The departure a week or so ago of the previous substantive CEO of the AIDH (Dr Louise Schaper) has provided an opportunity to some fundamentals of the Aust. Institute Of Digital Health (AIDH) to be re-examined and questioned.
Among these are:
Is change needed to the structures and functions of the AIDH?
Should the Academic functions and the Conference Organising functions be separated?
Does it make any sense to have two different sets of credentials (CHIA and FAIDH etc)?
How could a purely academic Digital Health group be sustained and supported, if desired?
What should be the functions of the different parts of the AIDH – or should they be totally separate?
Is the AIDH an appropriate organization to be offering credentials like CHIA. FAIDH etc. and, if so, how should they be managed and supported?
How should AI be managed within a Digital Health initiative?
I am sure there a zillions of other questions that should be also considered, as should be a mechanism to reshape the AIDH as members desire!
I hope the AIDH Board can take these issues up and really design a worthwhile way forward for all stakeholders!
What change do you think is needed?
David.
According to the AIDH website
ReplyDelete"The Institute’s mission is to improve healthcare for all"
https://digitalhealth.org.au/about/
and that's in the section "Who can take part in Institute activities?"
The webpage starts with
"The challenge
Under the current healthcare system, information about patients is not recorded efficiently or effectively, clinicians can’t easily share information and there are numerous adverse events (preventable medical error is the third leading cause of death). While most of healthcare still operates with paper or disconnected systems, complex and critical information is captured through processes not readily communicated or broadly accessible.
The Institute’s purpose is to change that through a connected health system and a connected and digitally competent health workforce."
So, there is a mission and a purpose which seem to be totally disconnected. Is information collection, curation and availability, the most useful thing that can be done?
I suggest they get their act together and start with an analysis of healthcare and identify the most important healthcare priorities before they even think about solutions to problems they have not identified, never mind the relative benefits of solving them. But that's not even a question they can even ask - they've been told what to do, so just get on with it
AIDH is a classic example of solutionism, which leaves no room for a proper analysis and strategy. Someone's made a decision to do something without knowing if it will deliver any value, let alone more value than other actions.
It's the usual political logic:
Something must be done.
This is something
Let's do it.
Next problem?
And if the robodebt fiasco is anything to go by, no public servant is going to tell upper management and politicians they are wasting the nation's taxes.
ADIH and it’s assorted cousin organisation’s are fast becoming quasi government entities. The gradual take over is evident. This happened to NEHTA and others. The Department injects cash, then ‘special projects’ then reshapes and reducing the purpose. This idea of quasi government’ purpose’ is, I think, very sinister. It opens the door to the creation by businesses of an Orwellian dystopian environment and the creation of thought police where everyone has to be on ‘message’.”
ReplyDeleteI may be wrong but if we start hearing deep purpose and other platitudes and there will doubtless be something after that. All these exercises end up generating the same meaningless statements in expensive consultancy-driven exercises.
As pointed out solutionisms reigns
The promises of the PCEHR (My Health Record) written in 2008 were...
ReplyDelete"2.5.1 Key benefits for patients
Poor availability of health information across healthcare settings can be frustrating and time consuming for patients and healthcare providers alike. It can also have damaging effects on a patient’s health outcomes through, for example, avoidable adverse medication events or lack of communication between healthcare providers following discharge from hospital or where multiple providers are involved in a patients care.
The PCEHR system will enable patients to have easy-to-access information about their medical history, including medications, test results and allergies, allowing them to make informed choices about their healthcare and be active participants in their healthcare.
The system will allow an individual’s key health information to travel with them through the healthcare system, making it available to support their endto-end healthcare needs regardless of where they seek healthcare assistance.
Patients will no longer have to remember every detail of their care history and retell it to every healthcare provider they see. Parents will not have to remember the vaccinations their child has had and healthcare providers will not have to search through paper records."
https://doi.org/10.1136%2Famiajnl-2013-002068
We are still talking about the problems of data silos, poor communication, need more interoperability/messaging, multiple records that are different/incomplete (no single record of truth) & adverse events...
Some features may work for babies as they grow up but I don't think much has changed, many problems still remain.
2008 was 15 years ago!
ReplyDeleteSo little of value has been delivered.
No real benefits have yet been realised.
The development costs have been huge.
No compelling convincing demonstration exists to justify all the money, time and resources invested to-date.
Hype and promises prevail; reality, pragmatism and accountability barely exist.
I agree Ian, it's very frustrating when there is a basic lack of understanding that working interoperability is built on layers and you need to focus on getting the lower layers working correctly before you try and get anything happening on higher layers.
ReplyDeleteInstead they try and get a higher level layer working, which it will only do with smoke and mirrors and is totally unreliable (Converting to pdf is in this class). The lower layer is compliant messages, that is wrt creation and consumption working reliably and safely. We are seeing a gradual reversal of quality in the health IT sector as it seems management gradually gets less and less knowledgeable about basic IT concepts and just says "Make it work" while not addressing the fundamental problems. I have been forced to stop paying it much attention as failure is assured, but people involved can't see that, so you have to let them find out for themselves while burning taxpayer (or borrowed) money at a great rate. Every generation of our "National eHealth Authority" has started from ground zero, which is at the clueless level and by the time they learn a bit they get the chop and get replaced by increasingly ignorant non-technical management.
In a way the problem is $$$ being available without any concern or evaluation of a return on investment, which is not something the private sector can do, but government can, so I guess we have to wait for a real economic collapse before the tap gets turned off?
Last night's 4 Corners revelations into the big four consultant firms led me to reflect on how much 'influence' Deloitte and KPMG have had on the direction of digital health over the last 15 years. What do others think?
ReplyDeleteI think Digital Health is structured of deep purpose with a sprinkling of ESG and you need to stay on message anonymous 12:37 PM.
ReplyDeleteA AIDH new policy platform on three planks: protecting health (data) freedom and use of blockchain's distributed ledger technology; fostering digital health innovation and economic growth; and empowering (health) data portability.
ReplyDeleteAIDH would be better served by cosying up to any one of these companies over gov't: https://builtin.com/blockchain/blockchain-healthcare-applications-companies
@Mike said...
ReplyDelete"AIDH new policy platform on three planks: protecting health (data) freedom and use of blockchain's distributed ledger technology; fostering digital health innovation and economic growth; and empowering (health) data portability."
Ask anyone at the coalface of healthcare delivery (i.e. patients, doctors, specialists, nurses etc) what that means and all you'll get is a blank stare.
It's an AIDH wet dream. And about as useful.
Blockchain may well be useful in the protection of sensitive data. However, it's the data itself that is the challenge. Or are we suggesting using blockchain to prevent people discovering how woeful the data quality is and its inconsistency?
ReplyDeleteMy 12 year Yesterday commented the pharmacy as we picked up a script. Thinking this was great - I was reminded by the digital generation that it probably took the energy consumption of 20 sheets of paper to create what was a single piece of paper - and could be recycled.
ReplyDeleteNo real science behind it, but it is probably not wrong - what does the AIDH. have to deal with the impact digital health has on scarce resources we have or the environmental impact?