This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Quote Of The Year
Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"
or
H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."
Tuesday, June 29, 2021
Commentators and Journalists Weigh In On Digital Health And Related Privacy, Safety, Social Media And Security Matters. Lots Of Interesting Perspectives - June 29, 2021.
-----
This weekly blog is to explore the news around the larger issues around
Digital Health, data security, data privacy, AI / ML. technology, social media
and related matters.
I will also try to highlight ADHA
Propaganda when I come upon it.
Just so we keep count, the latest Notes from the ADHA Board were dated
6 December, 2018 and we have seen none since! Its pretty sad!
Note: Appearance here is not to suggest I see any credibility or
value in what follows. I will leave it to the reader to decide what is
worthwhile and what is not! The point is to let people know what is being said
/ published that I have come upon.
The government (really it's the Department of Health, a policy agency trying hard to get involved in service delivery) has not exactly covered itself in glory.
In case you haven't been keeping up with the debacle, here's a summary
Four ways the government has bungled vaccination 29 June 2021 https://medicalrepublic.com.au/four-ways-the-government-has-bungled-vaccination/48043
And don't forget the CovidSafe app was designed to track people who were in contact with others for about 15 minutes. Now it turns out a "fleeting" encounter may be sufficient to pass on the Delta version.
I doubt the app was sized (never mind the poor old contact tracers) to manage the sort of hosepipe of data this would produce - assuming anyone is actually using it - we don't know 'cos it's a national secret.
In the context of our current digital health infrastructure, it has been significant. That context is that we don’t have a digital health infrastructure as such.
What we have is a fragmented melange of one government moonshot (now lost in space), several secure messaging dead ends, state government ‘not invented here’ bespoke solutions, most focussed at the tertiary sector, and a primary care sector stranded in legacy land.
The webinar I listened to with a co-worker left me rolling my eyes. It started okay, except the main speakers needed some coaching; it seemed staged in places; midway through this new attempt to use old thinking to solve a problem started raising more and more questions. By the Q&A, it was clear the barriers to success were still far too many, and nothing had taken place to gain the many layers of agreements or recognise where there are differences. I am sure in Business Analyst land; this seems a great solution and a well-defined problem. However, any fundamental understanding of how to implement was missing. (Guessing this is a reason for the change in leadership and the new talent pool).
So, in summary, the PCA looks like another dud to throw off the smouldering fire under the fax machine: so much funding, so much potential, so little effort or care.
The PCA is hardly a breakthrough in clinical medicine. It's little more than an up-to-date electronic telephone directory. Useful, but there are far more pressing problems facing the healthcare industry.
PCA is reflective of where ADHA thinking has been. Nothing to do with healthcare, all about business administrative tasks. Begs the question - what Role is extended to these advisory groups and clinical folk?
It's not so much the statistics themselves, but it would appear that they are having to shout. Everything on that page is now bigger than before.
They've put so much effort into redesigning the page, they've left out the stats for February.
It all fits in with their strategy of spin, spin and more spin. They are confusing activity with outcomes. There's a lot of the former and none of the latter.
Meanwhile, over on the Department of Health website, the PHN data is still stuck on May 2019.
But they helpfully answer the question: Who is using digital health?
"The Australian Digital Health Agency publishes information about which public and private hospitals are using digital health as well as the latest software products."
But the link they provide https://www.digitalhealth.gov.au/get-started-with-digital-health/what-is-digital-health/who-is-using-digital-health
The Clinician Vaccine Integrated Platform (CVIP) is used to manage vaccinations and report vaccination information to the Australian Immunisation Register (AIR)
I've just looked at it in the Google app store and it was released on 4 March, has had 100+ downloads, is up to release 9.2 and a rating of 3+ It's got no reviews.
"The Clinician Vaccine Integrated Platform (CVIP) is used to manage vaccinations and report vaccination information to the Australian Immunisation Register (AIR)".
It is my understanding that when a vaccine is administered the service provider, be it a medical practitioner or pharmacist, is required to notify vaccination details (patient ID, vaccine, date, dose, type, batch no) to the AIR. Most, if not all, medical practices and pharmacies, notify the AIR electronically direct from the practice system. The AIR then updates the patient's My Health Record.
Another non-healthcare "Digital Health" initiative.
The Qld hospital where patients use their mobile phones to rate the service https://inqld.com.au/news/2021/06/29/the-hospital-where-patients-use-their-phones-to-rate-the-service/
This is ADHA's bloated media release:
Cancer patients use smartphones to provide feedback on their care experience https://www.digitalhealth.gov.au/newsroom/media-releases/recent-media-releases/cancer-patients-use-smartphones-to-provide-feedback-on-their-care-experience
"Princess Alexandra Hospital (PAH) and digital health company The Clinician, have successfully completed an Australian Digital Health Agency pilot project that enabled cancer patients to use their smartphones to provide feedback on the quality of care they received."
and these wild claims:
"The Clinician’s Chief Health Information Officer, Dr Koray Atalag said 'This digital health project had the most ambitious interoperability and integration goals I have encountered in my 20 years of professional career in this area so far.'
'The scope of health information exchange included full integration with the state-wide deployed Patient Administration System (PAS), Hospital Based Corporate Information System (HBCIS) and electronic medical record system (ieMR) as well as My Health Record.' "
Talking about the uselessness of the Covidsafe app....
'Very useless': COVIDSafe has not been updated for the more infectious Delta variant https://www.abc.net.au/news/science/2021-07-01/covidsafe-has-not-been-updated-for-the-delta-variant/100255028
Since its launch in early 2020, COVIDSafe has been giving state and territory public health officials access to contact information from COVIDSafe users who have been within 1.5 metres of each other for a period of 15 minutes or more.
These parameters have not changed despite the emergence of the more infectious Delta variant, a Department of Health spokesperson confirmed.
The legacy of the COO and sometimes CEO and her merry band. I am not surprised they did not answer Mr Knibbs questions, to hard basket and reflects the contempt some have with stakeholders who are obstacles and things that have to be spoken to (rather then with).
This is what happens I guess when you leave all the wrong people in place for all the wrong reasons. Tim Kelsey and his executive team got conned.
It's a much more comprehensive approach to Digital Health than ADHA is ever going to be able to deal with.
These guys are much smarter than our health bureaucrats and lawyers, but eves so, this comment at the end rather says it all:
"Paul Hurton Jun 25
A misleading post title. The title of this post should be: "How a start-up plans to make money from our Healthcare mess". There is nothing in their ambition that offers ideas to cure what ails our health care system."
If they are as successful at making money as ADHA is at saving money, a lot of money is going to go down the drain.
There's an interesting article in the premium version of The Mandarin (which I haven't read as I don't subscribe)
This is from an email that advertises the article.
"Transparency and trust missing from Australia’s COVID-19 crisis response
According to Bill Bowtell, a former bureaucrat and political adviser involved in Australia’s response to HIV/AIDS pandemic, the nation’s low scorecard for trust and transparency between the federal, state and territory governments is hampering efforts to control the COVID-19 virus.
Bowtell has coined a phrase that sums up his view of the way governments, both federal and state, have responded to COVID-19: ‘Nature creates viruses but politicians create pandemics’.
This is not a cynical view, the UNSW adjunct professor and strategic health policy consultant tells The Mandarin, but one grounded in decades of public health experience."
IMHO, this goes a long way to explaining the miserable failure of My Health Record.
It was supposed to have grown out of COAG, when all the states, territories and the Federal government agreed to build a system that would create a single system that could access all the different health data repositories to form a virtual health/medical record. As we all know, that never happened. What we have is a shadow of the intended system, which the Federal government still pretends was delivered.
Reviewing what happened, it could be argued that the states and territories just let the Federal government throw money at a system (>$2billion and rising) without actually engaging in the process. Considering the states and territories actually deliver healthcare services this didn't help at all. In fact they all seem to have gone their own way and most are determined to build their own systems that meet their needs as health care providers.
This has left the Federal government with a system that does not meet the needs of the states and territories, so they now claim that it meets the needs of patients. Which it obviously doesn't and can't. Will they admit this? Don't hold your breath.
So we now have the Federal Department of Health and the ADHA desperately trying to get involved in whatever healthcare service delivery they can but not having the expertise. COVIDSafe, CVIP and My Health Record and Digital Health are just technology sideshows which can be safely ignored. The real failures are the vaccine roll out, the delivery of aged care services and the NDIS.
It's the same old story. The Federal government thinks it is better than the States. The States don't agree and quietly prove them wrong.
Agree, I was less than impressed with the engagement aspect. ADHA appears to swing from one extreme to the other, we have polished online collaboration now the pendulum has swung in the complete opposite direction. Not sure playing favourites in Q&A or being condescending towards the audience is a winning strategy.
One consistency seems to be the content, have baked, poorly thought through and desperate.
Hopefully this is a turning point and the pendulum swings back towards a more collaborative and engaging place.
15 comments:
The government (really it's the Department of Health, a policy agency trying hard to get involved in service delivery) has not exactly covered itself in glory.
In case you haven't been keeping up with the debacle, here's a summary
Four ways the government has bungled vaccination
29 June 2021
https://medicalrepublic.com.au/four-ways-the-government-has-bungled-vaccination/48043
And don't forget the CovidSafe app was designed to track people who were in contact with others for about 15 minutes. Now it turns out a "fleeting" encounter may be sufficient to pass on the Delta version.
I doubt the app was sized (never mind the poor old contact tracers) to manage the sort of hosepipe of data this would produce - assuming anyone is actually using it - we don't know 'cos it's a national secret.
Another might be
In the context of our current digital health infrastructure, it has been significant. That context is that we don’t have a digital health infrastructure as such.
What we have is a fragmented melange of one government moonshot (now lost in space), several secure messaging dead ends, state government ‘not invented here’ bespoke solutions, most focussed at the tertiary sector, and a primary care sector stranded in legacy land.
The webinar I listened to with a co-worker left me rolling my eyes. It started okay, except the main speakers needed some coaching; it seemed staged in places; midway through this new attempt to use old thinking to solve a problem started raising more and more questions. By the Q&A, it was clear the barriers to success were still far too many, and nothing had taken place to gain the many layers of agreements or recognise where there are differences. I am sure in Business Analyst land; this seems a great solution and a well-defined problem. However, any fundamental understanding of how to implement was missing. (Guessing this is a reason for the change in leadership and the new talent pool).
So, in summary, the PCA looks like another dud to throw off the smouldering fire under the fax machine: so much funding, so much potential, so little effort or care.
The PCA is hardly a breakthrough in clinical medicine. It's little more than an up-to-date electronic telephone directory. Useful, but there are far more pressing problems facing the healthcare industry.
PCA is reflective of where ADHA thinking has been. Nothing to do with healthcare, all about business administrative tasks. Begs the question - what Role is extended to these advisory groups and clinical folk?
Read what Jeremy Knibbs thinks of the PCA.
https://medicalrepublic.com.au/adha-provider-connection-project-would-save-practices-a-bomb/48080
The more you read the less impressed he seems to be.
It looks like yet another use-case of what's at the top of this blog:
H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."
The failings of the PCA solution are outside of both ADHA's control and the technology they are trying to deliver.
There's more to the problem than the technology solution can deliver.
Have you seen the ADHA's latest statistics?
https://www.digitalhealth.gov.au/initiatives-and-programs/my-health-record/statistics
It's not so much the statistics themselves, but it would appear that they are having to shout. Everything on that page is now bigger than before.
They've put so much effort into redesigning the page, they've left out the stats for February.
It all fits in with their strategy of spin, spin and more spin. They are confusing activity with outcomes. There's a lot of the former and none of the latter.
Meanwhile, over on the Department of Health website, the PHN data is still stuck on May 2019.
https://www1.health.gov.au/internet/main/publishing.nsf/Content/PHN-Digital_Health
But they helpfully answer the question: Who is using digital health?
"The Australian Digital Health Agency publishes information about which public and private hospitals are using digital health as well as the latest software products."
But the link they provide
https://www.digitalhealth.gov.au/get-started-with-digital-health/what-is-digital-health/who-is-using-digital-health
is dead.
Have you seen the whole new website?
Rather than deliver anything useful, it seems they've spent time and money redeveloping the look and feel of the site.
This page just about says it all:
https://www.digitalhealth.gov.au/about-us
A bunch of faceless bureaucrats.
Has anyone seen anything about the CVIP?
https://www.digitalhealth.gov.au/healthcare-providers/cvip
The Clinician Vaccine Integrated Platform (CVIP) is used to manage vaccinations and report vaccination information to the Australian Immunisation Register (AIR)
I've just looked at it in the Google app store and it was released on 4 March, has had 100+ downloads, is up to release 9.2 and a rating of 3+ It's got no reviews.
"The Clinician Vaccine Integrated Platform (CVIP) is used to manage vaccinations and report vaccination information to the Australian Immunisation Register (AIR)".
It is my understanding that when a vaccine is administered the service provider, be it a medical practitioner or pharmacist, is required to notify vaccination details (patient ID, vaccine, date, dose, type, batch no) to the AIR. Most, if not all, medical practices and pharmacies, notify the AIR electronically direct from the practice system. The AIR then updates the patient's My Health Record.
What then is the purpose of the CVIP?
Another non-healthcare "Digital Health" initiative.
The Qld hospital where patients use their mobile phones to rate the service
https://inqld.com.au/news/2021/06/29/the-hospital-where-patients-use-their-phones-to-rate-the-service/
This is ADHA's bloated media release:
Cancer patients use smartphones to provide feedback on their care experience
https://www.digitalhealth.gov.au/newsroom/media-releases/recent-media-releases/cancer-patients-use-smartphones-to-provide-feedback-on-their-care-experience
"Princess Alexandra Hospital (PAH) and digital health company The Clinician, have successfully completed an Australian Digital Health Agency pilot project that enabled cancer patients to use their smartphones to provide feedback on the quality of care they received."
and these wild claims:
"The Clinician’s Chief Health Information Officer, Dr Koray Atalag said 'This digital health project had the most ambitious interoperability and integration goals I have encountered in my 20 years of professional career in this area so far.'
'The scope of health information exchange included full integration with the state-wide deployed Patient Administration System (PAS), Hospital Based Corporate Information System (HBCIS) and electronic medical record system (ieMR) as well as My Health Record.' "
It's like watching children at play.
Talking about the uselessness of the Covidsafe app....
'Very useless': COVIDSafe has not been updated for the more infectious Delta variant
https://www.abc.net.au/news/science/2021-07-01/covidsafe-has-not-been-updated-for-the-delta-variant/100255028
Since its launch in early 2020, COVIDSafe has been giving state and territory public health officials access to contact information from COVIDSafe users who have been within 1.5 metres of each other for a period of 15 minutes or more.
These parameters have not changed despite the emergence of the more infectious Delta variant, a Department of Health spokesperson confirmed.
The legacy of the COO and sometimes CEO and her merry band. I am not surprised they did not answer Mr Knibbs questions, to hard basket and reflects the contempt some have with stakeholders who are obstacles and things that have to be spoken to (rather then with).
This is what happens I guess when you leave all the wrong people in place for all the wrong reasons. Tim Kelsey and his executive team got conned.
If you want some idea about what's going on in the big wide world outside the ADHA bubble, have a read of this:
The Secret 3-Step Master Plan to Cure Healthcare
https://www.notboring.co/p/the-secret-3-step-master-plan-to
It's a much more comprehensive approach to Digital Health than ADHA is ever going to be able to deal with.
These guys are much smarter than our health bureaucrats and lawyers, but eves so, this comment at the end rather says it all:
"Paul Hurton
Jun 25
A misleading post title. The title of this post should be: "How a start-up plans to make money from our Healthcare mess". There is nothing in their ambition that offers ideas to cure what ails our health care system."
If they are as successful at making money as ADHA is at saving money, a lot of money is going to go down the drain.
The Digital Health contagion is quite widespread.
There's an interesting article in the premium version of The Mandarin (which I haven't read as I don't subscribe)
This is from an email that advertises the article.
"Transparency and trust missing from Australia’s COVID-19 crisis response
According to Bill Bowtell, a former bureaucrat and political adviser involved in Australia’s response to HIV/AIDS pandemic, the nation’s low scorecard for trust and transparency between the federal, state and territory governments is hampering efforts to control the COVID-19 virus.
Bowtell has coined a phrase that sums up his view of the way governments, both federal and state, have responded to COVID-19: ‘Nature creates viruses but politicians create pandemics’.
This is not a cynical view, the UNSW adjunct professor and strategic health policy consultant tells The Mandarin, but one grounded in decades of public health experience."
IMHO, this goes a long way to explaining the miserable failure of My Health Record.
It was supposed to have grown out of COAG, when all the states, territories and the Federal government agreed to build a system that would create a single system that could access all the different health data repositories to form a virtual health/medical record. As we all know, that never happened. What we have is a shadow of the intended system, which the Federal government still pretends was delivered.
Reviewing what happened, it could be argued that the states and territories just let the Federal government throw money at a system (>$2billion and rising) without actually engaging in the process. Considering the states and territories actually deliver healthcare services this didn't help at all. In fact they all seem to have gone their own way and most are determined to build their own systems that meet their needs as health care providers.
This has left the Federal government with a system that does not meet the needs of the states and territories, so they now claim that it meets the needs of patients. Which it obviously doesn't and can't. Will they admit this? Don't hold your breath.
So we now have the Federal Department of Health and the ADHA desperately trying to get involved in whatever healthcare service delivery they can but not having the expertise. COVIDSafe, CVIP and My Health Record and Digital Health are just technology sideshows which can be safely ignored. The real failures are the vaccine roll out, the delivery of aged care services and the NDIS.
It's the same old story. The Federal government thinks it is better than the States. The States don't agree and quietly prove them wrong.
Sarah ConnerJune 30, 2021 8:15 AM
Agree, I was less than impressed with the engagement aspect. ADHA appears to swing from one extreme to the other, we have polished online collaboration now the pendulum has swung in the complete opposite direction. Not sure playing favourites in Q&A or being condescending towards the audience is a winning strategy.
One consistency seems to be the content, have baked, poorly thought through and desperate.
Hopefully this is a turning point and the pendulum swings back towards a more collaborative and engaging place.
The story in medical republic 2 July presents an old and all to familiar problem inflicting our health system
How ‘buying IBM’ to sort out covid became a monumental fail
Old and all to familiar - this time round it has put everyone’s lives and well-being at risk.
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