Sunday, June 12, 2022

We Are Seeing A Lot Of Commentary On The #myHealthRecord With A View That Most Optimism Is A Triumph Of Hope Over Experience!

It al seemed to kick of with the Guardian article which was covered on Monday this week. Here is a link and brief extract.

My Health Record

My Health Record: after 12 years and more than $2bn, hardly anyone is using digital service

Research shows many Australians find medical records not uploaded and clinicians fail to see benefits of using the national online database

Melissa Davey Medical editor

@MelissaLDavey

Mon 6 Jun 2022 03.30 AEST Last modified on Mon 6 Jun 2022 03.31 AEST

Twelve years after the introduction of My Health Record, Australians are struggling to access their medical information, while clinicians report frustrating difficulties uploading and finding vital health details such as pathology results and diagnostic tests.

The latest annual report from the Australian Digital Health Agency shows just 2.69 million of the 23 million people registered for a My Health Record accessed it in 2020-21. While this is an increase of 14% from the previous year, it was largely driven by people accessing Covid-19 vaccination records and Covid-19 test results.

The chief executive of the Consumers Health Forum (CHF), Leanne Wells, said while upgrades to My Health Record to include access to vaccination information and Advanced Care Plans were welcome, day-to-day health records from consultations, emergency department visits, hospital discharges, pathology, and diagnostic testing were still missing from many records. This is despite more than $2bn being spent on the system since it launched in 2012.

“These items represent the vital health information that should be shared between health service providers, however, consumers report that their expectations are not met when these are not visible, or are only visible on supply from some, but not all, providers,” Wells said.

Lots more here:

https://www.theguardian.com/australia-news/2022/jun/06/my-health-record-after-12-years-and-more-than-2bn-hardly-anyone-is-using-digital-service

Then a day or so later:

Pandemic prompts massive spike in My Health Record use

Immunisation details and PCR results have raised the database’s profile, but queries remain about its reliability and usage among general practices.


Jolyon Attwooll


08 Jun 2022

The pandemic has had many unforeseen consequences – and one of them seems to be a surge in the use of My Health Record, the digital database intended as a ‘single source of truth’ for patients and health professionals.
 
Figures published by the Australian Digital Health Agency (ADHA), which oversees My Health Record,
show an exponential increase in visits to the website in the past year.
 
The ADHA reports a figure of 1.57 million for April last year, which rose to a high of 13.75 million in January. While the most recent statistics have fallen from that peak – in April 2022, they stood at 4.83 million – they still reflect a tripling in use from 12 months previously.

According to the organisation, those statistics 'are at a total viewing level' so could include one person viewing several documents. It also clarified that they are views by consumers, not healthcare providers (see update below).
  
Regardless of who is looking, the numbers reflect a huge increase in use and visibility for the patient database.
 
The ADHA attributes much of that to the pandemic, with upgrades last year allowing vaccination certificates and details from the Australian Immunisation Register to be accessed on the database more easily.
 
It explains a 61% month-on-month rise in October last year by the lifting of lockdown restrictions in NSW with residents looking for proof of vaccination. The ADHA also links the January peak to soaring COVID-19 case numbers, which again prompted people to check their vaccination status and PCR test results on My Health Record.
 
One of the most pertinent questions is whether the surge in public familiarity with the database will translate into greater reliability and detail within the individual patient records.  
 
For Western Australian GP Dr David Adam, who sits on the RACGP Expert Committee – Practice Technology and Management (REC–PTM), there are positive signs. A former IT administrator himself, Dr Adam believes there have been noticeable improvements since the system changed from an opt-in database to opt-out in early 2019.
 
‘I’ve definitely found it more useful recently compared to the early days,’ he told newsGP.
 
‘Our public hospitals in Western Australia are being much more consistent about uploading letters and results, and the Medicare, PBS and immunisation views are very helpful at times, especially with new patients.’
 
The My Health Record database has been one of the flagship digital programs under successive governments, although at times it has proved contentious.
 
The Australian National Audit Office reports a Federal Government investment of $1.15 billion from 2012–2016, with another $374.2 million spent from 2017–2020. The Department of Health previously told The Guardian almost $2 billion has been spent on the record since 2009.
 
After ‘opt-out’ legislation came into effect in 2019, the number of patients on the database has more than quadrupled.
 
There are now 23.3 million active My Health Records, the ADHA reports – or more than nine in 10 Australians. Of those registered for Medicare services in the country, around 9.5% are thought to have opted out.
 
In 2018, before the opt-out laws came into place, there were around 5.7 million patients on the database.
 
But while 99% of general practices have also now signed up, GPs report mixed results on the level of detail contained within the records, with around one in every 25 currently containing no data at all.
 
Among those is Dr Rob Hosking, who chairs the REC–PTM.
 
‘It is hit and miss as to whether results and other useful information is on My Health Record,’ Dr Hosking told newsGP.  
 
He believes more legislation is required to make it work better.
 
‘To make it more functional, it should be mandated that pathology and imaging results are uploaded. Currently only some results are uploaded,’ he said. 
 
‘Likewise, hospital discharge summaries should be mandatory to be uploaded as well as sent to GPs.’
 
However, Dr Hosking also sounds a strong note of scepticism about the likelihood of success.
More here:

https://www1.racgp.org.au/newsgp/professional/pandemic-prompts-massive-spike-in-my-health-record

Interesting that the usage increase was really a just a spike which has since dropped off and COVID and all the testing has eased off.

It is also of note the ADHA makes a really weak response to the main question as I see it.

“1. How far can GPs trust the completeness of information on MHR?
ADHA: My Health Record contains a summary of key health information to support the delivery of health care and is not intended to be a comprehensive record of an individual’s health information.  The completeness of the record is growing as more health providers connect to and use My Health Record.”

We then had a strange commentary I noticed:

Talking HealthTech

249 – Digital health strategies – Australia and beyond; Tjasa Zajc, Faces of Digital Health

Will the My Health Record ever become a valuable infrastructure?  Peter Birch is the founder and host of the Talking HealthTech podcast and is one of the board members of…

June 9, 2022

https://www.talkinghealthtech.com/podcast/249-digital-health-strategies-australia-and-beyond-tjasa-zajc-faces-of-digital-health-1372

249 - Digital health strategies - Australia and beyond; Tjasa Zajc, Faces of Digital Health

In this episode, you'll hear something slightly different; it's Pete getting interviewed by Tjasa Zajc on her podcast; Faces of Digital Health. Pete and Tjasa discuss the My Health Record (MyHR), which  over twenty-three million Australians are currently using. They also explore the opt-in and out controversy surrounding MyHR, clinicians' ability to connect to the record and how that affects the record's completion status, including the populations being covered and much more. 

My Health Record's Progress

My  Health Record is undoubtedly an exciting piece of health tech solution,  and it actually existed for quite a while but lacked the public's interest. It was introduced as a means of having a central health record  for every Australian, and for good reasons too. However, a lot of  information has to be loaded into the record, which relies on each person actually setting it up by going through an arduous process. Then,  what do we actually do with this PDF format information?

MyHR then went from an opt-in to an opt-out system, which worked for a while until questions around data security and privacy came up from many concerned Australians. During COVID-19, much focus was placed on the MyHR since vaccines were administered, and the My Health Record was used as the place of reference for vaccine certificates. 

As  such, there was a massive uptake of the record; nonetheless, the challenge going forward will be to invest in additional use cases that more of the public would see as beneficial and Interesting. 

Lots more at this link:

https://healthpodcastnetwork.com/episodes/talking-healthtech/249-digital-health-strategies-australia-and-beyond-tjasa-zajc-faces-of-digital-health/

I will leave it to the reader to sort fact from fiction with this one!

Lastly I noticed there was an editorial from Pulse+IT yesterday here:

My Health Record: 10 years, no progress, no news

Written by Kate McDonald on 10 June 2022.

https://www.pulseitmagazine.com.au/blog/6633-my-health-record-10-years-no-progress-no-news

This is a strange piece which says the #myHR is ‘no good’ has cost heaps and delivered little but that in the absence of any alternatives should be persisted with and that clinicians should be paid to use it!

Summary: lets increase ongoing spend hoping that a 10 year failure will suddenly start working!

Overall we are seeing a bizarre view that if 10 years of spend fails to work that 20 or so will, and despite all its flaws all will come good in the end! What nonsense I say!

There is really a lot of ‘magical thinking’ going on about the #myHR and it really needs to stop!

What do you think!

David.

 

8 comments:

  1. Dr Ian ColcloughJune 12, 2022 3:26 PM

    It doesn't really matter what I or others think. The only thing that matters is what the Treasurer and the Finance Minister think. They are the ones who hand out the money.

    ReplyDelete
  2. "They are the ones who hand out the money."

    and they probably expect to get the billions of $ of savings that the DoH promised a decade ago.

    Fat chance of that.

    ReplyDelete
  3. @4:46PM It sounds like you think they are naive and only capable of handing out money.

    ReplyDelete
  4. @5:01 PM

    well, they've never interested so far in the failure to deliver on their promises.

    ReplyDelete
  5. @10:20PM You must be short sighted one eyed and anti labor. The Treasurer and Finance Minister have only been in the job for two weeks. Give them a break.

    ReplyDelete
  6. @11:26 The last time I looked we've had a Treasurer and Finance Minister for decades. You're assuming I'm talking about the people who are currently in these roles. I'm not.

    ReplyDelete
  7. @6:41 AM You're not. I am. The past has gone. The incompetents are no longer relevant. I live in the present.

    ReplyDelete
  8. It will come down to where this sits in the pile of problems. I fear the ADHA and MYHR will survive because as big a waste as it is, it does not get in the top 100. That said, Service Australia is closing a bunch of call centres and laying people off, so maybe.

    I know those most vulnerable in the community would prefer to speak with someone hiding behind MyGov rather than visit an incomplete and irrelevant list of health information the government has on them.

    ReplyDelete