tag:blogger.com,1999:blog-23447705.post4643897639179351739..comments2024-03-28T17:49:03.998+11:00Comments on Australian Health Information Technology: Now Here Is A Question I Am Sure The ADHA CEO Is Wondering About During January.Dr David G More MB PhDhttp://www.blogger.com/profile/06902724829795199526noreply@blogger.comBlogger30125tag:blogger.com,1999:blog-23447705.post-33614407239310805232018-01-08T19:18:32.831+11:002018-01-08T19:18:32.831+11:00On tonight's news "this huge problem is d...On tonight's news "this huge problem is due to a decade of non-compliance and a record of cutting corners" .... sounds like they are referring to the My Health Record .... not so, they are referring to the inflammable cladding on more than 1,000 buildings in Melbourne.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-9268770957382660092018-01-08T18:51:58.973+11:002018-01-08T18:51:58.973+11:00Re: Bernard 9:20 AM "A review of medication e...Re: Bernard 9:20 AM "A review of medication errors involving opioids in palliative care has found under-dosing may be contributing to the burden of the pain of terminally ill patients in the last weeks of their lives."<br /><br />These findings should not be surprising. So often one observes a tendency for ‘palliators’ to administer the ‘lowest dose’ they consider acceptable just in Dr Ian Colcloughnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-62015535961059289152018-01-08T17:22:34.871+11:002018-01-08T17:22:34.871+11:00While you are browsing the Health Record document ...While you are browsing the Health Record document from NSW Health:<br /><br />http://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2012_069.pdf<br /><br />Have a look at who in the NSW system is authorised to see a patient / client's health record:<br /><br />"A person authorised to provide assessment, diagnosis, treatment / care, observation, health evaluation or professional advice Bernard Robertson-Dunnhttp://www.problemsfirst.com/blognoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-86856774643240159122018-01-08T10:16:56.635+11:002018-01-08T10:16:56.635+11:00re "That suggests a job for ADHA - audit all ...re "That suggests a job for ADHA - audit all of them and tell us which are still running on Windows XP."<br /><br />That's a job that might be within their capabilities, however would you trust them to report what they've found?<br /><br />This does nothing to engender trust in the government:<br /><br />"Cooking the books on climate change policy"<br />http://Bernard Robertson-Dunnhttp://www.problemsfirst.com/blognoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-58392403014517741042018-01-08T09:56:43.345+11:002018-01-08T09:56:43.345+11:00Bernard (9.20am) re "existing medical record ...Bernard (9.20am) re "existing medical record systems".<br />That suggests a job for ADHA - audit all of them and tell us which are still running on Windows XP.Trevor3130https://www.blogger.com/profile/08148555743063226957noreply@blogger.comtag:blogger.com,1999:blog-23447705.post-84830684512771083182018-01-08T09:20:01.423+11:002018-01-08T09:20:01.423+11:00There are reports in today's media of a resear...There are reports in today's media of a research paper looking at opioid use in palliative care. The SMH report starts<br /><br />"A review of medication errors involving opioids in palliative care has found under-dosing may be contributing to the burden of the pain of terminally ill patients in the last weeks of their lives.<br /><br />In a paper published in British Medical Journal Bernard Robertson-Dunnhttp://www.problemsfirst.com/blognoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-8894484777786924282018-01-07T19:26:42.086+11:002018-01-07T19:26:42.086+11:00re: "the National Architecture repository&qu...re: "the National Architecture repository"<br /><br />As David said, there isn't one.<br /><br />If you go to the bottom of this page, <br /><br />https://www.privacy.org.au/Campaigns/MyHR/<br /><br />you'll find two links, one to the original Concept of Operations document which was circulated for comment, but what has disappeared from government websites. The link is to an Bernard Robertson-Dunnhttp://www.problemsfirst.com/blognoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-3643681244306499132018-01-07T18:51:48.736+11:002018-01-07T18:51:48.736+11:00"From a solution architecture viewpoint many ..."From a solution architecture viewpoint many of these solution and specifically the current approach to the MyHR would appear to be introducing a swathe of problems into the system of systems that makeup health IT. I cannot find any impact assessments that have looked into this, could anyone direct me to the National Architecture repository?"<br /><br />I'll go out on a limb here Dr David G More MB PhDhttps://www.blogger.com/profile/06902724829795199526noreply@blogger.comtag:blogger.com,1999:blog-23447705.post-7806978751521345532018-01-07T18:46:07.914+11:002018-01-07T18:46:07.914+11:00I am new into health, an architect for some four y...I am new into health, an architect for some four years now I am still learning which is one reason I looked to do some time in health. I was informed of this blog late last year and I have to say it is a great source of viewpoints. The community however seems to be positioned at two extremes, I have not encountered division of opinion quite like this. There seems to be qualified folks in both Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-50264837517121057112018-01-07T17:58:13.698+11:002018-01-07T17:58:13.698+11:00David,
I agree, and it shouldn't take an IT o...David,<br /><br />I agree, and it shouldn't take an IT or health care expert to ask the simple question: How did the business case that justified the PCEHR show what value there is in the system and exactly how that value would be delivered?<br /><br />My betting is that the business case just had motherhood and wishful thinking in it. <br /><br />With a bit of luck, one day the ANAO will Bernard Robertson-Dunnhttp://www.problemsfirst.com/blognoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-53795466247091596362018-01-07T16:59:39.154+11:002018-01-07T16:59:39.154+11:00Indeed you can't blame the pollies other than ...Indeed you can't blame the pollies other than to wonder why they don't realise they are out of their depth and have some experts audit the whole mess!<br /><br />David.<br />Dr David G More MB PhDhttps://www.blogger.com/profile/06902724829795199526noreply@blogger.comtag:blogger.com,1999:blog-23447705.post-30785734161981462932018-01-07T16:55:01.576+11:002018-01-07T16:55:01.576+11:00@4:35 PM you can't blame the politicians entir...@4:35 PM you can't blame the politicians entirely when the AMA, RACGP, PGA and Department bureaucrats in their ignorance tell the Ministers how wonderful it is. A huge confidence trick the likes of which Australia has never before seen.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-83934491828298131822018-01-07T16:49:05.499+11:002018-01-07T16:49:05.499+11:004:35 PM ... you can't blame the politicians to...4:35 PM ... you can't blame the politicians too much when AMA, RACGP, and Health Department Advisors tell the Minister how wonderful it is.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-86344085615019513852018-01-07T16:35:42.173+11:002018-01-07T16:35:42.173+11:00I think it totally incomprehensible Health Ministe...I think it totally incomprehensible Health Ministers across ALL jurisdictions do not understand they are overseeing and therefore responsible for a hugely costly system which is of no benefit to anyone! Totally incomprehensible, Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-75552711035117899672018-01-07T16:01:23.446+11:002018-01-07T16:01:23.446+11:00When myhr goes opt-out most of the data in it will...When myhr goes opt-out most of the data in it will be what the government puts in - MBS/PBS billing data.<br /> <br />I went to see a new GP the other day. My myhr now shows that I had a consultation with a GP. That's it. No reason, no medical data at all, nothing.<br /><br />If the patient's nominated service provider doesn't upload a shared health summary and the patent doesn't Bernard Robertson-Dunnhttp://www.problemsfirst.com/blognoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-26713634106676044202018-01-07T14:19:11.251+11:002018-01-07T14:19:11.251+11:00Bernard @12:34 PM said "ADHA are desperate to...Bernard @12:34 PM said "ADHA are desperate to load MyHR with more and more data in the false belief that more data is the way to go."<br /><br />Wait till they have 20 million mandatory records loaded full of 'stuff' AND no doctors are using it. <br /><br />Oh, how the world will laugh, how Tim will blab far and wide, how Australia will look so stupid and how Mr Hunt will say &Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-37609757151520513502018-01-07T10:52:45.943+11:002018-01-07T10:52:45.943+11:00Well said Bernard. Throughout my working life I ha...Well said Bernard. Throughout my working life I have always embraced your points #4,6&7. Unfortunately they do not fit the ADHA's culture and modus operandi and with the way the ADHA Board and organisation have been set-up they never will. Dr Ian Colcloughnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-1547260715784770592018-01-07T00:30:56.361+11:002018-01-07T00:30:56.361+11:00Fully agree Bernard, there is an old business sayi...Fully agree Bernard, there is an old business saying - it cost far more to win a market position back than to keep it. the ADHA Board may not have started the demise of standards in Australian eHealth but they certainly contributed to its continued demise. I see little evidence of any broad intellect at ADHA that could orchestrate policy, and standards. Yes innovation is great, but behind all Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-12527883818616780232018-01-06T19:14:24.192+11:002018-01-06T19:14:24.192+11:00"That's the easy bit. BUT who will fund s..."That's the easy bit. BUT who will fund such an exercise? And how do you get the right people to take on a project like that, starting from scratch?"<br /><br />1. you don't fund such an exercise<br />2. you don't take on such a project<br />3. you learn from the English Industrial Revolution<br />4. you remove as many impediments as possible<br />5. you set ground rules re Bernard Robertson-Dunnhttp://www.problemsfirst.com/blognoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-18089050731690118892018-01-06T18:00:11.049+11:002018-01-06T18:00:11.049+11:004:35 PM I agree. That's the easy bit. BUT who ...4:35 PM I agree. That's the easy bit. BUT who will fund such an exercise? And how do you get the right people to take on a project like that, starting from scratch? There is plenty of criticism but to what avail?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-41028585584019748552018-01-06T16:35:41.576+11:002018-01-06T16:35:41.576+11:00IMHO, Digital Health, which is just a new buzzword...IMHO, Digital Health, which is just a new buzzword and which is code for IT, is starting at the wrong end. IT is a solution, but, in its present forms, is the wrong solution. You need to start with medicine and new ways of practicing medicine, not with solutions that store data gathered from old ways of doing medicine. Nor with new solutions that replicate old solutions. That's the lipstick Bernard Robertson-Dunnhttp://www.problemsfirst.com/blognoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-41906926512794629032018-01-06T16:17:59.401+11:002018-01-06T16:17:59.401+11:00Doctor Foster - the father of health analytics wou...Doctor Foster - the father of health analytics would be a good start, internationally acclaimed digital health leader and high sort after speaker, not to mention a regular attraction at datapolozia Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-39086667079984089272018-01-06T15:45:56.806+11:002018-01-06T15:45:56.806+11:00@3:40 PM you've nailed it. Where are these peo...@3:40 PM you've nailed it. Where are these people? Which of those 'criteria' can the current CEO lay claim to?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-68063346776841586972018-01-06T15:40:19.364+11:002018-01-06T15:40:19.364+11:00Nous, open mindedness, and a questioning mind, tog...Nous, open mindedness, and a questioning mind, together with problem solving analytical skills, logic, pragmatism and enlightened vision, underpinned by a solid mix of - business, political, clinical acumen, health informatics, engineering and mature leadership skills - are all that is required to achieve the 'desired' outcome. Dr Ian Colcloughnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-61800858210958828302018-01-06T15:16:28.480+11:002018-01-06T15:16:28.480+11:00Bernard's comment is on the money. To paraphra...Bernard's comment is on the money. To paraphrase part of his comment: If your only tool is a hammer, every problem starts to look like a nail.<br /><br />I have been trying, and failing, to understand the mindset within ADHA that fails to fess up to the patient safety issues surrounding incomplete data in the myHR. The more categories of data you try to collect - the worse the problem becomesBruce Farnellhttps://www.blogger.com/profile/03895794526347112930noreply@blogger.com