During last week there was a release from Prime Minister and Cabinet on extra funding for a range or IT projects including the #myHR.
Enhancing Government Service Delivery
Digital technology is changing how Australians and businesses interact with government.
The Government is investing in its own digital service delivery to enhance the services it provides to Australians and to save them time and hassle, committing:
- $200.1 million to enhance myGov to deliver a simpler and more tailored experience for Australians based on their preferences and interactions
- $301.8 million to enhance the My Health Record system, adding support for COVID-19 testing and vaccinations, connecting Residential Aged Care Facilities and connecting specialists in private practice and delivering improved telehealth, emerging virtual healthcare initiatives and digitised support across all stages of healthcare.
Streamlined and simpler myGov
The Government is enhancing myGov. The system, which was established in 2013, is the main portal for Australians to access government services online and is currently used by nearly 20 million Australians.
The changes to myGov will deliver a simpler and more tailored experience for Australians based on their preferences and interactions, through streamlined and enhanced digital delivery of the government services they need. The time saved alone from these enhancements is estimated to generate benefits across the economy totalling $3.6 billion over 10 years.
myGov enhancements will include:
- an advanced service dashboard and document upload functionality to allow people to view and manage their upcoming payments, claims, debt status and activities all in one place, saving people time and hassle
- a digital assistant and notification functionality, making it easier for Australians to find the services that meet their needs, whether that be seeking childcare providers or disaster relief support.
My Health Record
My Health Record is Australia's best-connected clinical information system, providing health care providers with vital information for patients at the point of care.
The Australian Government is working to reduce the reliance on paper-based records and to digitise information from primary healthcare providers, medical specialists, pathology, diagnostic imaging and allied health services. This will allow Australians to easily access more of their information through the enhanced My Health Record. This easy-to-use digital interface will provide an overview of all relevant aspects of a patient's healthcare history and medical information to better support them and their care.
The Government is investing to build the next wave of My Health Record which will:
- provide Australian's with their COVID-19 test result and immunisation status as well as receiving alert notifications about their COVID-19 vaccinations directly from the device of their choice
- connect a consumers My Health Record information with their Residential Aged Care Facility, delivering improvements in medication management and transitions of care between health care settings.
Example:
Towards 2030: Wattle View Aged Care Facility – My Health Record
The Wattle View Aged Care facility is using the My Health Record system to assist in managing the health care needs of their residents.
Vicki is a new resident at the Wattle View Aged Care facility, which is now connected to the My Health Record system. Vicki's current medication, recent test results and treatment plan from her GP are available to the facilities' nursing staff. This will reduce errors and make Vicki's transition to aged care safer and more efficient.
Here is the link:
https://digitaleconomy.pmc.gov.au/fact-sheets/enhancing-government-service-delivery
The budget history in the last few years has been as follows:
FY 2017/18 $274.0M over 2 years.
FY 2020/21 $200.0M
FY 2021/22 $301.8M
From these figures it seems base line #myHR operations comes in at about $150-200M p.a. including operating the ADHA and the 300 or so staff – which has to be $30-50M p.a. at least.
What is
also promised this year is work on the
vaccination rollout as well as all sorts of work linking aged care to the #myHR
in a desperate effort to find a use case for the failed program.Some Medication Management seems also to be included,
In passing, I have to say on Aged Care, the thought of using the #myHR as the medium for exchange of information at care transitions is just a nonsense. There are much, much better and more effective ways to handover care information. The whole idea also relies on the aged care plan being in digital form and if that is the case (hardly the norm at present) a simple printout makes a great deal more sense in that situation. If not available a phone call or written note is much more likely to be safe! We are decades away from interoperation between aged care and hospital systems I reckon! All this said it is not deny there are some Aged Care Facilities who are really using pretty advanced technology for care management and documentation - with really positive outcomes. The following link is well worth a browse to see what is possible:
When all this is done it is hard to see much more that a very minor investment in maybe planning for re-platforming actually being funded – which really does make one wonder if anyone in Government is serious about a major investment = which would surely be needed to make a significant difference.
I am forced to conclude that – despite the optimistic note struck in the release - the funding is little more than a holding action that signals at some time soon we will see the thing shut down and a proper more modern, more decentralised strategy rolled out to support necessary health information exchange and patient access to their health information as needed.
I think the #myHR is really on its last legs after this release given the major re-platforming investment seems not to be happening, and the funding is only for one year. What do you think?
David.
34 comments:
I think that the ADHA is now overseen and managed by operational people - that is their careers and livelihoods are measured on things not changing, they are adverse to change and will ensure stagnation in the name of stability. They will have the entire collection of Status Quo on their Camera phones.
New functionality to support COVID - the time they roll that out everyone will be vaccinated - or are they intended to track those who do not?
As for aged care, seems we are handing over large amounts of cash to a bunch of people who committed serious crimes against our elders in care. I am not sure this should be the case. There are those that committed and those that allowed it through negligence or worse.
New functionality to support COVID - the time they roll that out everyone will be vaccinated
Not sure I would bet on that - the roll out continues to be a wave of confused messaging
"What Seems To Be The Plan And What Does It Mean?"
The plan is to pump up expectations. When it becomes obvious that MyHR isn't what the government keeps telling us what it is, the s**t will hit the fan. The greater the expectations the worse the outcomes. The government is probably hoping the bubble doesn't burst until they get turfed out. Which is what always happens. Then it's a different government that will get the blaame.
DRIP is the problem, unable to tap in the MyHR is an ATM of technical debt and to many have credit cards
Someone asks earlier if ADHA new what the asset really was - I wonder if they could also answer what is meant by DRIP? Somehow I doubt it.
I doubt many would know what DRIP means. Am I stupid? Please enlighten.
The Government is investing to build the next wave of My Health Record which will:
provide Australian's with their COVID-19 test result and immunisation status as well as receiving alert notifications about their COVID-19 vaccinations directly from the device of their choice
This sounds like app development - are there not already taxpayer funded apps in existence that take my bookings and provide me calendar functionality and alerts? Why would government compete here? MyHR is a platform (infrastructure) is should enable innovation not squash it, how is that driving a digital economy?
Anyone have any words of wisdom?
AnonymousMay 10, 2021 8:56 AM - what do you think the MyHR asset of value is ?
re: The Government is investing to build the next wave of My Health Record which will:
provide Australian's with their COVID-19 test result and immunisation status as well as receiving alert notifications about their COVID-19 vaccinations directly from the device of their choice
myhr already provides test results and immunisation status and so do other systems.
mygov can already send notifications. Centrelink makes use of this capability when sending someone a letter. You get an email telling you to log on and see the letter.
And many (most?) GP practice systems will send you a reminder of your next appointment by SMS.
There's a lot of misinformation going round these day.
@10:57 AM Bernard, when it comes to Digital Health the government virtually always sets itself up to COMPETE with private software developers and obstruct their progress in the misguided belief government can do it better. This non-sensical stupidity results in no winners, huge waste of taxpayers' funds and businesses failing. Why?
Is it because bureaucrats feel they are irrelevant, because they want to be seen to be at the centre of new developments where they can exercise power over others, because they don't know how to support the private sector, or a multitude of other equally non-sensical reasons?
The strategic move here would be to leave MyHR as it stands- maybe a view interfaces for new feeder systems. Shift investment and energy to clinical communication, bring forth FHIR and put the old girl to work. Hard to see how FHIR would not be the standard for secure messaging and data sharing. It could then underpin the national platform that any number of consumer records, analysis and analytic tools and beyond.
Seems a cross road FHIR was born for unless I am missing something.
Agree any progress forward would surely involve adoption of FHIR more broadly. I guess that will come through in the next level. As the strategy is formed into actionable plans which should be quick as this has been in the making for over four years.
@Sarah "The strategic move here would be to leave MyHR as it stands"
AFAIK, that's exactly what the replatforming is all about. The aim is to remove from myhr all the bits except the database and implement them in a new front end that can act as an interiperability hub, rather than just a way into myhr.
That way the backend big-data systems that the government owns and operates can suck all the data out of the rest of the health environment.
The first part is to get rid of the Oracle gateway
ADHA moves to replace My Health Record's Oracle API gateway
https://www.itnews.com.au/news/adha-moves-to-replace-my-health-records-oracle-api-gateway-555937a
There may just be enough money in the kitty to achieve this over the next couple of years. It won't change any of the functionality of myhr, it will just replace a bit of infrastructure.
To fully implement the ecosystem will take a lot of money and time (say ten years?) and all that will have been achieved will be a change of infrastructure architecture. If they are lucky they may be able to implement some FHIR interoperability capability but implementing FHIR at the nodes will probably take even longer.
By then they may be on the road to implementing the original PCeHR vision of joining up existing data repositories. myhr will then be able to serve its original purpose of only storing summaries. Except it will be full of copies of (some) data held in data repositories and they will have a massive data integrity problem.
And unless they also fix the NASH problem (i.e. access based on individuals, not institutions) they will still not have delivered on the PCeHR vision 20-25 odd years after it was released.
By then they may have realised that health providers do not want access to huge amounts of data, most of which is irrelevant, they want well managed and relevant data.
That's a whole new problem that AFAIK, nobody has the solution to.
It still leaves a situation where data is exchanged not data is shared. Until we have an interoperable landscape capable of supporting the formation and dissolvement of care teams from whatever profession and organisation required by a patient for a specific purpose. Until then it’s bollocking. All the MyHR is is data rich information poor, an absolution waste of space, a distraction, and does not help in achieving findable, interoperable, accessible, and reusable data principles.
Clinical communications is what is required, get that working and well … the rest is gravy
"Clinical communications is what is required"
Yeah, right, so simple. It's like saying that if only everybody had more money, nobody would be poor. Sounds nice but there's a few practical difficulties.
Here's a challenge: give us a definition of "clinical communications" that all healthcare providers would agree on.
It's like saying that if only everybody had more money, nobody would be poor. - seriously that is your response it has now similarity or relevance.
Once again this thread has arrived back at the starting gate best encapsulated by Bernard's comment "health providers want access to well managed and relevant data", ... "they do not want access to huge amounts of data, most of which is irrelevant".
@7:46 AM The second sentence "Until we have .... .... for a specific purpose.", is a muddled, incomplete and therefore meaningless statement. It is this sort of random garbage that gets embraced by the ego-driven verbage merchants around the 'committee table' and in various project documents that leads to the mess we have today.
Right on target and that leads to the next level of issues to be considered but we won't go there because it's too hard for most people's minds to wrestle with.
Exactly Ian, if there is large amounts of data it needs to be atomic so it can be viewed in cumulative way, otherwise its the same as getting a wad of paper at the start of a 30min consult, you just don't have time to look at it all and make sense of it. It was that exact situation (A wad of unordered paper) that motivated my interest in eHealth!
Hence the term - data rich, information poor DRIP. We really need to seperate the two. I think defaulting to lazy data it clouds what is being asked for.
Agreed Andrew. For a decade or more multiple, disparate, stakeholders have been invited and funded by government to participate in stirring the broth. Many cooks, many views, many egos, many vested interests have coalesced like sticky platalets stuck in the mangrove swamp losing sight of the very essence of the problem and unable to arrive at any meaningful agreement on two things:
1. How to define the problem(s), 2. How to solve the problem(s).
All this time I have called for embracing new ways of thinking, all to no avail. Without new ways of thinking being brought to bear, underpinned by unconditional financial support, there will be little progress, continued frustration and dissillusionment for all involved, and little progress.
re "All this time I have called for embracing new ways of thinking, all to no avail."
New ways of thinking will get us nowhere unless there is a new way of listening and acting on that thinking.
The Federal Department of Health is not equipped to listen to and act on new ways of thinking. Over the years the Federal Public Service has been hollowed out of expertise. They don't realise that you can't go to a consultant or outsourcer and get an opinion or advice that is free of vested interest.
The days of "frank and fearless advice" from people who are true domain experts are long gone. Now we get people who think they understand a problem, who write a specification and hand it over to someone else to implement the solution. It's called a tender.
Many times, you don't fully understand the problems, until you start working on the solution. Which is when you need to change your specifications. The tender/contract process works against this, hence the all too frequent IT project failures.
The problem is systemic which is why the ADHA is totally incapable of improving myhr. It's the wrong people trying to do the wrong thing in an organisation positioned to fail.
If the system has got you to where you are, and where you are is good then why would you think the system is in need of fixing? Those who need convincing of new ways, survived and thrive on the old ways - what is their motivation to see change?
Oh Sarah, leave them alone to keep beating their heads against their brick wall, don't try to change them.
@3:03 PM They have no motivation to see change if they see that where they are is good and that the system is not in need of fixing. So what is your point Sarah? No-one has suggested any effort should be invested in changing those people.
Perhaps a little more expansion may assist - "new ways of thinking" embraces listening, agreeing, visualising, compromising, planning, acting and reviewing. And it goes well beyond that.
It involves an openness of mind, a sublimation of excessive ego, acceptance of mature intelligent leadership, creative self-sustaining business model options, tolerance of personality conflicts, acclknowledgement and acceptance of one's shortcomings.
‘Those’ people hold the keys to the system, to change the system those people would want it to change. They will permit minor tweaks but nothing significant. There are always one or two exceptions to the rule. But in the APS you follow the rules without question.
@6:55PM Such constrained, narrow thinking, well suited to the APS you describe. You will find it a perfectly safe environment in which to tweak away achieving "nothing significant".
There is no point trying to talk to them, remember they are "Not even trying" to solve the problem. I have tried many times, its a waste of energy.
@Andrew "remember they are "Not even trying" to solve the problem"
I'd go one step further. They don't want the system to change.
"It is difficult to get a man to understand something when his salary depends upon his not understanding it."
Upton Sinclair
Why then, one is driven to ask, do they continue spending hundreds of millions of dollars (current estimate is now $2.5+ billion), on the My Health Record and promoting the development of an integrated health system as the underlying driver for reforming health service delivery?
That's a great question - if they don't want the system to change why spend the $2.5 billion in the first place?
Don’t confuse sales with delivery.
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