The Robo-Debt Saga Has Some Interesting Parallels For The myHR.

For those who came in late Robo-Debt programme was at its core a plan to use technology to control financial waste in the Social Services department that used a flawed algorithm to identify that waste / debt and to then demand some half million people pay back money they did not owe.

The myHR was a plan to use inadequate and flawed technology at a national scale to store patient clinical records with no clear plan or purpose for their use and any real idea what value these records would deliver.

In both cases we see an unevaluated, poorly designed and flawed system pushed on the unsuspecting citizenry with minimal consultation and no care for the harm that might be caused.

Of especial concern is the following:

Robo-debt bureaucrat on leave amid doubts over her $900k job

By Anthony Galloway

Updated July 8, 2023 — 11.00pmfirst published at 5.05pm

Former top public servant Kathryn Campbell went on leave from her $900,000 a year job with the Defence Department last week – a day before the robo-debt royal commission made damning findings against her.

There are now doubts within Defence over whether Campbell will return from leave after the royal commission made a range of scathing findings including that she repeatedly failed to act when the scheme’s flaws and illegality became apparent.

Pressure is also mounting on former prime minister Scott Morrison with Prime Minister Anthony Albanese on Saturday accusing his predecessor of failing to show any contrition despite the royal commission ruling he had allowed cabinet to be misled over the legality of the scheme.

In an interview with this masthead, Government Services Minister Bill Shorten said he didn’t want to comment on specific individuals in the public service as that would be dealt with by “other jurisdictions and other people”.

But Shorten said he understood “the general sense of the anger” from robo-debt victims.

“They feel that people have got away with it,” he said. “I just want to assure them that they haven’t got away with it.”

Government Services Minister Bill Shorten has addressed the findings of the robodebt royal commission report.

Senior Defence sources confirmed that Campbell was on leave from her role with Defence on Thursday and Friday as the damning findings were handed down by royal commissioner Catherine Holmes, SC.

Campbell served as secretary of the Department of Human Services between 2011 and 2017, the period in which the illegal income averaging scheme was introduced.

The royal commission found that Campbell kept the true nature of the income-averaging scheme secret when advising cabinet because she knew then-social services minister Morrison wanted to pursue the program.

Much more here:

https://www.smh.com.au/politics/federal/robo-debt-public-servant-on-leave-amid-doubts-over-whether-she-will-stay-in-900k-job-20230707-p5dmn4.html

Basically it is clear that the politicians and bureaucrats knew Robo-debt was a pile of harmful abusive crock but just let it run. Same goes for the useless and wasteful myHR. They know it is a waste of space and money but just press on.

In both cases we must ask WHY?

I am stu…d if I know!

David.

 

AusHealthIT Poll Number 704 – Results – 09 July, 2023.

Here are the results of the poll.

Are You Expecting The National Health Interoperability Plan From The ADHA To Make A Significant Positive Difference To Information Handling In Australia?

Yes                                                                0 (0%)

No                                                               36 (100%)

I Have No Idea                                              0 (0%)

Total No. Of Votes: 36

A pretty clear outcome suggesting that most readers are not seeing much value in the Jnterop. Plan

Any insights on the poll are welcome, as a comment, as usual!

An OK number of votes. But also a pretty clear outcome. 

0 of 36 who answered the poll admitted to not being sure about the answer to the question!

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

David.

AusHealthIT Poll Number 703– Results – 02 July, 2023.

Here are the results of the poll.

Is Having The MyHealthRecord Sort Of Operational In Australia A Help Or Hindrance To Digital Health Progress Nationally?

A Help                                                                    1 (2%)

A Hindrance                                                        47 (98%)

I Have No Idea                                                       0 (0%)

Votes: 48

A pretty clear outcome suggesting that most readers think the MyHealthRecord is not much help

Any insights on the poll are welcome, as a comment, as usual!

A good count of votes. But also a pretty clear outcome. 

0 of 48 who answered the poll admitted to not being sure about the answer to the question!

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

David.

The ADHA Is Having Another Try At Extracting Value From Siloed Clinical Data.

 This appeared a few days ago.

ML project to unlock siloed data on chronic diseases

The project will "bring machine learning to data" while protecting privacy and integrity.

By Adam Ang

June 30, 2023 03:02 AM

A new project led by the University of Queensland seeks to create a national data network that will support the development of novel solutions for managing chronic diseases.

Recently, the National Infrastructure for Federated Learning in Digital Health (NINA) project secured A$6 million ($3.9 million) funding from the federal government's Medical Research Future Fund. It also received an additional A$7.7 million ($5 million) in contributions from UQ, Monash and Macquarie universities, and the Queensland Cyber Infrastructure Foundation.

WHAT IT'S ABOUT

According to a media release, the five-year project will enable researchers to use machine learning to access siloed information on debilitating chronic diseases, such as diabetes, rheumatoid arthritis and osteoarthritis. It will prepare and harmonise the data to global standards while protecting individual privacy. Analyses will also be generated and shared across health organisations and states.

UQ will collaborate with 23 Australian and global partners to co-design the conceptual framework for NINA and speed up the translation and adoption of the data model at a national scale. 

WHY IT MATTERS

Researchers across Australia find it difficult to access health databases and move their research forward on digital health. 

"Australia has excellent digital health records, but data is siloed across health systems, preventing talented researchers from accessing millions of records about treatments and trends in crippling chronic conditions," noted Clair Sullivan, associate professor at UQ’s Queensland Digital Health Centre.

Chris Bain, Professor of Practice in Digital Health at Monash University Faculty of IT, said various privacy and data sharing restrictions hinder the meaningful use of such databases. 

"This has ultimately led to an almost insurmountable divide across healthcare sectors, including a lack of data connectivity across primary, secondary and tertiary care," he said in a separate statement.

The NINA project intends to "put data to work" to find solutions for better managing chronic conditions. "Rather than attempting to merge different data sets to enable machine learning centrally, the project will bring machine learning to the data," Sullivan added.

THE LARGER TREND

Despite having the will to pursue digital transformation using data and analytics, most healthcare organisations across Australia and New Zealand lack the ability to share real-time data and integrate disparate systems, according to a recent study commissioned by InterSystems. They are also analysing a limited number of data despite having tons of it as multiple datasets are not interoperable.

Nevertheless, most providers wanted a standardisation of data exchange. The Australian Digital Health Agency is helping fulfil this through its National Healthcare Interoperability Plan, which envisions a more connected Australian health system by 2027. 

As part of this endeavour, the agency recently partnered with Health Level Seven Australia to promote the consistent adoption of FHIR standards in the country. It also tied up with CSIRO's Australian e-Health Research Centre to create the National Clinical Terminology Service, which will provide terminology services and tools that will enable connectivity across the health system.

Here is the link:

https://www.healthcareitnews.com/news/anz/ml-project-unlock-siloed-data-chronic-diseases

This is surely a project to watch to see what value is obtained for the $12 million being spent. I really struggle to bring to mind any similar data aggregation projects in OZ that have provided some significant value.

Let me know of any you are aware of!

David.

AusHealthIT Poll Number 702– Results – 25 June, 2023.

Here are the results of the poll.

Has Wesfarmers Done A Good Deal Buying InstantScripts For $135M?

Yes                                                                26 (59%)

No                                                                 13 (30%)

Have No Idea                                                  5 (11%)

Votes: 44

A pretty clear outcome suggesting that most readers think Westfarmers were pretty canny with the purchase.

Any insights on the poll are welcome, as a comment, as usual!

A good count of votes. But also a pretty clear outcome. 

5 of 44 who answered the poll admitted to not being sure about the answer to the question!

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

David.

 

I Took Six Months Off And Nothing Changed!

It is really amazing what rubbish continue to get fed to us by ADHA.

These 2 little gems appeared recently!

23 June 2023

ADHA announces ‘coalition of the willing’

Government Interoperability

By Wendy John

The Council for Connected Care has been launched to accelerate healthcare data sharing.

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A consortium of 25 health leaders has been assembled by Canberra with the imperative to finally make healthcare data sharing a reality.

The new Council for Connected Care was established by the Australian Digital Health Agency and has been tasked with accelerating interoperability.

Peter O’Halloran, chief digital officer of the ADHA, said he was excited about the creation of the Council, which would have a strategic voice and help accelerate implementation of the national interoperability plan.

“We’ve got all those people, some of the best and brightest in healthcare – academics, clinicians, consumers, policy and technical people – all in one room together to ensure that what we’re doing will meet the needs of healthcare consumers and clinicians,” he said.

The Council is chaired by Mr Rob Heferen, chief executive of the Australian Institute of Health, and is supported by a dedicated secretariat. Members represent key players in the healthcare sector including First Nations healthcare, consumers, digital health and peak bodies.

There is one representative from the medical software industry and currently no members who own or run digital health platforms.

However, Mr O’Halloran said a range of members had significant commercial expertise, including those providing services in the health and aged care sectors. He added that the Council was a strategic representation of the healthcare sector and that a series of task-specific working groups would be established at an operational level.

Mr O’Halloran told TMR that the Council was a missing piece of the puzzle of establishing interoperability in Australia.

“Now we’ve got the coalition of the willing who want to actually help us progress [interoperability] and progress it quickly. We have the national interoperability plan, there are 44 actions. The Council gives us the ability to get traction quickly, move forward quickly,” he said.

Here is the link to the full article:

https://www.medicalrepublic.com.au/adha-announces-coalition-of-the-willing/93909

And here is another interesting one.

25 May 2023

Digital health reform: Government can’t do it alone

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By Wendy John

Digital health heavyweights connect with industry to outline MHR strategy.

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The Federal Budget may have promised almost $1.1bn for reforms in digital health but using that money wisely and usefully will take comprehensive input from the industry, say experts.

Budget measures include $325.7m to run the Australian Digital Health Agency (ADHA), which is separate to extra buckets for e-prescribing ($111.8m), My Health Record ($429m over two years), modernising healthcare delivery ($69.7m), and intergovernmental agreement ($126.8m).

But money isn’t the only key to success, said Daniel McCabe, the Department of Health and Aged Care’s first assistant secretary in digital health, speaking at last week’s Medical Software Industry Association event.

“The government doesn’t have all the intellectual property or wherewithal to make this happen,” he said.

“It needs a lot of work with industry to move the plan forward. We realise now we need to bring on all healthcare providers including nurse practitioners. We are trying to put the patient back in the centre of the healthcare agenda.”

Some of that patient-centred goal would be created collaboratively with industry, while some would be mandated, he said.

Mr McCabe said the CSIRO would present an interoperability adoption strategy and roadmap in 2025.

Amanda Cattermole, chief executive at the ADHA, said the budget enabled the ADHA to do its part as a steward of the national health infrastructure, “providing some, but not all” of the digital health services patients required.

“The most exciting part is the policy environment the ADHA is now working in,” she said.

“Government support has moved digital health from the ‘nice to have’ into the absolute cornerstone. This an historic moment for the agency.”

Panelist Graham Grieve, the creator of fast health interoperability resources (FHIR) interoperability standards, was asked about what concerned him most about Australia’s digital health infrastructures.

He said that the rest of the world was designing systems that were “genuinely patient centred since they do not have something like the My Health Record (MHR)”.

“Given the ADHA’s significant operational stake in MHR, can it lead, and be trusted to lead, a system redesign that isn’t jaundiced by being tied to MHR? This is something that we’ll all need to pay close attention to,” he said.

Ben Cardillo, CEO of Capstone, said while it was encouraging to hear government and ADHA leaders state their commitment to consultation, a commercial lens was critical.

“Australia has a complex, multi-tiered health system. The department and ADHA’s challenge will be to develop a compelling business case to convince the myriad of different stakeholder groups to adopt new systems and processes based on common, national standards.  Not a trivial task,” he said.

David Rowlands, head of Digital Health Leadership Australia, revealed the development process for an Australian FHIR management framework. The framework would include a community process to develop interoperability standards and a governance structure. Mr Rowlands has been engaged by the CSIRO to develop a minimum viable plan by June 2023.

Here is the link to the full article:

https://www.healthservicesdaily.com.au/digital-health-reform-government-cant-do-it-alone/1048

One tiny question. Has anyone thought a Digital Health Future in Australia WITHOUT the MyHealthRecord might be best?

David.

AusHealthIT Poll Number 701– Results – 11 June, 2023.

Here are the results of the poll.

Is The Potential Of AI In Digital Health Over-Hyped?

Yes                                                                 38 (67%)

No                                                                  16 (28%)

Have No Idea                                                   3 (5%)

Votes: 57

A pretty clear outcome suggesting that most readers think there is a degree of excessive hype around AI in digital health. I am not sure they are right.

Any insights on the poll are welcome, as a comment, as usual!

A very good count of votes. But also a pretty clear outcome. 

3 of 57 who answered the poll admitted to not being sure about the answer to the question!

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

David.

I Asked ChatGPT - What Would Be The Impact of Artificial Intelligence (AI) in Digital Health?

 Here is what it thought!

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“The impact of artificial intelligence (AI) in digital health is expected to be significant and transformative. Here are several key areas where AI is already making an impact and is expected to continue doing so:

1. Improved diagnostics: AI algorithms can analyze vast amounts of medical data, including images, lab results, and patient records, to assist in the diagnosis of diseases. AI-powered diagnostic tools can help healthcare professionals detect conditions earlier, identify patterns and correlations, and provide more accurate and personalized treatment plans.
2. Personalized medicine: AI can enable personalized treatment plans by analyzing individual patient data, including genetic information, medical history, lifestyle factors, and treatment responses. This information can be used to tailor therapies and interventions to specific patients, optimizing outcomes and minimizing adverse effects.
3. Remote monitoring and telehealth: AI-enabled remote monitoring devices and telehealth platforms can continuously collect and analyze patient data, allowing healthcare providers to monitor patients' health status remotely. This can help in early detection of health issues, improve chronic disease management, and reduce the need for in-person visits, particularly in underserved areas.
4. Drug discovery and development: AI algorithms can sift through massive volumes of biomedical data, including scientific literature, clinical trial data, and genetic information, to identify potential drug candidates and accelerate the drug discovery process. AI can also optimize clinical trials by identifying eligible participants and predicting treatment responses.
5. Workflow optimization: AI can streamline administrative tasks, such as appointment scheduling, medical coding, and billing, allowing healthcare professionals to focus more on patient care. Natural language processing (NLP) algorithms can also automate medical transcription, enabling faster and more accurate documentation of patient encounters.
6. Predictive analytics: By leveraging machine learning techniques, AI can analyze patient data to identify patterns and predict health outcomes. This can be valuable in predicting disease progression, identifying high-risk patients who may benefit from proactive interventions, and improving population health management.
7. Health chatbots and virtual assistants: AI-powered chatbots and virtual assistants can provide 24/7 support to patients, answering their health-related questions, providing medication reminders, and offering general health advice. These tools can help individuals access information and support, especially in areas with limited healthcare resources.

While AI holds great potential in digital health, there are also challenges to address, including privacy concerns, data security, algorithm bias, and the need for regulatory frameworks to ensure safe and ethical use of AI in healthcare. Nonetheless, AI has the potential to revolutionize healthcare delivery, improve patient outcomes, and enhance the overall efficiency and effectiveness of the healthcare system.”

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That’s telling me!

David.