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."

Monday, January 16, 2017

Weekly Australian Health IT Links – 16th January, 2017.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

The message of the break seems to have been how bad IT can really ruin your holidays and have you spending hours on the phone trying to sort things out…..what a fiasco!
Other interesting stuff also happened so do browse on!
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Screw-up nation: Why the tech we count on keeps letting us down

January 8, 20177:23am
THE Centrelink debacle that’s slugged thousands of Aussies with unfair debt is the latest in a string of disasters in which technology has let us down - with devastating consequences.
We have become a nation where screw-ups are the new normal.
Almost exactly a year ago, Centrelink was in the middle of another storm, when it was forced to apologise for a New Year’s computer glitch that incorrectly told 73,000 families they were in debt.
When Family Tax Benefits claimants checked their accounts online, they were wrongly shown to owe money, with one mother mistakenly charged more than $700.
The Australian Bureau of Statistics then paid IBM $9.6 million to run the bungled 2016 Census because its own systems were antiquated and unreliable. The national survey was a massive failure, with the website going down for 40 hours and a Senate Committee inquiry finding “significant and obvious oversights” in its delivery.

Centrelink crisis 'cataclysmic' says PM's former head of digital transformation

Paul Shetler, appointed to transform the government’s digital approach, says Centrelink’s error rate would put a private firm out of business
The man handpicked by Malcolm Turnbull to head the government’s digital transformation has said the error rate in Centrelink’s data-matching process is so unfathomably high that it would send a commercial enterprise out of business.
Paul Shetler, the former digital transformation office head, criticised the government’s response to its latest IT crisis, telling Guardian Australia it was symptomatic of a culture of blame aversion within the bureaucracy.
“It is literally blame aversion, it is not risk aversion,” Shetler said. “They’re trying to avoid the blame, and they’re trying to cast it wide.
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Trial to give pharmacists more power over scripts

Antony Scholefield | 12 January, 2017 | 21 comments Read Later
Pharmacists will be free to change medication doses, issue repeat scripts and perform point-of-care tests for patients with chronic diseases under a trial starting this year.
Running for 18 months, the Victorian trial is a way of freeing up GP time to deal with complex clinical issues, according to the state government.
Supporters argue the trial will not fragment care and GPs will retain control over what happens to patients.
The GPs taking part will write shared care plans that will guide pharmacists in monitoring and refining the medication regimen of patients with asthma, hypertension and hypercholesterolaemia, and those on anticoagulation medications.
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Better broadband needed in the bush

BETTER BROADBAND NEEDED IN THE BUSH
AMA Position Statement on Better Access to High Speed Broadband for Rural and Remote Health Care
The AMA has warned that health services in rural, regional, and remote Australia could fall even further behind city services, without urgent Government action to ensure all Australians have access to affordable and reliable high speed broadband.
The AMA today released its Position Statement on Better Access to High Speed Broadband for Rural and Remote Health Care, which calls on the Government to improve internet access across the nation.
AMA Vice President, Dr Tony Bartone, said that rapid improvements in technology have the potential to deliver better health outcomes at lower cost outside major cities and towns through telemedicine and eHealth.
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Doctors underwhelmed by NBN for e-health

By Ry Crozier on Jan 10, 2017 5:12PM

Peak medical body calls for fibre and wireless expansion.

Australian GPs have delivered a lukewarm assessment of the NBN as an enabler of e-health services in regional, rural and remote Australia, just days after the network builder publicly talked up its credentials in the space.
The Australian Medical Association (AMA) unveiled a position statement Tuesday calling on the government to take “urgent action” on bush broadband to ensure regional Australia could access “the same standard of healthcare … as those living in the major cities”.
It warned that without access to telemedicine and e-health services, those in regional, rural and remote Australia “could fall even further behind” in terms of access to quality health services.
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Ehealth: AMA call for bush broadband boost

NBN fixed line and fixed wireless footprint should be extended wherever possible, says the Australian Medical Association
Rohan Pearce (Computerworld) 11 January, 2017 10:27
The Australian Medical Association has called on the government to tackle barriers to the use of ehealth and telemedicine in rural and regional Australia.
In a position paper released this week the AMA argued that “the utilisation of telehealth and telemedicine in rural and remote Australia remains patchy and is not used to full potential, because of no, or inadequate internet access”.
Internet connections in rural areas are often expensive, slow and have relatively small download allowances, the AMA said.
The AMA called for “measures to prioritise or optimise the broadband capacity available by satellite for hospitals and medical practices, such as exempting or allocating higher data allowance quotas, or providing a separate data allowance”.
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Health starts briefing vendors on new Medicare IT

By Paris Cowan on Jan 9, 2017 3:15PM

Meetings begin this week.

Officials from the Department of Health are set to meet with IT industry representatives in Sydney and Melbourne this week, as they prepare to take bids for the right to build Australia’s new Medicare payments engine.
The agency will partner with a third party systems integrator to build the new IT system, after plans to fully outsource the end-to-end process of calculating and paying health rebates to a bank, telco or other organisation were officially canned during the 2015 election campaign.
The Turnbull government was forced to turn its back on a proposal to privatise the rebate processing work after a major public backlash threatened to derail its re-election prospects in July.
It had been tentatively taking market proposals from potential outsourcers, including Australia Post, since August 2014.
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Reform the PBS, consumer group demands

Chris Brooker 11/01/2017

Government should scrap co-pay increases and move to electronic recording, CHF says

The Federal Government should reform the PBS safety net so consumers with high usage of PBS medicines have “smoothed out annual co-payments”, the Consumers Health Forum believes.
In its 2017-18 Budget Submission, released last week, the CHF calls for reforms to PBS administration and payments to better aid consumers, with these proposals winning support from the Pharmacy Guild of Australia.
The CHF endorsed pharmacy as a “key element in the strong and sustainable primary healthcare system that Australia needs”, while calling for its integration into ongoing health structural reforms.
“CHF supports the strengthening of this crucial sector through: the removal of the PBS co-payment increase, the development of a new health payment system and through the reform of the PBS safety net”, the submission states.
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Personal health records now available online

12 Jan 2017, 10:25 a.m.
Following a Federal Government trial in Western Sydney, local hospitals are now uploading around 570 discharge summaries to My Health Record each month.
What this means is that GPs can easily access information about their patients after a stay in hospital and our clinicians can access important health information about patients that their GPs have uploaded.
As a resident of the Nepean Blue Mountains regions, which also includes Hawkesbury residents, can access their personal health record online and even set access restrictions and add information about allergies, medication and other important health information.
“In the event of a medical emergency, residents will know that their health information is stored safely and securely and can be accessed immediately by emergency doctors if required,” a spokesperson said.
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How the Turnbull government killed off its big website dream

Noel Towell
Published: January 12, 2017 - 11:48AM
The Turnbull government has quietly killed off one of its biggest plans for "digital transformation": the hugely ambitious GOV.AU website project.
Fairfax understands that Minister for Digital Innovation Angus Taylor pulled the pin on the program, at the urging of the powerful Finance Department, just minutes before plans for its next phase were due to go to cabinet in August 2016.
Mr Taylor's office insists that a rebadged version of the plan will go ahead and that it is a "priority project".
The dramatic dropping of the much-hyped centrepiece of Malcolm Turnbull's "agile and innovative government agenda" came after a Canberra turf war that had raged for months between Finance and the Prime Minister's pet public service project, the Digital Transformation Office.  
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Three simple ways to avoid more IT failures like Centrelink and the census

Centrelink’s debt recovery system is just the latest IT failure by government. It needs to fix labour hire practices if it wants better software
Centrelink’s software problems, like those of Queensland Health, the Census and Victoria Police before them, arise from pathologies created by the powerful labour hire and outsourcing industries.
Centrelink’s software invents second employers and additional income. Queensland Health bungled the pay of nurses and doctors and also sent them nasty legal letters. Queensland lost a staggering $1bn through that disaster. The census website system fell over.
These would be extraordinary mistakes even for a small business, and yet they’re being made by government departments with hundreds of millions of dollars to spend. How does this happen? 
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Commonwealth Ombudsman launches Centrelink investigation

Tom McIlroy
Published: January 9, 2017 - 4:19PM
Pressure is growing on the Turnbull government over the Centrelink debt-recovery controversy, after the Commonwealth Ombudsman launched a wide-ranging investigation amid calls for the system to be shut down.
The ombudsman moved to initiate an investigation this month over significant concerns about automated data-matching processes being used to check welfare recipients' eligibility for some Centrelink payments, leading to outcry over the Christmas period as about 170,000 debt notices were issued.
Independent MP Andrew Wilkie and South Australian senator Nick Xenophon both referred the matter to the Ombudsman in December, but the investigation was already under way within the office.
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Centrelink debt recovery drive has caused summer from hell, Bill Shorten says

Matthew Knott
Published: January 9, 2017 - 12:15AM
Opposition Leader Bill Shorten has called on the Turnbull government to immediately suspend Centrelink's controversial automated debt recovery program, describing it as a "toxic mix of incompetence and cruelty" that has ruined Christmas for vulnerable Australians.
Mr Shorten, who is on summer holidays until the end of the week, has not previously commented on the project, which the government estimates will add an extra $4.5 billion to the budget. The automated system has been accused of miscalculating bills and sending debt notices to people who do not owe.
Stories have mounted in recent weeks of Australians – including asylum seekers and people with disabilities – who say they have been sent inaccurate debt notices.
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Centrelink's debt debacle: It's going to get worse, says union

Noel Towell
Published: January 10, 2017 - 12:15AM
Beleaguered Centrelink staff are bracing for a "perfect storm" of customer service problems in the coming weeks, heaping more misery on the welfare agency's millions of clients, according to the main workplace union.
The ongoing debt recovery debacle already has public servants at Centrelink stretched to breaking point, the CPSU is warning, and the agency's workers will soon have to cope with hundreds of thousands of student benefit applications and pensioners trying to make sense of changes to their payments.
But the department says customer demand is normal for this time of year.
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New digital health chief to get $522,000 a year to fix troubled My Health Record system

Daniel Burdon
Published: January 11, 2017 - 11:08AM
The head of the Turnbull government's six-month-old Australian Digital Health Agency will be paid a tidy $522,000 annual salary package after beating more than 100 other applicants to take the role fixing the plagued My Health Record system.
The chief executive's pay comes with the difficult task of overseeing the $156 million agency and its remit to digitise the nation's health systems, including fixing the delayed national roll-out of My Health Record.
Despite a number of teething problems, about 4.4 million Australians have signed up so far, as the government moves towards an "opt-out" system rather than the previous "opt-in" system.
The government's creation of an agency dedicated to improving digital health systems was been widely supported, although some stakeholders have been sceptical of how much the agency will achieve given past problems.
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Australian Medical Association appoints new group CIO

Chartered Accountants ANZ’s former ICT strategy chief joins AMA
Rohan Pearce (Computerworld) 12 January, 2017 08:06
The Australian Medical Association has appointed a new group chief information officer to replace Colin O'Sullivan, who left the AMA last year to return to Ireland for family reasons.
An AMA spokesperson told Computerworld Australia that the organisation had recruited Phil Barton to take charge of IT.
Barton joins the doctors organisation from UGL Unipart – a joint venture between Australia’s UGL and the UK’s Unipart Rail that provides heavy maintenance and supply chain services for Sydney’s rail fleet.
At UGL Unipart Barton was head of program, which included developing the consortium’s ICT roadmap and strategy and leading its project management team. Barton joined the company in April 2015.
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National Digital Health Strategy consultation: What have we learned so far?

Created on Friday, 13 January 2017
How should Australia take advantage of the opportunities that new technologies offer to improve health and care? What do Australians want and expect from a modern healthcare system?
Over 600 online submissions have been received and more than 2,500 people have attended meetings, forums, workshops, webcasts and town halls across Australia – watch the video below to see what the Australian community has been saying!

Survey and written submissions

Our survey provides you or your organisation the opportunity to have your say about the future of digital health in Australia.
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Child Immunisation and Digital Health

Monday, 09 January 2017
The week before Christmas 2016, with temperatures peaking at 43 degrees, I travelled with our CEO, Tim Kelsey and Chief Medical Adviser, Clinical Professor Meredith Makeham to Perth, Bunbury and Busselton in Western Australia.
The trip was part of our national conversation with the Australian people about digital health; how we can best shape it around Australia's needs, wants and aspirations. This conversation is part of a larger consultation activity as we work towards co-producing a National Digital Health Strategy for the Australian Government.
All up, we talked to around 100 people across the WA health sector. Many subjects were raised and discussed, including the important subject of child immunisation.
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12 January 2017

Smartwatches know you’re getting a cold days before you feel ill

By Alice Klein
Once we had palm-reading, now we have smartwatches. Wearable tech can now detect when you’re about to fall ill, simply by tracking your vital signs.
Michael Snyder at Stanford University in California experienced this first-hand last year. For over a year he had been wearing seven sensors to test their reliability, when suddenly they began to show abnormal readings. Even though he felt fine, the sensors showed that his heart was beating faster than normal, his skin temperature had risen, and the level of oxygen in his blood had dropped.
“That’s what first alerted me that something wasn’t quite right,” says Snyder. He wondered whether he might have caught Lyme disease from a tick during a recent trip to rural Massachusetts.
A mild fever soon followed, and Snyder asked a doctor for the antibiotic doxycycline, which can be used to treat Lyme disease. His symptoms cleared within a day. Subsequent tests confirmed his self-diagnosis.
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Engineering technology resilience through informatics safety science

Enrico Coiera, Farah Magrabi, Jan Talmon
DOI: http://dx.doi.org/10.1093/jamia/ocw162   First published online: 31 December 2016
With every year that passes, our relationship to information technology becomes more complex, and our dependence deeper. Technology is our great ally, promising greater efficiency and productivity. It also promises greater safety for our patients. However, this relationship with technology can sometimes be a brittle one. We can quickly cross a safety gap from a comfortable place where everything works well, to one where the limits of technology introduce new risks. Whether it is through a computer network failure, applying a system software patch, or a user accidentally clicking on the wrong patient name, it is surprisingly easy to move from safe to unsafe. As the footprint of technology across our health services has grown, so to by extrapolation, has the associated risk of technology harms to patients.1 It is the potential abruptness of this transition to increased risk of harm, this lack of graceful degradation in performance, and the silence accompanying degradation, that remain unsolved challenges to the effective use of information technology in healthcare.
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Problems with health information technology and their effects on care delivery and patient outcomes: a systematic review

Restricted access
Mi Ok Kim, Enrico Coiera, Farah Magrabi
DOI: http://dx.doi.org/10.1093/jamia/ocw154 First published online: 23 December 2016

Abstract

Objective: To systematically review studies reporting problems with information technology (IT) in health care and their effects on care delivery and patient outcomes.
Materials and methods: We searched bibliographic databases including Scopus, PubMed, and Science Citation Index Expanded from January 2004 to December 2015 for studies reporting problems with IT and their effects. A framework called the information value chain, which connects technology use to final outcome, was used to assess how IT problems affect user interaction, information receipt, decision-making, care processes, and patient outcomes. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
Results: Of the 34 studies identified, the majority (n = 14, 41%) were analyses of incidents reported from 6 countries. There were 7 descriptive studies, 9 ethnographic studies, and 4 case reports. The types of IT problems were similar to those described in earlier classifications of safety problems associated with health IT. The frequency, scale, and severity of IT problems were not adequately captured within these studies. Use errors and poor user interfaces interfered with the receipt of information and led to errors of commission when making decisions. Clinical errors involving medications were well characterized. Issues with system functionality, including poor user interfaces and fragmented displays, delayed care delivery. Issues with system access, system configuration, and software updates also delayed care. In 18 studies (53%), IT problems were linked to patient harm and death. Near-miss events were reported in 10 studies (29%).
Discussion and conclusion: The research evidence describing problems with health IT remains largely qualitative, and many opportunities remain to systematically study and quantify risks and benefits with regard to patient safety. The information value chain, when used in conjunction with existing classifications for health IT safety problems, can enhance measurement and should facilitate identification of the most significant risks to patient safety.
  • health information technology
  • patient safety
  • adverse events
  • systematic review
  • unintended consequences
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Downside of fitness trackers and health apps is loss of privacy

December 23, 2016 6.08am AEDT
Do you know how the data from your running app is being used?

Author

  1. Victoria J Palmer
Postdoctoral Researcher Applied Ethics, University of Melbourne
At the touch of an app, Emma tracks her diabetes. She enters food, exercise, weight and blood sugar levels, then sets up medication reminders.
Suzanne uses the latest wearable device to track her running route and distances walked. As she has not slept too well in the past month, she also records her sleep patterns.
Richard takes his tablet for schizophrenia. The tablet contains a sensor that communicates with central health databases to tell health professionals if he has taken his medication.

The participatory health revolution

This is the participatory health revolution, where people use apps and wearable devices, and swallow sensors, to keep track of their health and well-being, to take control in the name of empowerment.
Latest figures indicate two in three Australians have a social media account and most spend almost the equivalent of one day a week online. In 2017, 90% of Australians will be online and by 2019 most households will have an average of 24 home devices (like alarms, phones, cars and computers) connected online.
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Enjoy!
David.

Sunday, January 15, 2017

Is It Right To Grossly Oversimplify Communication To The Public About The myHR?

This appeared last week:

Personal health records now available online

12 Jan 2017, 10:25 a.m.
Following a Federal Government trial in Western Sydney, local hospitals are now uploading around 570 discharge summaries to My Health Record each month.
What this means is that GPs can easily access information about their patients after a stay in hospital and our clinicians can access important health information about patients that their GPs have uploaded.
As a resident of the Nepean Blue Mountains regions, which also includes Hawkesbury residents, can access their personal health record online and even set access restrictions and add information about allergies, medication and other important health information.
“In the event of a medical emergency, residents will know that their health information is stored safely and securely and can be accessed immediately by emergency doctors if required,” a spokesperson said.
“Pharmacies are also uploading to My Health Record so we can easily see what medications a patient is on – this helps doctors treat you safely if you need emergency care and are unable to communicate.”
More here:
Talk about painting a totally positive picture.
We all know that no amount of enthusiasm can cover up the fact that only few doctors or patients have actually accessed their myHR and we also know that very few patient records have a clinician curated Shared Health Summary that can be relied on to some extent.
To me this reporting should be explaining the way the patient can access their record (if they accepted one (by not opting out)  – apparently 1.9% of individuals declined the offer of having a record – and by explaining just what content they can expect to find and how it may, or may not, make a difference to their care.
They should also be told that the discharge summaries may or may not be complete, will almost certainly have been created by the most junior member of the clinical team, will probably not have been reviewed by senior doctors and will not have been reviewed by the patient for embarrassing content before being posted.
For some reason my most recent discharge summary was posted by a clinical pharmacist with no attempt to obtain consent from me. I wonder why this is seen as reasonable?
As far as drug information is concerned it is all dependent on the individual local pharmacist who may or may not upload information.
At the very least there should be a link in the article to some more detailed myHR information.
This really should be being managed with rather more openness and transparency as far as I am concerned but I accept others may think it is not needed. Comments welcome.
David.

AusHealthIT Poll Number 352 – Results – 16th January, 2017.

Here are the results of the poll. 

Is The ADHA Correct In Assuming That 'National Digital Health' Is A 'Good Thing' And All We Need To Do Is Work Out How To Do It Correctly And Get On With It?

Yes 21% (22)

No 58% (62)

ADHA Does Not Assume Digital Health Is A Good Thing 0% (0)

I Have No Idea 21% (22)

Total votes: 106

An interesting outcome with a good majority thinking this is a more complex issue than Digital Health simply needing to be done properly. Some more fundamental rethinking seems to be called for. Comments welcome!

A good turnout of votes for so early in year.

Again, many, many thanks to all those that voted!

David.

Wednesday, January 11, 2017

Does This Qualify For The Term Fake News Do You Think?

This popped up a little while ago.

New digital health chief to get $522,000 a year to fix troubled My Health Record system

Daniel Burdon
Published: January 11, 2017 - 11:08AM
The head of the Turnbull government's six-month-old Australian Digital Health Agency will be paid a tidy $522,000 annual salary package after beating more than 100 other applicants to take the role fixing the plagued My Health Record system.
The chief executive's pay comes with the difficult task of overseeing the $156 million agency and its remit to digitise the nation's health systems, including fixing the delayed national roll-out of My Health Record.
Despite a number of teething problems, about 4.4 million Australians have signed up so far, as the government moves towards an "opt-out" system rather than the previous "opt-in" system.
The government's creation of an agency dedicated to improving digital health systems was been widely supported, although some stakeholders have been sceptical of how much the agency will achieve given past problems.
Health Minister Sussan Ley has previously described the use of digital technologies in health as "a game changer".
Vastly more of the article is found here:
First off, just forget about the pay, as I for one would not be prepared to even consider the job, as framed, for four times the salary.
The real issue is just how wrong the article is, and this is found in the first few paragraphs.
First most of general practice, pathology, radiology and a good amount of other health service delivery entities are already digitised and communicating with many of their peers digitally as well. The job is not to digitise the nation’s health system – that is largely done!
Second the myHR is already ‘rolled out’ technically. All that is needed is the go-ahead to compel the rest of the populace to enrol and – much harder – actually use it. The reason we see few, if any usage stats it that the little if any actual clinical use of the system. So that job, supported by the rapidly developed evaluation reports, is largely done!
The actual job seems to be to run a limited scope consultation process which will come up with an evidence-free strategic endorsement of all things ‘digital health’ and especially the myHR, and support continuing funding for all the bureaucrats who have now been employed to mostly continue on with what NEHTA was doing. The Strategy  has to be at least partly evidence-free as there is no actual evidence that confirms the myHR is a ‘good thing’  that anyone has yet seen. (If you have some worthwhile evidence let me and ADHA know!). Of course the Strategy will need to address other issues like SMD, NASH, SNOMED etc. but myHR is the main thrust, wrongly IMVHO!
So, in essence, the job is really to compulsorily foist a largely unrepaired, unwanted, unnecessary and useless system on an unsuspecting public and have them thank you for wasting all their tax money on it!
Now that is what I call a hard job!
David.

Monday, January 09, 2017

News Alert: Sussan Ley Has Stood Aside While An Enquiry Is Conducted!

Martin Parkinson is said to have been asked to conduct the enquiry.

Link is here for details:

http://www.abc.net.au/news/2017-01-09/sussan-ley-stands-aside-over-travel-expenses/8169410

Do you reckon there is any chance the Acting Health Minister (Arthur Sinodinos) might just have a close look at the myHR and give it the flick?

Just hope so!

David.


Sunday, January 08, 2017

Sussan Ley - Federal Health Minister - Admits To Errors Of Judgement! What About The myHR? She Needs To Go So It Can Be Abandoned.

This appeared today.

Health Minister Sussan Ley apologises for Gold Coast trip, agrees to repay expenses

Matthew Knott
Published: January 8, 2017 - 4:39PM
Embattled Health Minister Sussan Ley has admitted she made an "error of judgment" by charging taxpayers for a trip to the Gold Coast in which she bought a $795,000 apartment and will repay the cost of the trip.
Ms Ley's decision followed a conversation with Prime Minister Malcolm Turnbull in which he said she had not met the standards he expects of ministers. 
Ms Ley has come under pressure to provide a full explanation of the trip or resign from the ministry since it was revealed on Friday.
Ms Ley originally said the apartment purchase was "not planned nor anticipated", a claim that has been questioned given subsequent revelations that her partner owns a business located near the unit.
In a statement released on Sunday afternoon Ms Ley said the apartment auction was not the reason for her trip to the Gold Coast but she understood the purchase had "changed the context of the travel undertaken".
…..
More to come
Here is the link:
If she has trouble with less than $1.0m house investment how can the manage the investments in the myHR?
Passed on without comment. (Other than I reckon she should go! My call is not related the Gold Coast home unit nonsense - which is just maybe a little off at worst - but the continuing total incompetence in digital health - which I do care about!)
David.

It Seems To Me There Is Something Somewhat Dishonest At The Core Of the ADHA Consultation On Digital Health.

A day or so ago we were all reminded to get going and respond to the ADHA Consultation. I have reproduced the whole thing so you can respond to the request.

How do you see the future of digital health? Your health. Your say. Survey and written submissions.

Created on Friday, 06 January 2017
The Australian Digital Health Agency wants to hear from you. Whether you’re a patient, a member of the public, a healthcare provider, scientist or researcher, entrepreneur or technology innovator. Tell us what is important to you so that what we do is shaped around what you need.
There’s nothing more important than our health and the health of those we care about. Putting data and technology safely to work for patients, consumers and the healthcare professionals who look after them can help Australians live healthier, happier and more productive lives.
How should Australia take advantage of the opportunities that new technologies offer to improve health and care? What do Australians want and expect from a modern healthcare system?

Survey and written submissions

Our survey provides you or your organisation the opportunity to have your say about the future of digital health in Australia.
Alternatively, you are also welcome to send us a written submission. To provide us a written submission, email your feedback directly to yoursay@digitalhealth.gov.au.
Reminder: Submissions will be collected until Tuesday 31 January 2017, 5pm AEDT.
Have any further questions? Please contact us on 1300 901 001 or yoursay@digitalhealth.gov.au.
Here is the link:
Now in the post-truth / false news era it rests with all of us to wind up our falsity checking meter to the maximum and keep on at that level of scepticism.
In that vein it the second paragraph that stands out.
“There’s nothing more important than our health and the health of those we care about. Putting data and technology safely to work for patients, consumers and the healthcare professionals who look after them can help Australians live healthier, happier and more productive lives.”
I am sure all who read here will be well aware of the risk of making ‘sweeping generalisations’, and that somehow glossing over detail a false impression can be created. When this impression leads to government expenditure on a grand scale then we all have a problem.
So stepping back, obviously, appropriately used data and information is crucial for the proper operation of the health system in most aspects from research to patient care etc. Think everything from research management systems to patient management and scheduling systems. Trying to do without these systems would clearly be a waste of time and money – if not impossible – think the management of major clinical trials to the optimisation of patient flow in a major hospital – all basic stuff that, if it did not work, no one would pay for and use it!
Equally there are a zillion technologies that are vital from MRI Scanners and drug discovery to the various monitoring systems that track our patient’s progress. The evidence that these technologies do / have make a positive difference is well documented.
But the ADHA is not interested, as far as I know, with all this. Their interest is in patient specific information and how it is shared and communicated by digital systems and this is where we hit a problem with evidence as well as all the other issues of safety, privacy and so on.
There is no doubt that a well-designed GP System can improve the quality and safety of what the GP does with and individual patient and make it easier to follow a patient’s clinical journey and treatment. There is good evidence to this as well as much evidence that current systems are by no means perfect and still need more work.
This makes the point very recently:

Engineering technology resilience through informatics safety science

Enrico Coiera, Farah Magrabi, Jan Talmon
DOI: http://dx.doi.org/10.1093/jamia/ocw162 First published online: 31 December 2016
With every year that passes, our relationship to information technology becomes more complex, and our dependence deeper. Technology is our great ally, promising greater efficiency and productivity. It also promises greater safety for our patients. However, this relationship with technology can sometimes be a brittle one. We can quickly cross a safety gap from a comfortable place where everything works well, to one where the limits of technology introduce new risks. Whether it is through a computer network failure, applying a system software patch, or a user accidentally clicking on the wrong patient name, it is surprisingly easy to move from safe to unsafe. As the footprint of technology across our health services has grown, so to by extrapolation, has the associated risk of technology harms to patients.1 It is the potential abruptness of this transition to increased risk of harm, this lack of graceful degradation in performance, and the silence accompanying degradation, that remain unsolved challenges to the effective use of information technology in healthcare.
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The link in the text gives access to the lucky few paid subscribers only for some reason.
What we lack is evidence that national systems such as the myHR are really offering both benefit and value for money.
What the consultation process should be doing is surfacing and making available this evidence and not be trying to run a consultation on the value of motherhood!
Surely part of the process need to be to explain what works and what doesn’t and why and to then propose what is planned for comment – based on evidence not vague feelings and assumptions.
I will nod off now for another week and, God willing, will be back up and rolling from next week.
David.

AusHealthIT Poll Number 351 – Results – 8th January, 2017.

Here are the results of the poll.

Given The Rather Poor Progress, Few Benefits And Huge Cost Of Australian National EHR Programs, Over The Last 20 Years, Should They Just Be Abandoned?

Yes 98% (158)

No 2% (4)

I Have No Idea 0% (0)

Total votes: 162

Well that was very clear cut with 98% saying we should just stop this myHR program and so work out something more useful to do.

A good turnout of votes.

Again, many, many thanks to all those that voted!

David.

Tuesday, January 03, 2017

ScoMo Advised To Stop The myHR Program! Hard To Disagree.

Sorry, it’s the silly season so I could not ignore the chance for a fun headline!
This appeared earlier today:
  • Updated Jan 2 2017 at 11:45 PM

Scott Morrison needs to go micro if he wants big results 

by Stephen Anthony

Treasurer Scott Morrison needs to find a policy breakthrough from somewhere if he is drive Australian growth against rising global headwinds
The Australian economy suffers low competitiveness and productivity when compared with most other developed economies. It lacks a hard core advanced manufacturing and services sector. It lacks leadership and a game plan for jobs and growth. Sadly, the Australian government has not achieved a major micro-economic reform since Humphry B. Bear last made regular appearances on national television screens.
Australian households are facing low wages growth and rising mortgage interest rates due to a rise in wholesale lending costs, depressing discretionary spending and raising pressure on highly indebted homeowners. A glut of high-density apartment building in Sydney and Melbourne could risk a massive build-up of non-performing loans or banks and non-bank lenders.
But there are positive measures that Morrison can take to help grow the economy and jobs in 2017.
First, he should follow the advice of audit commissioner Tony Shepherd and move "carefully, incrementally and fairly" to put fiscal policy back on a sustainable path by overcoming the confidence-sapping budget deadlock in the Senate. He needs to stop the fixation on the winners and losers from individual budget measures by announcing a complete budget repair and taxation reform "package" where the pain is carried more by those who benefit from the measures contained there.
Second, the Treasurer should pursue a ruthless strategy targeting waste reduction and productivity in government and the broader economy. We need to apply a simple metric to each and every government spending program and tax expenditure – "why it is in place and what does it deliver?" If the answer is, "not really sure", then probably a good time to abolish it.
There are 5 more suggestions in the full article found here:
If the last paragraph is not referring to the myHR it is hard to imagine what might be a more obvious target!
“We need to apply a simple metric to each and every government spending program and tax expenditure – "why it is in place and what does it deliver?" If the answer is, "not really sure", then probably a good time to abolish it.” This fits the myHR perfectly.
I will just pop off back to sleep again now!
Have a great 2017!
David.

Sunday, December 25, 2016

AusHealthIT Poll Number 350 – Results – 25th December, 2016.

Here are the results of the poll.

Overall How Would You Rate 2016 For Progress In E-Health? (10 Massive, 1 None)

10 1% (1)

9-8 0% (0)

7-6 3% (3)

5-4 2% (2)

3-2 44% (51)

1 50% (57)

I Have No Idea 1% (1)

Total votes: 115

Well that was clear cut with 94% ranking progress 4 or below and 50% ranking progress just 1 (None!).

Happy Christmas to All! Surely 2017 will be better?

A very large turnout  of votes.

Again, many, many thanks to all those that voted!

David.

Friday, December 23, 2016

Well That Is Your Bloomin Lot For The Year!

Many thanks to all who have browsed over 2016. I hope the blog has added some value!

To all a Happy Christmas and A Great 2017!

My plan is to come back again for another round in 2017, after a break.

David.