There Is Some Serious Effort Now Being Directed To AI In The Health Sector.

This appeared last week:
 Artificial intelligence 'facing barriers' in our health system

Authored by Sam Hunt

Issue 1 / 15 January 2024

Barriers abound in implementing artificial intelligence across Australia’s health care systems, with Queensland researchers calling for more government funding to take advantage of this emerging technology.

Australia’s health care system has been described as “impervious” to the alure of artificial intelligence (AI), with a lack of clinician trust and data privacy the main barriers to adopting the technology in clinical settings.

Other main concerns preventing the greater rollout of AI-related technology in Australian clinical settings include health inequity concerns due to possible biases in underlying data and not enough government regulation, according to a Perspective published in the Medical Journal of Australia.

“Across a network of clinicians in a national AI working group, only one hospital was known to have an AI trial underway,” Dr Anton Van Der Vegt and his colleagues wrote.

“As far as we are aware, there is no clinical AI implemented across Queensland Health despite having Australia’s largest centralised EMR system, which could make large-scale AI feasible.

“In stark contrast to the number of implemented AI systems, AI research abounds, with nearly 10 000 journal articles published each year across the world.”

Dr Van Der Vegt, a mechanical engineer by background, is an Advanced Queensland Industry Research Fellow with the Centre for Health Services Research at the University of Queensland Faculty of Medicine.

The WHO urges caution

The World Health Organization (WHO) last year called for caution in the use of AI in medicine.

“[The] growing experimental use [of AI] for health-related purposes is generating significant excitement around the potential to support people’s health needs,” the WHO said.

“It is imperative that the risks be examined carefully when using [large language model tools (LLMs)] to improve access to health information, as a decision-support tool, or even to enhance diagnostic capacity in under-resourced settings to protect people’s health and reduce inequity.”

Data used to train AI may be biased, “generating misleading or inaccurate information that could pose risks to health, equity and inclusiveness,” it said.

“LLMs may be trained on data for which consent may not have been previously provided for such use, and LLMs may not protect sensitive data (including health data) that a user provides to an application to generate a response.”

Government response

There is currently no specific AI legislation in place in Australia.

The Australian Government last year consulted on the potential risks of AI and how they can be mitigated, releasing this discussion paper.

The Department of Industry, Science and Resources, which ran the consultation, is using the 150 responses from industry and the community to inform the “appropriate regulatory and policy responses” (here).

“Patch work” of regulations

The Australian Human Rights Commission has described Australia’s AI regulations as a “patchwork”, saying that if the technology is not developed and deployed safely, it can threaten human rights.

“AI operates in a regulatory environment that is patchwork at best,” the Commission said.

“This has allowed AI to proliferate in a landscape that has not protected people from human rights harms.

“The Commission is especially concerned about emerging harms such as privacy, algorithmic discrimination, automation bias, and misinformation and disinformation.”

Algorithms “developed separately”

AI algorithms are typically developed and evaluated on different datasets to the ones at hospital sites, Dr Van Der Vegt and colleagues wrote.

This means that changes to clinical workflows, presenting patient conditions, data quality levels and patient demographic distributions can significantly affect algorithm performance.

“For example, AI algorithms developed on large city populations may perform poorly for hospitals in rural and remote areas, further perpetuating poor health outcomes for underserved and marginalised patient cohorts,” they wrote.

“Without this evaluation checkpoint, the AI remains untested. We argue this is one of the major reasons for the slow or absent uptake of AI within Australian hospitals today.”

AI may assist with diagnosis and treatment

Australian Medical Association President, Professor Steve Robson, said artificial intelligence has the potential to transform medicine.

“This will be just as big a culture shock for doctors as it will be for their patients,” Professor Robson said.

“The most advanced AI that most doctors use at the moment is often Siri, or their Netflix preference guides.”

The first doctors to embrace the potential of AI have been radiologists, Professor Robson said.

“For several years now, AI software applications have been introduced to assist with image recognition and, increasingly, with decision-support,” he said.

“Interpreting medical scans can be challenging for even the most experienced specialists, and the stakes are high. Missing an important diagnosis, such as an early cancer or a subtle bone fracture, can have serious consequences for patients.

“The use of AI to assist radiologists as they work to read multiple images has been shown to enhance accuracy and improve outcomes for patients.

“AI is so powerful in its capabilities that it may detect subtle changes in human tissues that elude the human eye.”

The technology also has the potential to change pathology services, such as the diagnosis of cancer, he said.

“At a time when the pathology workforce is under great pressure, the introduction of AI technologies that act as a co-pilot and assist the pathologist in dealing with high workloads will be attractive to health services,” Professor Robson said.

Call for AI funding

Public funding outside of health care organisations’ budgets is required to develop this infrastructure, Dr Van Der Vegt and his colleagues argue.

More here:

https://insightplus.mja.com.au/2024/1/artificial-intelligence-facing-barriers-in-our-health-system/

This is a useful summary of the issues. It is interesting to see that the AMA is also very much on board:
Artificial intelligence has the potential to transform medicine

Published 18 January 2024

The MJA this week looks at the future role for AI in Australia’s healthcare.

The AMA’s journal — the Medical Journal of Australia (MJA) — this week looks at the barriers and possibilities for artificial intelligence (AI) in Australia’s healthcare system.

AMA President Professor Steve Robson told the MJA artificial intelligence has the potential to transform medicine.

“For several years now, AI software applications have been introduced to assist with image recognition and, increasingly, with decision-support,” Professor Robson said.

“Interpreting medical scans can be challenging for even the most experienced specialists, and the stakes are high. Missing an important diagnosis, such as an early cancer or a subtle bone fracture, can have serious consequences for patients.

“The use of AI to assist radiologists as they work to read multiple images has been shown to enhance accuracy and improve outcomes for patients. AI is so powerful in its capabilities that it may detect subtle changes in human tissues that elude the human eye.”

“The technology also has the potential to change pathology services, such as the diagnosis of cancer. At a time when the pathology workforce is under great pressure, the introduction of AI technologies that act as a co-pilot and assist the pathologist in dealing with high workloads will be attractive to health services,” Professor Robson said.

In other recent media on AI Professor Robson warned that “we are about to see the start of a quiet revolution that will, in the long run, be almost as transformative as the introduction of technologies such as antibiotics, blood banking and safe anaesthesia”.

“If we are to harness its power for the greatest good, then we need to ensure it is a safe and trustworthy co-pilot in human health care, and never takes over the controls.”

Last August, the AMA published its first position statement on AI, outlining the need for regulation to be put in place before the widespread use of the technology in healthcare.

Read the position statement

Here is the link:

https://www.ama.com.au/ama-rounds/19-january-2024/articles/artificial-intelligence-has-potential-transform-medicine

All I can really suggest is watch this space or better still get a job in the area and make a contribution.

David.

 

Now We Know Why We Don’t Know What Is Going On In The Health Sector.

This popped up last week
More than 900 parliamentary questions on health and aged care unanswered

By Olivia Ireland

January 14, 2024 — 5.06pm

More than 900 questions from the Senate about the health and aged care portfolio have been left unanswered since October, as crossbench and opposition members accuse the government of having “contempt for transparency”.

As of January 12, data collated from the Senate community affairs committee found only 62 questions on notice were answered for the health and aged care portfolio since the supplementary budget estimates on October 26, with 931 unanswered.

In comparison, the social services portfolio has published 339 answers to questions on notice with 19 outstanding. Similarly, the Services Australia portfolio has answered all 362 questions with none outstanding.

While more than 900 questions on notice would be a lot for the department to get through, says former secretary of the Health Department Stephen Duckett, answering only 62 after months highlights possible management problems.

“Questions on notice are a really important part of the democratic process. Senate estimates should be about finding out what the facts are, they should be about looking at issues that might not yet be in the public domain,” he said.

“It is really important I think that there is this accountability, that when members of parliament and senators are seeking information, that we deal with that seriously and answer the questions as quickly as possible.”

‘It is disappointing that this government’s commitment to transparency is clearly only measured by what they think they can get away with.’

Previously, an answered question on notice in 2019 revealed the percentage of bulk billing attendances by electorate, which Duckett said was the first time the data had been conveyed in that way and gave important context on the distribution of health services.

In the lead up to parliament’s first sitting week in February, Liberal senator Jane Hume has submitted a notice of motion that asks the Senate to provide a statement on the number of total unanswered questions on notice and an explanation for why they have not been answered.

Hume, who asked 667 questions of the health and aged care portfolio during the last round of Senate estimates hearings, was unapologetic about the number, saying the Coalition would never apologise for holding the government to account.

“It is disappointing that this government’s commitment to transparency is clearly only measured by what they think they can get away with,” Hume said.

“Questions put to departments that are not answered will be pursued, regardless of whether the government thinks it can hide this information.”

Examples of outstanding questions on notice range from updates to election commitments such as the $39 million pledge to expand the newborn bloodspot screening program to detect up to 50 conditions and whether an interim Australian Centre for Disease Control will begin on January 1.

Health Minister Mark Butler declined to comment, while the Department of Health and Aged care stated it was working to finalise outstanding responses as soon as possible.

Opposition health spokesperson Senator Anne Ruston, who has asked 96 questions to the committee, condemned the delay in answering the questions, arguing the responses were in the public interest.

“These questions … pertain to important issues including the aged care taskforce, medicine listings, general practice grants and the prime minister’s broken election commitment of newborn blood spot screening,” she said.

“This government’s contempt for transparency is a concerning trend and reflects their attitude towards openness and honesty.”

ACT senator David Pocock was also critical on the delay, saying he recognised the work of the public service required time, but it was important it get adequate resources.

“Since entering parliament, I’ve found the estimates process a really important tool to help to hold the government accountable on behalf of our community,” he said.

“Transparency is key to a healthy democracy and providing timely responses to questions on notice is part of that. I am still waiting for answers to questions on notice from May last year.”

Pictures etc. here:

https://www.smh.com.au/politics/federal/more-than-900-parliamentary-questions-on-health-and-aged-care-unanswered-20240112-p5ewx1.html

No wonder the ADHA just does what ever it likes and we are still spending a fortune on that hopeless myHR! No one is even seeing the questions!

David.

AusHealthIT Poll Number 730 – Results – 21 January, 2024.

 Here are the results of the poll.

Are You Concerned About A New Outbreak Of COVID-19 In The Next Few Weeks?

Yes                                                                         14 (44%)

No                                                                          18 (56%)

I Have No Idea                                                        0 (0%)

Total No. Of Votes: 32

It looks like many are a bit concerned but rather more feel we are over the hump!

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

A great number of votes. But also a very clear outcome! 

0 of 32 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 Releases Its Annual Report For 2022-23 And Pushes on With The myHR.

The new Annual Report arrived recently:

Here is the link:

https://www.transparency.gov.au/publications/health/australian-digital-health-agency/australian-digital-health-agency-annual-report-2022-2023

Whatever is contained in the report the front page is totally amazing claiming that “Our work means so much to so many” Certainly they are pretty full of their own importance!

Part 1 of the Report has some useful facts!

Information about this Part

Part 1 provides a view of the Agency at a glance – an overview of the Agency’s purpose, role, strategy and functions and an outline of the path ahead.

The Agency at a glance

Purpose

Better health for all Australians enabled by connected, safe, secure and easy-to-use digital health services.

Foundations

The Agency was established on 30 January 2016 and began operations on 1 July 2016, with a vision of improving health outcomes for Australians through the delivery of digital innovation, health systems and services.

Enabling legislation

The Public Governance, Performance and Accountability (Establishing the Australian Digital Health Agency) Rule 2016 (Agency Rule) ¹ created the Agency and governs its operations. The Rule was made by the Minister for Finance under Section 87 of the PGPA ² that allows for the establishment of corporate Commonwealth entities. The Agency was the first in the Commonwealth to be established by Section 87 of the PGPA Act.

Products and services

The Agency has a lead role in stewarding, operating and developing the national digital health infrastructure that underpins the delivery of digital health in Australia. This vital infrastructure is an enabler for digital health foundations including:

• My Health Record system
• Healthcare Identifiers (HI) Service
• National Authentication Service for Health (NASH)
• Secure messaging delivery
• National Clinical Terminology Service (NCTS) including SNOMED CT-AU and Australian Medicines Terminology (AMT)
• Clinical content specifications based on Clinical Document Architecture (CDA) and Fast Healthcare Interoperability Resources (FHIR®)
• Provider Connect Australia (PCA)
• Vaccine Clinic Connect Finder.

Governing, operating and maintaining this infrastructure is a core activity for the Agency and ensures that Australian healthcare consumers and healthcare providers can be confident they are using clinically safe systems to support their health and care needs. Part 1 provides further detail on this activity. 

Delivery priorities for 2022–23

Over the course of 2022–23, the Agency led the way in advancing and expediting digital innovation as part of the broader national health agenda. The Agency’s Corporate Plan 2022–23 championed 3 strategic areas of focus:

• Infrastructure solutions and initiatives
• Interoperability supporting connected health and care
• National digital health initiatives.

Performance against each priority area is captured in Part 2 of this report. 

Governance structure

The Agency is a corporate Commonwealth entity, established by a rule under the PGPA Act. Information about our governance, management and accountability framework is covered in Part 3 of the report.

Board as the accountable authority

A Board, chaired by Dr Elizabeth Deveny, is the Agency’s accountable authority. As the accountable authority, the Board sets the objectives, strategies and policies ³ for the Agency and is responsible for the proper and efficient performance of the Agency’s functions. ⁴

Advisory committees

The Board is supported in the performance of its functions by advisory committees. Four standing advisory committees are established under the Agency Rule:

• Clinical and Technical Advisory Committee
• Jurisdictional Advisory Committee
• Consumer Advisory Committee
• Privacy and Security Advisory Committee.

The Agency also has an Audit and Risk Committee, as required under the Public Governance, Performance and Accountability Rule 2014.

Intergovernmental

The Agency operates under an Intergovernmental Agreement between the Commonwealth and state and territory governments. Under this agreement, the Agency works closely with the states and territories to transform how health information is used to deliver better healthcare and implement a world-class digital health capability in Australia.  

Portfolio and ministerial oversight

The Agency sits within the Health and Aged Care portfolio and is accountable to the Ministers of the Health and Aged Care portfolio:

• The Hon Mark Butler MP, Minister for Health and Aged Care
• The Hon Anika Wells MP, Minister for Aged Care and Minister for Sport
• The Hon Ged Kearney MP, Assistant Minister for Health and Aged Care
• The Hon Emma McBride MP, Assistant Minister for Mental Health and Suicide Prevention and Assistant Minister for Rural and Regional Health
• Senator the Hon Malarndirri McCarthy, Assistant Minister for Indigenous Health.

Our people and their location

At 30 June 2023, the Agency had 412 permanent staff with offices in Brisbane, Sydney and Canberra.

Funding

The Agency is jointly funded by the Commonwealth ($229.5 million) and the states and territories ($32.25 million), reflecting the commitment at all levels of government to the delivery of digital health reform.

Financial outcome

• Operating loss: $32.8 million
• Operating revenue: $255.9 million
• Operating expenses: $288.7 million

The Agency’s financial performance and the Australian National Audit Office’s (ANAO) audited financial statements are presented in Part 4 of this report.

---- End Section

The Corporate Plan can be accessed from this link:

https://previewapi.transparency.gov.au/delivery/assets/80a82ed1-3e33-027b-b7e0-6493f97f18f8/f802dc8b-2e84-43a4-822b-ffbf7a38db4a/adha_cp_2022-23.pdf

It is 54 pages and says that the Agency is funded until June 30, 2023.

There are pages and pages of measures as to how the ADHA is going but no results for any of these measures.

I wonder how anyone actually knows who is doing what for whom.

Surely with $250M + and 400+ staff there should be progress reports and outcome measures!!!

Can someone send me some?

David.

What Do You Think Of Australia’s 10 Year Digital Health Plan?

Somehow this was released while we were all busy with other things.

Australia's digital health pipeline in 10 years

The government is doubling down on modernising My Health Record and building a framework for national health information sharing.

By Adam Ang

January 12, 2024 03:26 AM

In the coming decade, Australia is expected to carry out several digital health initiatives that it outlined in its recently published blueprint. 

An accompanying Action Plan to the 2023-2033 Digital Health Blueprint explains each initiative and how target outcomes are going to be met in short, medium, and long-term horizons.

Many of those initiatives, such as electronic prescribing, the Health Delivery Modernisation Program, and several digital population health tools, are ongoing. Meanwhile, a couple of initiatives outlined are in the pipeline, including:

·         continued modernisation of My Health Record and making sharing of other key health information by default to My Health Record;

·         connecting Allied Health to My Health Record;

·         supporting preliminary work to develop a national legislative framework on health information sharing in states and territories;

·         establishing Genomics Australia, which will guide the responsible collection, storage, use and management of genomic data;

·         Dollars Going to Care, which will publish standardised and benchmarked financial information of residential aged care providers, promoting financial transparency and accountability;

·         Government Provider Management System, which will allow aged care providers to self-manage, view, and maintain their records with the government

WHY IT MATTERS

The modernisation of Australia's digital health record system is a major focus of the Department of Health and Aged Care in the coming years. It is working to fulfil some of the recommendations provided by the Strengthening Medicare Task Force last year, including overhauling the "clunky" My Health Record and establishing robust national governance and legislative frameworks to better connect health data across the health system.

"Planning for the modernisation of the My Health Record system to meet [national health information] sharing requirements for consumers and healthcare providers is underway, with future phases to be considered by [the] government," it said. 

Last year, the government also invested A$5.8 million ($3.8 million) to help allied health software vendors connect to My Health Record. Funding was also set aside for initial legislative policy and analysis work by states and territories to establish a national legislative framework for national health information sharing across settings and borders.

THE LARGER CONTEXT

Australia's Digital Health Blueprint envisions a "trusted, timely and accessible use of digital and data underpins a personalised and connected health and wellbeing experience for all Australians."

It has identified four key outcomes which revolve around digitally empowering consumers and the health workforce, safe data and information sharing, and building modern digital foundations of a standard-based health system. 

The blueprint was created to meet growing expectations and demand from consumers to have more control over their health through digital means. It consolidates the federal government's long-term investment in digital health, as well as complements the National Digital Health Strategy, which is currently being redefined.

More here:

https://www.healthcareitnews.com/news/anz/australias-digital-health-pipeline-10-years

Here is the reference:

https://www.health.gov.au/sites/default/files/2023-12/the-digital-health-blueprint-and-action-plan-2023-2033_0.pdf

Digitl Helth Blueprint 2023-2033

A more personlised and connected helth and wellbeing experience for all Australians

There is extensive commentary here:

How to make GP digital health gravy

By Jeremy Knibbs  - 12 January, 2024

A short critique of our Gravy Day digital health blueprint.

On 21 December last year DoHAC published what should rank as one of our most important health planning summary documents for decades: the Digital Health Blueprint

2023-2033. So I wrote a quick song …

Hello Dan, it’s Jeremy here, I hope you’re keeping well
It’s the 21st of December, and they’re ringing the Blueprint bell
If you turn out to be a saviour, we’ll be out of here by July (2033)
Hope to kiss patients on Christmas Day (2033), please don’t let them (continue to) cry…

GPs will be familiar with the song but probably not Dan(iel) McCabe, who is the main man inside the Department of Health and Aged Care running a pretty good new digital health agenda for the country, and one which will eventually impact GPs in a big way.

So what’s with the timing on something so important?

I was Christmas shopping at the time the plan came out, as I suspect were most other people who might have found it interesting.

We at TMR had largely stopped all our news services to go on break. We do still break big news over Christmas if it’s big enough, but even though this is a very important document, there wasn’t exactly any breaking news in it.

I did eventually read the blueprint and its associated action plan over my break. When East of Eden starting to get really slow (after the 350-page mark if you haven’t read it yet), I’d stop every now and then and read a bit of the blueprint, until eventually I’d read it all.

Maybe this explains the timing.

People need to be relaxed and have nothing much else to do to get through an important summary document like this, thus allowing them to savour the ideas a bit longer and ponder what might really come of it.

That’d be my get best attempt at a “get out line” if Mark Butler sent a WTF email though to my boss on the timing of the plan’s release – which if he didn’t, he probably should have.

If you haven’t read it yet, and everyone – including GPs – should at least try, here’s a tip: skip the blueprint and read the action plan first.

The blueprint is the sort of political PR aspirational puffery that might turn away the most hardened digital health nerd from persisting even with the far more important action plan.

For those non hardened nerds who want to save even more time and not even give the action plan a decent go (I’m going to assume a lot of GPs might be in this category), here it is in shorthand (note, my interpreted words not the blueprint’s):

By 2033 we want:

• Patients and healthcare providers to be able to share meaningful and important health data in real time anywhere, anyhow
• We want to empower both providers and patients to make much better health decisions in real time using this meaningful information
• We want to make the system transformationally (not a real word, but it fits) more efficient, not just for cost but convenience, for providers and patients

We’re going to do that by:

• Improving the relevance and functionality of the My Health Record significantly
• Getting technology vendors and providers to play ball by quickly agreeing to sets of standards which would enable modern web-based sharing technology to be implemented nationwide and create the ability for meaningful real-time data sharing
• Aligning the states, the federal government and emerging private providers on healthcare data sharing standards, data privacy and sharing legislation and technology so it all works for providers and patients

Of course this is a somewhat kindly (and horrifically simplified) summary (and you probably can’t see the word GP in there, but you’re there big time, believe me).

The first thing I’d say is that to at least have a government with these collective goals and some plan to achieve them – no matter how insanely wicked many of us know the detail under it actually is – is probably a very important starting point for transforming health in Australia, and a not a point we’ve been at, probably since someone pretty clever thought of Medicare (Medibank back then) in the early 70s, and how that might help things along much better for quite a few years.

On the other hand, given just how wickedly complex the issues are, you soon realise that what detail there is is not the detail required to inspire a lot of confidence that this plan is achievable, even given its 10-year horizon.

The action plan does list quite a few actual projects, either in play already, or in planning (way too many in planning), and most of them do go to the overall goals above, some even with just a whisper of co-ordination, which is another glass-half-full observation of the document.

They include (with some short observations in brackets):

• modernising the My Health Record (“modernising” says it all given we’ve spent over $2 billion and 10 years on it for no net meaningful result so far)
• enhancing digital medication management (expand a pretty good start on e-scripts across hospitals, aged care and so on)
• creating national standards to support real-time data sharing (doable big goal with a lot of power to change things quickly; question is, when?)
• create e-requesting for pathology and imaging in the mould of the national e-scripts service (big issues here emerging with software vendor resistance, especially GP software vendors – more below)
• create a national Health Information Exchange capability (sounds good but no one is sure how it could happen, given how eclectic our state-federal system is; and if it could do what is being suggested it might, why would you need the My Health Record?)
• equip the health workforce digitally (whatever that means, and, the key issue here, what workforce? We need digital faster precisely because we know we are never going to have the workforce we’re predicted to need)
• fix mental health with lots of cool new digital apps (I’ll expand below)
• get genomics fixed in Australia and integrate that infrastructure to the whole plan (noble goal and a smart thing to do, but probably completely unrealistic given the major basic interoperability issues to overcome first and the government funding paradigm)
• fix aged care with all of the above (it’s getting silly now, the plan is far too sprawling, but you can’t not mention aged care in a digital health blueprint)
• and a throwaway par about AI and health (I guess there had to be one as this is a digital plan and AI is going to help at some point if we get it right).

You may have recognised that some of really cool things in here that we’ve done already (electronic scripts for instance) are not the product of superior goals and planning from the past, but accidents of a pandemic that forced us all to drop our weird bureaucratic and protectionist behaviours for a couple of years.

But everything in this list (bar perhaps the My Health Record) all go to a set of collective aspirations and goals which are mostly sensible.

You may also have again noted that there is still not a lot about general practice. But keep reading. If the government does what it can do now fast, general practice is going to see a lot of change in how it interacts with the rest of the healthcare system and its patients within a couple of years.

Back to my awkward reinterpretation of the first verse of a Paul Kelly classic for a sec.

Can we afford to wait 10 years to achieve some of the key goals in this plan?

It’s a question I think everyone in charge should be pondering a lot harder following the release of this blueprint.

We know the time frame is not the government giving themselves tons of wiggle room to protect themselves. If you include some of the big throwaways in the blueprint at the end – “we’re gonna fix aged care and mental health with this here plan” – 100 years might be a better time frame.

Even if we look at the basic obstacles this plan faces in just getting data sharing, standardisation and technology alignment going, 10 years is pretty optimistic.

Ten years can also easily be argued a wise time frame if we are to avoid large scale and very expensive screw-ups given the complexities, politics and interdependencies associated with healthcare provision. Mind you, if anyone ever wants to get honest about the ROI of more than $2 billion for the My Health Record, it’s pretty hard to see how anyone today could engineer an ongoing mistake that big again.

So, it’s sensible to plan this long, right?

I don’t think so.

Here’s why:

• Some parts of our system are going to crash almost certainly soon without bolder faster action. The most immediately identifiable collapse is within most aspects of our health workforce. All areas of workforce are vita and stressed but if our general practice network collapses our system will collapse entirely and the time frame for fixing that will be a lot longer than 10 years.
• Ten years is good and bad for healthcare planning. The bad side is that a lot of organisations and people can keep doing average and even bad things, often driven by natural commercial pressures, without being outed in such a long-term plan. Such constant long-term resistance can be very destructive in the end. Being bolder makes everyone clearer about what is going on and provides very little room for bad actors to hide.
• We’ve wasted maybe 20 years in Australia trying to get our act together in digital health and we find ourselves a very long way behind. We should learn from our many and large mistakes, trust our new plan and instincts, and not be afraid to be a little bold. We owe it to Australian health consumers and providers.

I think most people looking at where we are might recognise a climate change-type problem in our healthcare system.

Nearly everyone’s livelihoods and security – perhaps except GPs who are getting slaughtered anyway, so haven’t got a lot to lose through change – are tied in some way or another to the system not changing, or at the least not changing fast.

Vastly more follows here

https://www.medicalrepublic.com.au/how-to-make-gp-digital-health-gravy/104186

Having gone this far I am sure most readers need a summary in a line of two!

Basically the Government wants to run the decrepit, dysfunctional My Health Record for more years forward that I expect to be on this earth and still hope that it will be suddenly found useful and worthwhile.

In the meantime, as far as I can tell, the rest of Australia is getting on with their life and the usage of the myHR is as low as ever.

Have a look here to see just what little change there is in record use over 18 months or so. The thing just sits there with data going in and no apparent impact or use.

https://www.digitalhealth.gov.au/initiatives-and-programs/my-health-record/statistics

The key to all this is the lack of clinical impact and the total lack of any attempt to measure impact.

As we go into 2024 and beyond the myHR becomes less relevant and hopefully other Digital Health initiatives will be better supported and encouraged.

For the sake of the Almighty can’t we kill off the myHR and spend the funds on the other much more useful Digital Health initiatives like referrals and prescribing! That would be a Blueprint we could all agree on!

David.