The Editor Of The Medical Republic Sounds Off On The Absurdity Of The #myHealthRecord Program. You Know He Is Right As Does The ADHA!

Jeremy has really lost his rag this time and he sounds totally sick of the silliness! Read here:

21 August 2020

My Health Record vs telehealth: a government innovation and investment dilemma

Posted by Jeremy Knibbs

The $2 billion My Health Record has largely been MIA during COVID-19 while the idea to allow doctors use their phone to do a consult may end up as the catalyst for health system transformation.

What is wrong with this picture?

One of our top five all-time trafficked articles is a blog penned just over two years ago by then Kangaroo Island-based rural GP Dr Tim Leeuwenburg titled Why I am opting out of the My Health Record – for now . A lot of what Tim said in that blog still resonates, and that is probably why the story he tells still gets quite a few hits, despite its age and the fact that Tim has moved on from being a rural GP for now. He never did opt in to the MHR as things turned out, and he says he has never used it in his work. But many GPs will tell you Tim is one of the most dedicated, passionate and competent GPs and rural proceduralists they know.

While COVID continues to rage around us, we’ve been reluctant at The Medical Republic to raise the obvious absence of the MHR among the many war stories of COVID-19 emergency management. Even when the Australian Digital Health Agency (ADHA) put out one of its confusing press releases implying there had been a huge surge in MHR use as a result of COVID and quoting statistics that had no referencing baselines for progress and actual meaningful engagement by healthcare professionals, on June 23, we decided to leave it alone. It just seemed a distraction to the main issues at hand, like an argument that just isn’t worth having any more. In July I did a one-hour podcast with ADHA interim CEO Bettina McMahon on all the good stuff the agency was getting done. There turns out to be quite a bit outside of the MHR. I had meant to ask the MHR question, but the topic never came up. That seemed to me to say a lot.

It feels like those who continue to champion the MHR as the base piece of infrastructure for all our future healthcare system development and innovation are destined to do it forever. Just as baked-on Trump followers aren’t ever going to vote Democrat, or the supposed radical alt-left that he often alludes to would see anything good in anything he does. It’s wholly polarised.

Just to give you some sense of how frustrating it is trying to tie down how much healthcare professionals are actually meaningfully using the MHR, and how much value it is bringing to the system, try to get a hold of the last 12 months of statistics from the ADHA, in a neat line, so you can compare what has happened longitudinally in the past year with the MHR. The last statistics update it published on the MHR was on June 23, with the press release we are referring to above. But there is no history to go with it. It is a point-in-time snapshot with no reference points – as usual. We asked the ADHA to give us the same report for the past 12 months so we could do some trend analysis, but so far it hasn’t been able to manage that – for whatever reason. I once did an editorial on the subject titled “You can’t manage what you won’t measure”. Nothing has changed since that was written apparently.

It doesn’t really matter that much. If you try to make sense of the ADHA’s current report HERE, and the last one we could find that they published HERE, you just can’t, no matter how hard you try. There is no baseline for any of their statistics so you can’t reference progress. Worst of all, as far as meaningful healthcare professional engagement, and increasing demonstrable value to the system and HCPs is concerned, the stats are just nonsense. Take this statement from the June 23 press release for example:

“As pharmacies took advantage of changes made in March to allow medicines to be dispensed based on an electronic prescription, pharmacies registered for the My Health Record also increased from 91% to 97% in May and the viewing and their uploading also increased from 69% to 78%. GPs similarly had a big increase in viewing and uploading from 73% to 82%. The result is that more than 8 million medicine documents have been uploaded by healthcare providers like pharmacists and GPs, increasing the total medicine documents to more than 136 million.”

We asked the ADHA to clarify what uploading and viewing constituted for the purpose of these numbers. That is, what does 82% of GPs viewing and uploading the MHR actually mean? We know it doesn’t mean that 82% of GPs are using the MHR each month. It likely means that most practices are making sure they get their ePIP payment by uploading summaries in bulk, we guess, at best. But the ADHA won’t tell us. Not yet anyway. Most of these uploaded summaries sit as PDFs in the system doing nothing, by the way, and many GPs have little idea that they’ve been uploaded on their behalf.

And what does eight million medicine documents uploaded by “healthcare providers like pharmacists and GPs” mean to anyone? What are the documents, are they being used for anything? And so on.

…… Lots omitted

Will we allow it to drift quietly into a corner, as a fond memory of a misspent digital health development youth, to be used only for the collection and distribution of important but difficult and expensive to attain medical data?

Will we take what we have learnt from a project so big and dense that its gravity pulled in all around it when its fundamental principles of centralised non-atomised data owned and controlled by the government, not the patients or the healthcare providers, were known to be flawed many years ago now?

We made a big mistake. We then doubled down on that mistake a few years back and added momentum to something that should have sunk long ago into the bog.

COVID, for all its horror and waste, has provided the system and those who run and guide it to reboot the system onto a new and more productive path. A path that will be hubbed initially by universal telehealth, and then radiating from this, a series of well understood modern connected technologies that fundamentally allow distribution of data, and control of it where it needs to be controlled.

I hope this is my very last major rant on the MHR and all who sailed with her.

I hope that we are truly embarking on a new era in Australian healthcare where the patients and healthcare professionals drive the agenda via readily available enabling technologies like telehealth, the cloud, and sharing standards such as FHIR.

And I hope the people with the power in Canberra to set a new course now see what went wrong and are keen to make changes that push us in a more productive direction.

Here is the link:

http://medicalrepublic.com.au/my-health-record-vs-telehealth-a-government-innovation-and-investment-dilemma/33439

If you have access it is well worth reading the whole article.

You know Jeremy is right. The MHR is a useless dud that is simply not appropriate to be part of the digital transformation in/to the post COVID world which is where all available funds need to be directed. To make continuing investments in the MHR while it is simply not possible to resolve the fundamental conceptual and structural deficiencies of the system is simply absurd. It really is as simple as that!

COVID19 is a hinge to the future and we need a genuine pivot. We must not just hide under the doona and pretend nothing has changed.

David.