This appeared last week.
Report finds My Health Record ‘plagued’ with poor usability
16 May 2024
It also found automation of simple tasks could free up to 30% of clinicians’ time, and data sharing could save $5.4 billion.
A new
Productivity Commission report has revealed that investment into digital technology in healthcare and improving
the management of My Health Record (MHR) could save more than $5 billion a
year.
Increased data sharing in healthcare could save $355 million from fewer
duplicated tests alone, it found.
The report states that while nine out of 10 GPs now practice digitally, with no
paper records, progress is ‘more mixed when it comes to realising the gains of
digital information sharing’.
With around 7000 accredited GP clinics and 700 public hospitals in Australia,
the report said there is a lag in information access between acute and
community care.
‘These providers have invested in different digital systems, each with their
own data structures, clinical terminology and standards,’ it states.
‘MHR was intended to be a solution to this siloed data structure, providing a
central access point for a patient’s most important health data.
‘But despite an investment of more than $2 billion, it continues to be plagued
by incomplete records and poor usability.’
Repairing this ‘disconnected information management and sharing landscape’ will
be challenging, the report highlights, but overall would result in ‘significant
payoffs’.
‘In addition to the substantial cost savings it could provide, better data also
lays the foundation for other digital health applications, such as remote care
and AI,’ it reads.
RACGP Expert Committee – Practice Technology and Management Chair Dr Rob
Hosking said GPs often get frustrated when they find key information missing
from MHR.
‘It’s a bit of a vicious cycle because once you look a few times and there’s
nothing there, you stop looking,’ he told newsGP.
‘But every now and again, there’ll be more information.
‘What will probably eventually drive more uploads is more utilisation by the
patients, when they are reviewing their own records and realise that the
records are incomplete.’
The Productivity Commission found data sharing across healthcare providers can
also reduce the incidence of adverse events.
‘When GPs do not receive hospital discharge summaries, the risk of an
individual being readmitted to hospital within seven days increases by 79%,’
the report reads.
It also says there are major issues in MHR that have created gaps in the
system.
‘Consumers need to link their MHR through MyGov to access their records,’ it
states.
But as of March 2024, less than one-third, or 6.7 million had done so.
The report also highlights that despite almost all GPs being registered on the
system, they can also choose not to enter patient data into MHR, even for
individuals that have opted in, meaning ‘the amount of detail contained within
an individual’s record varies’.
The report has put forward making MHR uploading mandatory for GPs, but states
that ‘getting the information onto the system is only half the challenge –
clinicians also need to draw on this valuable information’.
If this is to occur, the Productivity Commission says mandatory uploading will
need to be accompanied by ‘changes that allow practitioners to efficiently
search large volumes of data and display reports in a way that is easy to read
and accessible’.
Commission estimates suggest that around 2% of documents uploaded by healthcare
providers are viewed by other healthcare providers.
But Dr Hosking says it is too early to mandate GPs to upload to MHR and adding
extra upload times to GPs’ hours would be ‘unacceptable’.
‘At the moment, we are rewarded [through the Practice Incentives Program
eHealth Incentive] for uploading a small percentage of our patients’ summaries
to MHR, so it’s a carrot rather than a stick,’ he said.
‘If it’s an upload, it’s going to add extra time, if it’s automated, that’s a
different story.’
Dr Hosking said it will become mandatory
for pathology and diagnostic imaging to be uploaded onto MHR if legislation
passes by the end of the year.
‘That’s going to make a huge difference,’ he said.
Additionally, the Commission says surveys show that administrative tasks are
consuming too much of healthcare workers time and should be taken over by
AI.
‘AI technology based on large language models has been developed that can
transcribe notes during a consultation, draft referral letters and care plans
and complete other forms of documentation,’ the report said.
‘AI can also automate labour-intensive tasks such as clinical coding of data, with
a recent pilot finding that processing time for a full-time equivalent worker
improved by 30% using AI.’
Dr Hosking agrees that AI can be used efficiently to transcribe consults but is
not ready to be used in clinical decision making.
‘Transcription of notes is time consuming for clinicians and GPs, so that’s one
area that it can work really well,’ he said.
‘If software is functioning as a medical device it needs to be registered with
the Therapeutic Goods Administration (TGA) and it has to undergo specific
testing and safety clearance.
‘At the moment that’s what the TGA is currently grappling – how to regulate it
and make sure that those tools are safe.’
AI and digital technology for general practice is set to be a talking point at the RACGP 2024 Practice
Owners Conference next week.
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Here is the link:
https://www1.racgp.org.au/newsgp/professional/report-finds-my-health-record-plagued-with-poor-us
I wonder when the PC is just going to admit the myHR is just a silly, obsolete idea and close the whole thing down, spending the money saved on something more useful?
We can dream I guess….
David.
7 comments:
Gee, what a debacle.
e.g.
"RACGP Expert Committee – Practice Technology and Management Chair Dr Rob Hosking said GPs often get frustrated when they find key information missing from MHR."
The patient's GP (their nominated provider, in the legislation) is supposed to be responsible for the patient's data in a MyHR.
So what does the RACGP say? It's the patient's fault!
‘What will probably eventually drive more uploads is more utilisation by the patients, when they are reviewing their own records and realise that the records are incomplete.’
All that education by ADHA telling patients that myHR is their responsibility has gone to waste. Oh! that's right, there has never been any eductation of patients.
This is what patients think of MyHR
"‘Consumers need to link their MHR through MyGov to access their records,’ it states.
But as of March 2024, less than one-third, or 6.7 million had done so."
The only way to get to MyHR is via MyGov. What that statistic tells us is that after 12 plus years, fewer that a third of Australians have bothered. Probably far fewer actually use it.
Then there's this "But Dr Hosking says it is too early to mandate GPs to upload to MHR and adding extra upload times to GPs’ hours would be ‘unacceptable’."
Too early? what the heck does that mean? Did the designers of the PCEHR not consider this extra time? No. Why? Because they designed a system that would link up existing data. A brief summary was to be provided by GPs. The problem is, that system did not get built.
This is what the Productivity Commission meant by "MHR was intended to be a solution to this siloed data structure, providing a central access point for a patient’s most important health data."
It never happened and the supposed improvements to MyHR won't deliver it. That's because it requires more than just interoperability, it needs data to be curated if it is to make sense.
That's why Dr Hosking comes up with "‘If it’s an upload, it’s going to add extra time, if it’s automated, that’s a different story."
and "Dr Hosking said it will become mandatory for pathology and diagnostic imaging to be uploaded onto MHR if legislation passes by the end of the year.
‘That’s going to make a huge difference,’ he said. "
and then the PC and he invoke the magic of AI. Oh dear, the promise of more technology.
re David's question "I wonder when the PC is just going to admit the myHR is just a silly, obsolete idea and close the whole thing down, spending the money saved on something more useful?"
They won't, it's not their job. The only body that could close MyHR down is the Department of Health and Ageing. But that means admitting that for 15 years they have been wrong.
Don't hold your breath.
Less than 6.7 million consumers (one third) have linked their MHR to MyGov! Without that link the consumer cannot access their MHR!
How extraordinary is that?
Therefore, as just about everyone has been 'given' an 'obligatory' MHR with very few bothering to opt-out, it follows that more than 66% of consumers have never accessed their MHR and have no interest in doing so!
This suggests to me that Dr Hosking's is deluding himself by asserting that:
"What will probably eventually drive more uploads is more utilisation by the patients, when they are reviewing their own records and realise that the records are incomplete."
How extraordinary is that?
Maybe the Government will forcibly link every consumer's MHR to their MyGov account (if they have one). And if they don't have a My Gov account penalise them in some way for not having one!
How extraordinary is that?
You can mislead citizens and sign them up to a data lake, but you can't force them to drink—just the last flutters of a sunset. We will, I am sure, see similar desperate and last-ditch statements coming from other early ehealth efforts as they try to remain relevant.
It's much more than extraordinary. These people are aspirational fantasisers well practised in the art of deluding others into believing their fantasies.
The ADHA and the DOH will focus their energies on smothering the Productivity Commission's Report under a blanket of 'Progress Reports,' good news stories and 'new Consulting Initiatives'.
It's politically impossible for the DOHA to close down the MHR or dismantle the ADHA after 15 years of claiming great progress and advances year on year. They genuinely believe that if they just keep 'going', doing what they have been doing, they will get there one day - wherever there is! The technocrats keep feeding the bureaucrats and vice versa and the Minister unquestioningly believes what they both say!
My HR will be updated to align with the soon to be announced love child of OpenEHR and HL7 (again)
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