digital Health is such an exciting area with lots of opportunities to make a name for oneself, especially with the Commonwealth Government's resources behind you, why did Timmie jump ship and why has it taken well over six months to find a new CEO?
why has it taken well over six months to find a new CEO?
I reckon that anyone good enough for the role would be smart enough to know it is a 'poisoned chalice' - especially being stuck with the super lemon of the #myHealthRecord.
David.
Re the lack of a CEO....
Based on a few rumours and knowledge about how the government works, this is what seems to have happened.
The government engaged an international head hunter to find a new CEO for ADHA
They decided after the disasters of multiple project manager and Tim Kelsey, none of whom know anything about health IT and the complexities of health data, they instructed the head hunter to find someone who did.
The head hunter found two types of candidate – those who understood the problems and looked as though they could deliver and those who didn’t have a clue but thought they did.
The second group were easy to weed out.
Of the first group, those who understood the problems and were aware of the current situation in Australia, nobody was willing to sign up for the most important desired outcome – to deliver the sort of savings to the government that were promised over and over again by the incompetents who previously worked for Health and then ran NEHTA/ADHA.
Cost savings are all that matter now. The ADHA has run out of excuses and options to get people to use My Health Record in any meaningful way.
The government has now realised it has dug itself a hole and needs to get out of it. The optics of walking back their promises about My Health Record (similar to those made for COVIDSafe) has been made more difficult by the pandemic.
The key to what appears to be happening is the extent of Dr Hambleton’s appointment - effectively until the end of the year – four months. It is quite possible that he is advising the government on how to get out of their hole. It will be interesting to see if the government attempts to sell My Health Record to a commercial enterprise. That would be a courageous decision, in the Sir Humphrey sense. It has to stay with the Federal Government.
IMHO, there are three potential options.
1. It goes back into Health. This would be dumb. Health is a policy agency and has a track record of IT stuff ups.
2. It goes to Human Services. At least they know how to run big IT shops, although they are probably fully aware of its failings.
Giving it to either Health or Human Services would be mad because at a minimum they would need to make it pay for itself, but preferably deliver those mysterious savings.
3. Bite the bullet, retire it. They could claim to have learned lessons and that the world has moved on technologically since it was initially proposed. They could also claim that there are now better alternatives coming out of the states.
All this is conjecture and rumour, nobody who knows first hand has told me anything, but it sounds reasonable.
@1:19 PM & 1:48 PM -
Few people are equipped to undertake this role; three qualities are paramount; deep health IT experience, an abundance of nous, extraordinary leadership abilities.
A ‘poisoned chalice’ it may be. The CEO will need to concoct an antidote to neutralise the poison before accepting the position.
On the premise the government genuinely wants to find a politically acceptable expedient solution to the hugely complex problems confronting the ADHA the first step is for the government to ensure it controls the appointment of the CEO. The CEO will then negotiate with with the highest levels of government on the pathway that will be adopted to resolve the government’s and the ADHA's 'problems'.
That is only plausible if the the department sees GovHR and ADHA as a problem child. I do not see any real evidence that this is true. In fact quite the opposite. ADHA has been quietly shifting everything towards a long-term sustained MyHR. Have a look at the developer website, no longer broad it is all about MyHR.
Other than a few tinkering around in HL7 Aus with little vision or purpose, ADHA sees MyHR as the national standard that all need to ’post’ stuff to for interoperability to be seen as a success.
So why no CEO? Well you all may be correct in your assumptions, but then again if an international candidate has been selected, maybe they are unable to lift and shift their family and belongings. There is also a timing issue, you would want to be able to hug the ground running and make an impression. Not exactly the optimal time for that.
No of what I state has any basis of truth and might well be wrong.
@Long Live T.38 - almost as if by magic their biggest failure may prove to be their saving grace. If no one knows about it or uses it then no pesky citizen are going to demand it be turned off.
@11:48 AM Regardless, citizens, pesky or otherwise, are never going to demand it be turned off; it's of no interest to them. Also, government knows it has a problem but if it doesn't want to acknowledge that then it won't. 10:44 PM makes a lot of sense, it would be good to know what antidote he would concoct!
I suggest that the danger to myhr will come from the hard heads in Treasury and Finance.
ADHA made it clear two years ago that it was planning to replatform myhr
https://www.itnews.com.au/news/my-health-record-replatforming-talks-begin-494467
"However, with the contract expected to expire in 2020, ADHA is now starting to look at moving to a 'new, more flexible platform'"
To do that will cost money which will need budget approval. If those who give such approval do not revisit previous proposals and ask where the projected savings are, then they are being derelict in their duty, IMHO.
Even if ADHA ducks the replatforming issue, the small matter of contract renewal needs to be addressed. A certain Health project manager got hauled over the coals for inappropriately renewing the IBM outsourcing contract.
ADHA has extended the contract once already, to 2021. They cannot just keep on extending, not without causing all sorts of ructions in the central agencies - the ones who hold the purse strings.
Dr Brendan Murphy only took up his role as the Secretary of the Department of Health on 13 July 2020.
Looking at the current board members of ADHA none of them are SES officers of the Department of Health. This is puzzling, because the legislation that enables the ADHA https://www.legislation.gov.au/Details/F2016L00070 says:
Section 20
(2) One of the members must have the skills, experience or knowledge in the field mentioned in paragraph 19(3)(g) and must be an SES officer in the Department who is nominated in writing by the Secretary of the Department.
I wonder what was included about the ADHA in the briefing given to the new Secretary.
No CEO; no board papers for over 18 months; no annual report for the last year; no Health SES board member; upcoming myhr contract renewal; no cost savings from the myhr; very little public interest in the myhr; no report on the Emergency Department pilot;
The RAG report must be full of red lights.
(A RAG report refers to key indicators which are allocated a Red, Amber or Green status)
@2:19 PM You are probably correct about the ".. hard heads in Treasury and Finance ...", and if you are then the government would be well advised pre-empt that possibility and move quickly to take control. It sounds like they need to explore 10:44 PMs "antidote" asap.
What is the cost to commission?
Commission what?
Decommission - what would be the cost to decommission.
Putting to one side the cost and penalties involved in terminating supplier contracts the maximum decommissioning cost should be 10 to 20 cents per registered My Health Record; hence $2.5 to $5.0 million.
There would be other costs, all those feeder systems would need changing. There would be potential political cost, what if someone who has a MyHR that is shut down and they die, the death it is claimed could have been prevented if the data in their old record had been available?
There should very very little cost in closing down the system - just don't renew the contract. The ADHA people could be given the choice of moving to another part of the public service, although they may actually need to do some real work.
Considering that everything in MyHR is also available elsewhere and there is no evidence that the data in MyHR has ever been used to help anyone, the risk is minuscule.
@6:24 AM Rubbish. @7:19 AM Correct.
8:34 AM. Why would 6:24 AM Be rubbish? A lot has been invested to get people and systems to connect to the MyHR. What would be required to unwind HIPS for instance? You cannot just leave feeder systems untouched surely?
The system is built so that every patient has the option of not wanting data to be uploaded to MyHR. You just make that the default in all the feeder systems. The part of MyHR that accepts uploads could be programmed to accept the data but then delete it. After an appropriate time, the MyHR could inform those feeder systems that continue to upload that any future uploads would be bounced back.
The money saved by not uploading would pay for the transition. As soon as GPs stop getting epip money they would react pretty quick.
HIPS (and IHIs etc)could be passed over to DHS and maintained in the same way as other identifiers.
Reasonable bits to consider but afraid far to simplistic. You make the same mistake as those who blinding prosecuted the case to implement the system. There is more here than tin and wires.
@12:10. So, too useless to continue, too expensive to stop. A new CEO would have an unenviable task. I do hope they are smart enough to have done their due diligence, which includes reading this blog of course. More fool them if they haven't.
It's not all that difficult to decommission, but that presupposes that it should be decommissioned. To my mind that's not the issue.
As I noted at August 1, 10:44 PM, the central issue is whether the government wants to find a politically acceptable expedient solution to the hugely complex problems confronting the ADHA. It's that simple.
A centralised solution for a distributed model is undoubtedly proving to have been an unattractive investment. I wonder if the real challenge is that no matter what happens, a shift will be required in 5-10 years. The urgency to get standards back up and running and regain a proper architecture capability cannot be overstated, nor should architecture and standards dwell on current but instead think a decade ahead so we may converge at some point with realistic models and standards supported by a community of informed and listened to viewpoints.
@5:52PM Yes, it is the central issue as you so rightly say, however there is not the slightest bit of evidence to show that the government is interested any longer - the BOX has been TICKED, job done.
Correct, box ticked. So the ongoing sales pitch to government will be:
"Minister, 25 million people now have a MHR that people need and depend on. Close it down and the political backlash will be enormous and government will feel the people's wrath."
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