This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
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."
Both shows have transcripts or you can download the audio and listen.
Overall one gets the sense that this is a complex problem, will need carefully thought out solutions and that real time prescription monitoring will help but needs to be part of a wider program.
Hardly a surprise given the complicated causes that have got us to where we are with so many addicted and sadly dying.
The main problem is that it's a bureaucrat's solution which tries to be all things to all people, an anonymous GP writes.
The MyHealth Record is like my garden. You can stick fancy plants in, ask people the flower they want to see blossom and plant those too. It needs money, too, but then it will look very pretty. Then, no matter what you do, the plants suddenly wilt and die and the garden is left barren.
There is an alternative to health IT horticulture: you spend your time fertilizing the soil, digging it, nurturing the local ecosystem, and then sow tiny inexpensive seeds. Some germinate, grow and flower, some fail. But you learn what works.
Last year we were nearly self-sufficient in vegetables and herbs all year. And that only took two years.
How long has the My Health Record been going for now?
The trouble is this: it's not a clinical record, nor is it a true patient record. It’s something that is trying to be all things to all people – to patients, to politicians, to health department officials, to emergency doctors, hospital doctors, nurses, to private specialists, after-hours doctors, allied health workers and the neighbour’s dog.
But it’s a bureaucrat’s solution to a bureaucrat’s notion of the communications issues plaguing the health system. These solutions need to be clinically lead and clinically implemented — properly — not just token consultations so that someone in a suit can tick a box and say they’ve listened.
The My Health Record is built on a variety of assumptions: that more documents are better; that patients want and need access to everything; that patients have the necessary health literacy to use it in a way that will inform their health choices.
And it is built on the assumption that just accessing this information treasure trove without context or discussion is useful.
I would have to say this really gets it! As I have said often enough you cannot make an EMR that is ideal for clinician use while at the same time expecting the same record to provide a compelling consumer experience – forgetting all the other actors who want to have their problem solved!
The sooner we stop this madness the better in my view!
Dr Steve Hodgkinson has a message for digital health innovators: the longer a project takes, the more likely it is to fail.
Dr Hodgkinson, the CIO at Victoria’s Department of Health and Human Services, has overseen the launch of around 30 new applications in the past 18 months, with products delivered in as little as six weeks, and none taking longer than six months.
The thinking behind a swift roll-out was that it gave stakeholders a sense of how the application would work and provided an opportunity for feedback early in the process.
Rather than taking 18 months or two years to develop the “perfect”system, the department used existing cloud platforms to get a working model up as soon as possible and then executed the design based on user feedback.
This transparency promoted organisational learning and made people feel energised and excited about the project, Dr Hodgkinson said.
“Just getting started is the thing,” he said, speaking at Microsoft’s “Creating a Digital Difference” event in Sydney this month.
The department launched a thunderstorm asthma early-warning system in October, in partnership with the Bureau of Meteorology, the University of Melbourne, and Deakin University. The computing work was done by Microsoft’s Azure platform.
The system gave three days’ warning of a likely event and sent notifications to the public through the Vic Emergency app.
…..
This strategy, which Dr Hodgkinson named “Platform+Agile”, could be useful for the development of a range of digital health systems, he said. “But electronic health records it is a more complicated conversation,” he said.
Digital health often feels stuck in the mud, with systems unable to talk to each other and projects such as My Health Record eating into $2 billion without much to show for it.
Part of the problem was that government was trying to create “a single system to rule them all”, which was neither necessary nor practical in a fragmented sector like health, Dr Hodgkinson said.
A better solution would be for government to become an “intelligent consumer” of global digital services.
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 myHR is really in the news for both good and not so good reasons this week. Otherwise some more private sector activity and the NBN still seems to be causing some concern. Happy reading.
Privacy groups outraged over failure to inform Aussies about a new government health record
Sue Dunlevy, National Health Reporter, News Corp Australia Network
PRIVACY groups have slammed the Federal Government for their silence over a controversial internet health record forced on every Australian as of next year.
More than $1.7 billion of taxpayer’s money has gone into developing a personalised My Health Record for every Australian.
It will detail every subsidised medicine used, every doctor and hospital visit, blood test result, X-ray and scan ever provided to each person.
People who want to opt out of the system to keep private sensitive information like abortions, sexually transmitted disease, mental illness, obesity surgery will have three months to do so.
It’s cost an estimated $2 billion and taken five years to develop so far, but concerns are growing that the Federal Government’s My Health Record may be at risk of becoming a white elephant as hospital and GP groups claim it is yet to show clinical benefit.
New figures released by the Australian Digital Health Agency, which is rolling out the national repository for health information, show that while 21 per cent of the population has a My Health Record, only 263 specialists were connected to the system, less than 150 hospital discharge summaries are viewed each month by any healthcare organisation, and about 200 GP-generated shared health summaries were accessed by staff working in public and private hospitals in August.
The alarmingly low use of the system by clinicians has amplified the chorus of concerns from healthcare providers and technology experts who claim the My Health Record isn’t fit for purpose.
The main problem is that it's a bureaucrat's solution which tries to be all things to all people, an anonymous GP writes.
The MyHealth Record is like my garden. You can stick fancy plants in, ask people the flower they want to see blossom and plant those too. It needs money, too, but then it will look very pretty. Then, no matter what you do, the plants suddenly wilt and die and the garden is left barren.
There is an alternative to health IT horticulture: you spend your time fertilizing the soil, digging it, nurturing the local ecosystem, and then sow tiny inexpensive seeds. Some germinate, grow and flower, some fail. But you learn what works.
You would worry for the My Health Record this Christmas — simply because it still has the look of a giant, overfed turkey. Respect to the Australian Digital Health Agency — it was open and transparent about what’s been going on.
It could have buried the numbers as politicians have often done beneath the statistical irrelevancies of the millions of patients signed up to the system, that number so quoted in the media sound bites when pretending taxpayers dollars are not being squandered.
The shared health summaries being created by GPs are meant to be the “backbone” of the system, a quick, concise clinical overview that hospitals, private specialists, allied health practitioners can refer to when providing care.
For many years we have been talking about the ‘digital divide’ in healthcare, but the implementation of any digital solution does not itself improve outcomes, unless there is clear evidence to prove it. To gain this evidence involves the collection of the good data, and then a robust analysis of the data collected.
Unfortunately, most implementations of digital solutions in healthcare, especially electronic medical records (eMRs), have not applied sufficient resources to the governance of data collection, and resources for data analysis. This has led to a big ‘data divide’ between healthcare organisations, states and territories, and countries. Our recent meeting on Health Data Analytics in Brisbane highlighted this perfectly.
“My Health Record is making strong inroads into developing the support and services. This work will help fulfil the potential of a secure online summary for all Australians and ensure healthcare professionals have access to key patient information.”
More than 95% of Australian diagnostic imaging practices will soon be able to connect to the My Health Record system with 16 new software companies finalising service agreements with the Australian Digital Health Agency.
Over the coming months software companies will build My Health Record connectivity into their systems, according to the media release. By the end of 2018, less than 12 months after offering arrangements, diagnostic imaging centres will be able to access software that connects with My Health Record and to upload reports for their patients.
More than 95 per cent of Australian diagnostic imaging practices will soon be able to connect to the My Health Record system with 16 new software companies finalising service agreements with the Australian Digital Health Agency.
Over the coming months software companies will build My Health Record connectivity into their systems. By the end of 2018, less than twelve months after offering arrangements, diagnostic imaging centres will be able to access software that connects with My Health Record and to upload reports for their patients.
Demand from patients for a secure on-line summary of their health information is gathering momentum. Over 5.3 million Australians have a My Health Record and a new record is created every 38 seconds.
Every Australian with a My Health Record will be able to walk into a community pharmacy and have their Pharmacist upload important medicines information into their secure My Health Record to improve their health care.
Chemist Warehouse, representing 30 per cent of the community pharmacy market, and Corum representing 1,000 pharmacies, today announced their upcoming connection to My Health Record system in 2018. Every community pharmacy software vendor has now signed up to the Community Pharmacy Software Industry Partnership to connect to the My Health Record system.
Chemist Warehouse Managing Partner and Director Mark Finocchiaro said the company sees great potential to improve the health of Australians through technologies such as My Health Record.
Dr Steve Hodgkinson has a message for digital health innovators: the longer a project takes, the more likely it is to fail.
Dr Hodgkinson, the CIO at Victoria’s Department of Health and Human Services, has overseen the launch of around 30 new applications in the past 18 months, with products delivered in as little as six weeks, and none taking longer than six months.
The thinking behind a swift roll-out was that it gave stakeholders a sense of how the application would work and provided an opportunity for feedback early in the process.
Rather than taking 18 months or two years to develop the “perfect”system, the department used existing cloud platforms to get a working model up as soon as possible and then executed the design based on user feedback.
In what is being signalled as a leap forward in the development of secure messaging, two Australian health tech titans announced this week that they have achieved two-way interoperability for the sharing of clinical information.
Documents including referrals, specialist letters, diagnostic results and discharge summaries are now being securely exchanged by healthcare providers using Global Health’s ReferralNet and Telstra Health’s Argus secure messaging platforms, according to the announcement.
“This is what everyone has been waiting for,” Nikki Thrift, General Manager of Connectivity for Global Health, told Healthcare IT News Australia.
A Sydney-based start-up that has created an online platform to offer desperately ill patients access to clinical trials of new treatments is heading to the US after winning a pitching contest hosted by big-name US tech site TechCrunch.
HealthMatch, which is staffed only by co-founders Manuri Gunawardena and Arran Schlosberg, won the inaugural Australian TechCrunch Startup Battlefield event in Sydney last Thursday, meaning they will now head over to pitch in the high-profile US version of the contest next year, just as they are trying to secure a series A funding round.
HealthMatch is a platform that uses machine learning to sort through the thousands of clinical trials being run by contract research organisations (CROs) in Australia and matches registered patients that are relevant.
The Department of Human Services flagged the illegal sale of Medicare details on the dark web almost a fortnight before the illicit trade was exposed in a bombshell media report, The New Daily can exclusively reveal.
Internal emails, obtained under freedom of information laws, reveal that department officials discussed the security issue as early as June 22 – nearly two weeks before revelations that Medicare numbers were being sold online.
On July 4, The Guardian revealed that a dark web vendor was advertising the sale of any Australian’s Medicare number for the bitcoin equivalent of just $22 after exploiting a government system vulnerability.
In the wake of the revelations, Human Services Minister Alan Tudge said that he and his department had only learned of the illicit trade when contacted by a Guardian journalist on July 3.
An innovative glucose-monitoring device, which removes the need for multiple daily finger pricks, could be rolled out to hundreds of thousands of Australians with diabetes if the federal government agrees to fund it.
The device, FreeStyle Libre, is expensive to use full-time for many people, given it costs $92.50 every 14 days for discs used to monitor glucose levels. That equates to about $2500 annually, including the cost of the reader.
Elizabeth McKinley, 58, a single mother of five, who has had type 2 diabetes for 15 years, has called for the costs to be reimbursed. She has trialled the device and found it significantly helped in managing her diabetes, but the ongoing cost meant she had to stop using it.
I would say that almost every patient a GP sees these days has performed a Google search of their symptoms before turning up at the doctors.
Being a doctor, I’ve never had to perform a health-related Google search, but in the interests of getting to know my patients better, I decided to give it a go.
I took the plunge one early Saturday morning while I was getting my breakfast ready — what I wanted to know was, was my preferred plate of eggs and bacon a healthy option?
According to Healthline, eggs are one of the six healthiest foods on the planet. Feeling a little bit smug, I googled “bacon”.
Medicines are the most common medical intervention in Australian hospitals. As many as one in nine doses of medicine administered in hospitals are associated with a clinical error.
The company recently completed its fifth year of profitable operations.
At its current share price of $0.28, it offers a compelling dividend yield
Global Health Limited (ASX:GLH) has achieved two-way interoperability between its ReferralNet secure messaging service and Telstra Health’s Argus secure messaging platform.
The two platforms can now securely exchange clinical documents, including referrals, specialist letters and discharge summaries.
The collaboration represents a significant step forward for the Australian healthcare industry as it transitions to becoming fax-free, a structural shift that will result in considerable cost savings.
The Victorian government has selected pharmacy IT solutions provider Fred IT Group to build the state’s $29.5 million real-time prescription monitoring system.
The centralised tracking system known as SafeScript aims to reduce the misuse of prescription drugs and allow for safer clinical decisions by giving health practitioners “up-to-the-minute information on the prescription histories of their patients”.
Fred IT’s appointment follows the passage of the Drugs, Poisons and Controlled Substances Amendment (Real-time Prescription Monitoring) Bill 2017 through state parliament last month.
A Krack vulnerability sounds like something that’d send you straight to the ED. But it’s actually a security risk in the most common wi-fi protocol, WPA2, revealed last month by Belgian researchers.
The discovery made news across the world. Here at home, the Australian Digital Health Agency (ADHA) issued a formal security alert about it.
KRACK refers to Key Installation Atta-C-K, an acronym so illogical it could almost have been the title of a clinical trial.
London: An experimental therapy for people with schizophrenia that brings them face-to-face with a computer avatar representing the tormenting voices in their heads has proved promising in early stage trials.
Scientists who conducted a randomised controlled trial comparing the avatar therapy with a form of supportive counselling found that after 12 weeks, the avatars were more effective at reducing auditory hallucinations, or voices inside the head.
More research is needed to investigate the approach in other healthcare settings, so the therapy is not yet widely available.
But if further trials prove successful, experts said, avatar therapy could "radically change" treatment approaches for millions of psychosis sufferers across the world.
The AMA submission urges the government to adopt a carefully balanced position on the secondary use of My Health Record data. Our members recognize the positive opportunities the new My Health Record data set will create. But the extent and management of each disclosure decision must not breach the trust of patients who expect the government to keep their health data safe and protect it against any privacy breach. Doctors are also mission critical to the success of the My Health Record. The secondary use of My Health Record data must not breach their trust either.
Dr Radford will head to Europe next year on a Churchill Fellowship to further her work with electronic medical data collection and how it can benefit the health of patients.
CARLY DOLAN:What is the current data collection process in Tasmania?
JAN RADFORD: We’re doing a little bit in this area but it’s new, and how do you sustain it and then use it for the greater good? There are some projects we’ve just started to work on but it’s a matter of slowly progressing the whole thing because you’ve got to make sure that patient records are handled with very good care. So the data governance has to be right.
CD: Can you explain what it is you’re looking into?
JR: When I started as a GP 31 years ago, it was all written down and filed away. It’s slowly crept in that electronic records have become more and more used and are now really the norm in Australian general practice. Each country has become electronic in that sense at a different rate.
The Labor Party has raised the possibility that NBN users may be at danger during the forthcoming fire season if their phone services are running off the network.
A statement from Shadow Communications Minister Michelle Rowland said the fire chief in Western Australia had, recently, warned that phone services which were running off the NBN could be exposed during an emergency.
Rowland and Shadow Health Minister Catherine King said that the NBN Co itself had pointed out that two of the technologies being used to roll out the network — fibre-to-the-node and HFC — could not be relied upon during a power outage.
NBN chief executive Bill Morrow says the company is prepared to publish details of the theoretical maximum speeds achievable for households — possibly.
However, in an appearance yesterday at a Senate Estimates hearing the CEO reiterated that he didn’t believe that NBN would have to — and that he wasn’t even sure if, legally, the company would be able to.
Every Australian with a My Health Record will be able to walk into a community pharmacy and have their Pharmacist upload important medicines information into their secure My Health Record to improve their health care.
Chemist Warehouse, representing 30 per cent of the community pharmacy market, and Corum representing 1,000 pharmacies, today announced their upcoming connection to My Health Record system in 2018. Every community pharmacy software vendor has now signed up to the Community Pharmacy Software Industry Partnership to connect to the My Health Record system.
Chemist Warehouse Managing Partner and Director Mark Finocchiaro said the company sees great potential to improve the health of Australians through technologies such as My Health Record.
More than 95 per cent of Australian diagnostic imaging practices will soon be able to connect to the My Health Record system with 16 new software companies finalising service agreements with the Australian Digital Health Agency.
Over the coming months software companies will build My Health Record connectivity into their systems. By the end of 2018, less than twelve months after offering arrangements, diagnostic imaging centres will be able to access software that connects with My Health Record and to upload reports for their patients.
Demand from patients for a secure on-line summary of their health information is gathering momentum. Over 5.3 million Australians have a My Health Record and a new record is created every 38 seconds.
It’s cost an estimated $2 billion and taken five years to develop so far, but concerns are growing that the Federal Government’s My Health Record may be at risk of becoming a white elephant as hospital and GP groups claim it is yet to show clinical benefit.
New figures released by the Australian Digital Health Agency, which is rolling out the national repository for health information, show that while 21 per cent of the population has a My Health Record, only 263 specialists were connected to the system, less than 150 hospital discharge summaries are viewed each month by any healthcare organisation, and about 200 GP-generated shared health summaries were accessed by staff working in public and private hospitals in August.
The alarmingly low use of the system by clinicians has amplified the chorus of concerns from healthcare providers and technology experts who claim the My Health Record isn’t fit for purpose.
GPs, who are provided with financial incentives to upload shared health summaries to the system through the government’s ePIP program, said they don’t need to access My Health Record for up-to-date and accurate clinical information.
This seems to show that hardly anyone is using it and this also:
Privacy groups outraged over failure to inform Aussies about a new government health record
Sue Dunlevy, National Health Reporter, News Corp Australia Network
PRIVACY groups have slammed the Federal Government for their silence over a controversial internet health record forced on every Australian as of next year.
More than $1.7 billion of taxpayer’s money has gone into developing a personalised My Health Record for every Australian.
It will detail every subsidised medicine used, every doctor and hospital visit, blood test result, X-ray and scan ever provided to each person.
People who want to opt out of the system to keep private sensitive information like abortions, sexually transmitted disease, mental illness, obesity surgery will have three months to do so.
But privacy groups are gobsmacked by the government’s decision not to use TV, radio or newspaper ads to explain this to the public.
If you fail to opt out within the three-month deadline, the government will automatically create the record for you — and it will be kept for 130 years.
You would worry for the My Health Record this Christmas — simply because it still has the look of a giant, overfed turkey. Respect to the Australian Digital Health Agency — it was open and transparent about what’s been going on.
It could have buried the numbers as politicians have often done beneath the statistical irrelevancies of the millions of patients signed up to the system, that number so quoted in the media sound bites when pretending taxpayers dollars are not being squandered.
The shared health summaries being created by GPs are meant to be the “backbone” of the system, a quick, concise clinical overview that hospitals, private specialists, allied health practitioners can refer to when providing care.
So in summary were are all going to be enrolled in a system which we may, or may not be informed of, to gather all our health information willy nilly. Information will be added to this record without our knowledge and we can’t delete it – even if we really want to. Basically no on except the Government is likely to be using the information and we are all footing a huge bill to fund it!
You could not make this stuff up! They really have wandered off the reservation!
