It Seems The Great And The Good Reckon The ADHA Are Full Of It As Far As Global Digital Superiority Is Concerned!

These 2 reports of a recent international discussion appeared last week:

First we had:

https://wildhealth.net.au/three-nations-one-digital-health-message/

22 April 2021

Three nations, one digital health message

ADHA Big Data Booking Engine Cloud COVID-19 DoH EHR/EMR Hospital Insights Interoperability NHS Technology

Posted by Felicity Nelson and Talia Meyerowitz-Katz

A curious thing happens when you put digital health experts from America, Scotland and Australia side-by-side on a webinar panel. While the accents change from speaker to speaker, the message remains constant.

The core lesson from the Wild Health webinar (which you can watch on demand here) was that everyone wins when we put aside differences and pitch in to build sturdy, lasting, interoperable digital infrastructure – and we can win big in the middle of a global pandemic.

But each country has its own unique challenges and there’s always more work to be done.

The panel was chaired by Jeremy Knibbs, the publisher of Wild Health.

Representing Australia on the panel was Grahame Grieve (Founder of FHIR, global interoperability consultant and principal of Health Intersections) and Professor Dorota Gertig (Medical Director, Population Health at Telstra Health and a public health physician).

Professor George Crooks OBE (Chief Executive of the Digital Health & Care Innovation Centre) tuned in from Scotland.

And from the US, Wild Health invited Steven Posnack (Deputy National Coordinator for Health Information Technology) and Aashima Gupta (Director, Global Healthcare Strategy and Solutions, Google Cloud).

In Scotland, the pandemic generated “top-down permission” and the “bottom-up need” for change, leading to some truly impressive leaps in the use of ICT architecture and cloud-based digital technology in COVID contact tracing, said Professor Crooks.

Because the cloud infrastructure was already established, the government could quickly switch on a new application, allowing citizens to participate in the contact tracing process.

“The beauty is that it puts the citizens at the centre, they do their own contact tracing,” said Professor Crooks.

“And the average time from getting a positive notification to an individual starting self-contact tracing is 12 minutes,” he said. “And 55-60% of citizens actually actively participate within an hour and a half of that notification.”

In the US, major legislation pushed through in 2010 meant that 90% of US hospitals already had electronic medical records before the pandemic hit, said Mr Posnack.

COVID accelerated the expansion of digital health. “How we work has changed,” he said. “In the past year, I have set foot in the office once as a government employee running a government agency.”

Some provisions have been made to expand telehealth but there’s been a reluctance to establish payment methods, he said.

There is also more appetite for health information from patients now. “Everyone wants access to their test results,” he said. “Everyone wants access to their vaccination status.”

The US has the HIPAA law, which provides a right for citizens to gain access to their health information.

“My optimistic hope is that this may help prompt people to seek greater access and more engagement in their care overall from a digital health perspective,” he said.

Unfortunately, Australia’s digital health infrastructure was “very solution focused, very insular in in the way it’s conceived”, said Grahame Grieve

“Instead of building an infrastructure that leads to new integrated market development, it seems that we’ve headed towards an infrastructure that sucks everything into what it is,” he said.

“It’s very frustrating to see how that approach isn’t developing into, what I think we need, which is a resilient and adaptable architecture.”

Lots more here:

https://wildhealth.net.au/three-nations-one-digital-health-message/

and the next day:

23 April 2021

Why the UK and US are now in front of us in digital health

ADHA Government Interoperability MHR

Posted by Jeremy Knibbs

Last week’s Wild Health webinar on lessons from the US, the UK and Australia from COVID induced digital health innovation, sponsored by Telstra Health, revealed two countries now in front of us and moving much faster towards a more interoperable ecosystem as a result of COVID induced digital health innovation. What happened?

If you ask virtually any senior digital health staffer in any advanced country what was the greatest leap forward that COVID induced in their healthcare set up the inevitable answer is telehealth. In the UK, the US and Australia, telehealth made leaps of various sizes, often associated with governments accepting that they needed to establish pay signals the system for it to be used more effectively.

But while vastly applicable and useful in the crisis, in some ways the telehealth story belies what COVID really did in many countries, which was put their existing interoperability infrastructures to the ultimate test.

In last week’s Wild Health Webinar, digital health leaders from the US, the UK and Australia were asked what COVID induced innovations were significant and real, and what ones were more potentially illusionary. Which ones might slowly slide backwards despite the hype?

As expected, Telehealth was an initial winner nominated for each country. Notably in the UK, video telehealth took off, whereas in Australia video has not taken at all. It feels likely that video telehealth was able to take off because of existing or developing infrastructure in that country, especially around delivery of hospital outpatient services.

Three years ago the UK moved to put all of its health service providers and vendors a notice that the intention moving forward from that point was “cloud first”.  The NHS put a lot of detail around what they were expecting. It wasn’t a new standard (the route taken by the US) but it might have been as good as. If as provider you were going to doddle and not upgrade towards new web sharing technologies you would be in trouble. As a vendor there was nothing to do but start developing systems which met the criteria.

By the time the COVID pandemic hit, NHS cloud based solutions like Carenotes allowed staff to view and share patient medical records from a desktop or mobile device anywhere in the UK.

----- Lots omitted

The My Health Record, which should have been the centre piece of a crisis like COVID, if it was ever going to live up to the government’s promises, was almost entirely missing in action.

Unfortunately, Australia’s digital health infrastructure is  “very solution focused, very insular in in the way it’s conceived”, Grahame Grieve, the founder of FHIR, told the Webinar.

“Instead of building an infrastructure that leads to new integrated market development, it seems that we’ve headed towards an infrastructure that sucks everything into what it is,” he said.

“It’s very frustrating to see how that approach isn’t developing into, what I think we need, which is a resilient and adaptable architecture.”

The best that we could manage in Australia was expediting a program for electronic script writing, a program that was initially going to take a year, and we managed to get up in a raw working form in about three months.

Ironically, this program, which is yet to be fully implemented, is a case of cloud based and distributed architecture in the system. But it has virtually nothing to do with our supposed backbone project of the My Health Record.

If you read between the lines on the Wild Health webinar, which looked at COVID induced digital health innovation between the UK, the US and Australia, the single biggest message that was apparent is that Australia is stuck in the past as far as digital health is concerned.

Such a view might come as a surprise to most of our politicians, who don’t really understand the basics, but, ironically, have been given the My Health Record to point to as just how great progress has been in Australia.

While there was much in place to facilitate much better interoperability in the US and the UK systems when COVID hit, there simply wasn’t in Australia.

If it was meant to be the My Health Record, then what COVID demonstrated probably for once and for all was that this project is an interoperability dead end for the country.

We need to back up, check out in more detail what other countries are doing with modern distributed and open systems, and rethink our approach.

Part of that approach should probably also take note of both the US and the UK, which as base did not try to dictate technology or systems but gave the market context and direction, in the case of the US via an enforced standard, and in the case of the UK, at least by notice to everyone in the system that they should be hubbing around cloud, and then setting up support services to help align providers and vendors.

Both the UK and the US in varying degrees announced and dictated the future for vendors and providers, via some sort of standard setting, and then made sure they gave everyone the time and the support to make the transition.

In some ways, our government’s persistence now with the My Health Record is laziness brought about by a feeling that things are OK. That we managed the pandemic better than anyone else, and our health system is largely better than anyone else’s.

Both things are true.

But it’s a stark reality that our digital health policy and infrastructure are backwards now and fast starting to hold back the potential of our whole healthcare system.

It’s patients that will bear the brunt of this lazy approach in the end.

It’s a climate change like problem for Australian policy makers.

It’s difficult to see today, and there is a lot of politics resisting changing our current settings.

But like climate change, a weak digital health infrastructure and leadership from government, is going to blow up in our faces sooner or later. Likely, in a big way.

You can watch the Wild Health Webinar on which the ideas in this article are based HERE.

Here is the link:

https://wildhealth.net.au/why-the-uk-and-us-are-now-in-front-of-us-in-digital-health/

Seems like a good idea to watch and see what you think! Fascinating stuff.

The key lessons I took from the discussion from an OZ perspective were:

1. The #myHR is a useless piece of dated infrastructure that needs to go.

2. OZ needs to re-awaken its e-Health Standards processes and start moving towards distributed data management and interoperability.

3, The Digital Health Industry sees the #myHR as irrelevant and is just ignoring it.

David.