Monday, July 24, 2017

It Seems Poking The Dragon Worked - Suddenly New Board Minutes Appear!

Look what we now see!

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Board Papers

The intent of the Board is to publish as many Board documents as is feasible. Information and attachments to Board documents that are draft, not finalised or sensitive will not be published. An exception is made for draft material already in the public domain (in this instance the Board Advisory Committee Charters released on 16 September 2016).

Board Meeting 14 June 2017 - Board Papers (Download)


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A win for the good guys - but even this is far too late and totally incomplete!

David

Weekly Australian Health IT Links – 24th July, 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 biggest news this week is how the public perception of the NBN is unravelling and how public frustration is beginning to build.
Elsewhere we have the ADHA seeming to struggle with Strategy and solutions for some ongoing problems right now. Would be good to see some real progress.
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Can this man turn around one of Australia's costliest policy disasters?

20 July 2017

NEWS REVIEW

Can Tim Kelsey resuscitate the moribund My Health Record system?
Time Kelsey doesn’t smile much when you meet him. But then his job probably means he doesn’t have much to smile about. 
He is the man tasked with rescuing Australia from one of the most expensive policy disasters in the nation’s history — the My Health Record system.
Ten months ago, the Federal Government hired Mr Kelsey, a former journalist and one-time Telstra Health bigwig, to head up the newly created Australian Digital Health Agency.
No faceless bureaucrat, the animated and garrulous Brit immediately attracted plenty of media attention.
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Plan to give patients more power over referrals

Rachel Worsley | 20 July, 2017 |  
Patients will be encouraged to shop around for a different specialist to the one named in their GP referral, under a push to boost healthcare competition.
The idea — strongly condemned by the RACGP — is one of several presented in a draft Productivity Commission report exploring ways inject greater user choice by weakening existing referral networks.
The report says patients should be given greater scope to “independently choose” a public outpatient clinic or private specialist “after leaving the GP’s office”.
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Why Telstra proved no smooth operator in cancer register bungles

19 July 2017

ANALYSIS 

Last year, when the Turnbull Government awarded an $180 million contract to Telstra to set up and run a new National Cancer Screening Register, many people were surprised and a little sceptical.
There was a political stink, with the Labor Party claiming that the clinical information of 11 million women should not be handed to a for-profit corporate giant, allegedly with a track record of security blunders.
The task set for Telstra Health involved combining the state-level Pap smear registers into one national register. This system would then underpin the important shift to five-yearly HPV tests instead of two-yearly Pap smears.
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17 July 2017

How virtual reality may reshape healthcare – or not

A man walks into a virtual bar … but this is no joke, instead it just may be the future of mental-health treatment.
Just say you’re a patient with severe paranoia and persecutory beliefs. Being stuck in a bar with dozens of other people would be a highly stressful situation, where thoughts such as “People are talking about me”, “People can read my mind” or “Someone wants to kill me” come unbidden.
Of course, a natural reaction would be to put your head down and avoid eye contact, and to get out of there as soon as possible. Unfortunately, these safety-seeking behaviours help to support that original delusion – that people really were out to get you and the only reason they didn’t was because of the steps you took to prevent it.
This is where virtual reality (VR) steps in.
A key goal of treatment is to get patients with persecutory beliefs to experience these situations without taking those avoidant measures, so that they can see that their fears are unfounded. Unfortunately,  such exposure in real-life may be too overwhelming and stressful for some, or impractical if the feared situation is difficult to access.
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Should we care that Medicare numbers are being sold on the ‘dark web’?

17 July 2017

TECH TALK

Forget about the ‘dark web’, it’s all about money, writes Antony Scholefield.
Recent revelations that Medicare numbers have been up for sale on the ‘dark web’ has thrown up a lot of questions.
It was not just “What the heck is the dark web?”, but also the deeper question of “Should we really care?”.
The first answer is that the dark web is a group of internet sites only accessible with special software, where people can more easily cover their tracks.
A journalist at the Guardian went to one website that promised to deliver the Medicare number of any individual, provided you gave them the name and the date of birth.
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Medicare details available on dark web is just tip of data breach iceberg

Chris Berg
Published: July 18 2017 - 12:00AM
Modern governments use a lot of data. A lot.
Our social services are organised by massive databases. Health, welfare, education and the pension all require reams of information about identity, social needs, eligibility, and entitlement.
Our infrastructure is managed by massive databases holding information about traffic flows, public transport usage, communications networks, and population flows.
Our security is maintained by complex information systems managing defence assets, intelligence data, and capabilities and deployment information.
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US law enforcement takes down site hosting Medicare data sale

AlphaBay, Hansa darknet marketplaces shut down
Rohan Pearce (Computerworld)
The US Federal Bureau of Investigation (FBI), the US Drug Enforcement Agency (DEA), the Dutch National Police, and Europol have cracked down on darknet markets, shutting down two of the major Tor-concealed marketplaces for illegal goods and services: Hansa and AlphaBay.
The US Department of Justice overnight announced that it had seized AlphaBay, the darknet market site that hosted the so-called ‘Medicare Machine’ service.
AlphaBay has been offline since 5 July.
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MedsASSIST use hasn’t dropped

Most pharmacies are still using MedsASSIST, an AJP poll has found

As the deadline for the upscheduling of codeine-containing OTCs grows closer, AJP readers had warned that pharmacies might drop the decision-making tool.
Readers suggested that following the TGA’s decision to upschedule the medicines, as few as 40% of pharmacies were using MedsASSIST.
But our latest poll further supports data which consistently show that use of the tool has only slightly declined since it was announced that codeine would become prescription-only.
Seventy-four per cent of respondents to the latest poll said they were continuing to use MedsASSIST, and planned to do so right up until 1 February 2018.
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Nearly 20,000 Australians caught up in massive Bupa Global data breach

Tony Yoo
Published: July 17 2017 - 11:23AM
Bupa's international health insurance arm was hit by a malicious act in its British office, putting the private information of almost 20,000 Australian customers in danger.
The company admitted on Friday that an employee had "inappropriately copied and removed some customer information" at its Bupa Global division, which provides international health insurance for frequent travellers or people who work overseas.
"The data taken includes: names, dates of birth, nationalities, and some contact and administrative details including Bupa insurance membership numbers," Bupa Global managing director Sheldon Kenton said.

Global Health Ltd helping Australian healthcare become fax-free

14:00 17 Jul 2017
ReferralNet Secure Messaging meets all current Australian security and privacy standards.
As the messaging network grows, so does Global Health's potential customer base
Global Health Ltd (ASX:GLH) is playing a key role in the Australian Digital Health Agency’s (ADHA) trials for secure messaging.
The trials are a vital step to the healthcare industry becoming fax-free, a structural shift that will result in considerable cost savings.
The ADHA and the Royal Australian College of General Practitioners (RACGP) have helped fast-tracked interoperability efforts after listening to key partners in the healthcare industry.
ReferralNet Secure Message Delivery is Global Health’s secure message delivery platform for the exchange of confidential clinical and patient information between healthcare providers.
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Health system to finally ditch faxes

By Dylan Bushell-Embling
Tuesday, 18 July, 2017
The Australian Digital Health Agency, Telstra and HealthLink are working to develop interoperable secure electronic messaging capabilities for healthcare providers.
The partners are developing a technology to allow healthcare data to flow between healthcare providers regardless of the software they are using or the organisation they work for.
The agency is working with HealthLink and Telstra to conduct a range of trials with healthcare providers nationwide. The goal is to develop a messaging system that can be scaled nationally.
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Australian Digital Health Agency working towards secure electronic messaging between healthcare providers

It would enable the secure flow of health data between healthcare providers, irrespective of the software they are using, the organisation they work for, or with whom they are communicating.

18/07/2017
The Australian Digital Health Agency (DHA) is working together with clinical information systems vendors to develop nationally scalable secure electronic messaging between healthcare providers.
The technology would enable the secure flow of health data from one healthcare provider to another, irrespective of the software they are using, the organisation they work for, or with whom they are communicating. There would be no more need for insecure communication channels like facsimile (fax).
DHA called for tenders in February this year for industry and clinical consortia to work together to fix these integration problems. After a competitive process, DHA has entered into a contract with HealthLink to lead a consortium to send secure messages between General Practitioners (GPs) and specialists, and with Telstra to lead a consortium to send discharge summaries to GPs and other healthcare providers.
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Safeguarding Patient Confidentiality in Accessing Electronic Health Records

Guest: Kylie Ward
Presenter: Henry Acosta
Guest Bio: Adjunct Professor Kylie Ward has had a successful and celebrated career as a Nursing Leader and Health and Aged Care Executive in Australia for over 20 years. She has held positions of Managing Director, Director of Clinical Operations, Director of Nursing and Midwifery, Director of the Division of Medicine, Associate Director of Women’s and Children’s Health and Executive Director of Nursing and Midwifery in three major health services in NSW and Victoria. She has been a NUM, After Hours Coordinator, Campus Manager, Bed Manager and Patient Flow Manager. Her clinical background is in intensive care and aged care.
Kylie has enjoyed a long history with ACN and the organisations that ACN is founded upon, RCNA and the College of Nursing. After years of membership and involvement in both organisations including RCNA Chapter Chair of Sydney West Kylie was awarded Fellowship of both organisations in 2007. In 2009 Kylie was awarded a Wharton Fellowship from the University of Philadelphia, Pennsylvania. Understanding the history and commitment of these two great organisations to nursing professionalism in Australia Kylie is committed to honouring the past to lead the Australian College of Nursing as a dynamic and influential key professional organisational well into the future.
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DHS is hiring five managers for its CIO group

By Justin Hendry on Jul 17, 2017 12:30PM

To take charge of digital transformation.

The Department of Human Services is looking for a slew of technology leaders to sit within its CIO group and drive forward the agency’s IT transformation.
It has just opened applications for five national manager positions to fill vacancies across the agency’s Canberra and Brisbane IT offices.
The senior executives will lead digital projects, vendor management, and infrastructure design and assurance branches in Canberra, and service network systems and aged care redevelopment branches in Brisbane.
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HIMSS Asia Pacific and Elsevier Launch the CMO of the Year Award

News provided by
Jul 17, 2017, 04:46 ET
SINGAPORE, July 17, 2017 /PRNewswire/ --
New award category launched in celebration of the fifth year of the HIMSS-Elsevier Digital Healthcare Award in Asia Pacific 
Nomination process is now open and will close on 4 August 2017 
HIMSS Asia Pacific, a cause-based, not-for-profit organization focused on better health through information technology (IT), and Elsevier, the information analytics company specializing in science and health, are proud to launch the Chief Medical Officer (CMO) of the Year Award as part of the Asia Pacific HIMSS-Elsevier Digital Healthcare Award 2017.
Now in its fifth year, the HIMSS-Elsevier Digital Healthcare Award recognizes outstanding achievements and innovations globally in the use of health information and technology to advance patient care and safety. The launch of the CMO of the Year Award serves to give recognition to senior clinical executives who advocate the advancement of patient safety and quality care and who are driving the adoption of healthcare information technology in their organizations.
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Detailed Clinical Model Library v4.5 July 2017 Release

Created on Monday, 17 July 2017
The Clinical Informatics unit is pleased to announce the latest release of the Australian Digital Health Agency’s Detailed Clinical Model Library (v4.5).
You can download the full release file bundle from the following location on the Agency website:
The accompanying release note outlines changes in the Detailed Clinical Models and the triggers for the changes.
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Cyber Security Operations Manager

  • Recently created Government Agency
  • Location – Brisbane CBD
  • Cyber Operations Lead
Tasked with improving health outcomes for Australians through the delivery of digital healthcare systems and the national digital health strategy for Australia, the Australian Digital Health Agency commenced operations in July 2016 and is responsible for national digital health services and systems, with a focus on engagement, innovation, clinical quality, and safety. The Agency's focus is on putting data and technology safely to work for patients, consumers and the healthcare professionals who look after them.
The role has a strong strategic focused with elements of technically hands on activity. You must have excellent stakeholder engagement and management skills, whilst being able to effectively bridge the communication gap between the technical risks to the overall business risks. Providing delivery of pragmatic and secure ICT solutions while driving continuous improvement in our cyber security space. Taking the lead in the delivery and operations of the cyber security operations centre; lead the design and implementation of processes to ensure that Agency continues its journey in the cyber space. This role will give you exposure to key stakeholders and driving risk assessment, cyber operations, compliance monitoring, technical advice and security incident response and co-ordination.
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Be extremely afraid: Elon Musk has a grim warning for US governors

Matt O'Brien
Published: July 16 2017 - 11:57AM
Providence, Rhode Island: Tesla chief executive Elon Musk has warned a bipartisan gathering of US governors that government regulation of artificial intelligence is needed because it poses a "fundamental risk to the existence of human civilisation".
But first, he asked for some governors to lift a different kind of regulation: state franchise dealership laws that ban the direct sale of his company's electric cars to consumers.
Musk spoke broadly about solar energy, space travel, self-driving cars and other emerging technology during a question-and-answer session at the summer conference of the National Governors Association in Rhode Island on Saturday.
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NBN costs put brake on internet speeds

  • The Australian
  • 12:00AM July 18, 2017

Anthony Klan

Millions of Australians will see their internet speeds fall when they are moved on to the National Broadband Network, despite still being charged the same for access.
The cost structure of the superfast internet project — required in order to pay back the federal government $49 billion in construction costs — has meant ­telcos are being charged very high prices for downloads.
These high bandwidth charges — tiny under the nation’s existing Telstra and Optus broadband networks — has meant telcos are buying the minimum, resulting in NBN speeds plummeting during peak times, such as after 5pm on weekdays.
NBN Co has admitted its bandwidth pricing is a key factor ­behind speed issues, problems not seen in New Zealand where its broadband network does not levy such fees.
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Small businesses ‘lose money on NBN switch’

  • The Australian
  • 12:00AM July 19, 2017

Anthony Klan

Sam Buckingham-Jones

The Council of Small Business Australia says its members are frustrated and “shocked” with slow connections and poor service under the National Broadband Network, with the problems causing many businesses to suffer substantial losses.
The comments come as a top telco analyst says some NBN providers appear to be building business models based on the expectation the federal government will write down billions of dollars from the value of the network, meaning it will recover less of its investment to make way for faster and cheaper net speeds.
The small-business council’s chief executive, Peter Strong, said what the public was told about the NBN was “not the reality” and slow speeds hampered many businesses. “When people think NBN, they think fast internet but then they sign up and find they are getting slower speeds than they were before,” he said. “We were told it would be so fast it would shock us. It has shocked us but not because it’s fast.”
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ACCAN’s 5 things you need to know about the NBN

You’ve heard some things are on a “need to know” basis, but with the NBN, ACCAN’s five are things you definitely need to know.
The NBN.
It has moved from a mostly fibre to the premises (FttP) system to one that encompasses a mix of technologies, known as the MTM or Multi-Technology Mix.
Some have suggested MTM stands for Malcolm Turnbull’s Mess or Malcolm Turnbull’s Mistake, but let’s not talk about the Liberal Party.
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Rowland says NBN costs more, but does less

Labor's shadow communications spokesperson Michelle Rowland has described the national broadband network as a "second-rate network that costs more and does less" in the wake of reports that costs were putting a brake on NBN speeds.
Rowland said while a report in The Australian on Tuesday had quoted an NBN Co spokesman as saying that the CVC cost was a key determinant of the slow speeds experienced by consumers, the chief executive of NBN Co, Bill Morrow, had said the exact opposite on 11 May.
"So, which one is it?" Rowland asked. "The lack of coherence on these fundamental issues is remarkable.
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NBN problems will get worse as rollout proceeds: Patton

Internet Australia executive director Laurie Patton says unless there is a quick turnaround in thinking, the problems experienced by people who are switching to the NBN will get worse as the rollout proceeds.
Patton, who has been a constant critic of the multi-technology mix that the Coalition Government has opted for, told the radio station 2GB on Tuesday that the NBN Co was trying to use aging copper wires which did not deliver the speeds that people wanted now or in the future.
He spoke to host Ben Fordham on a day when a report in The Australian claimed that NBN costs were behind the slow speeds that consumers are experiencing.
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  • Jul 19 2017 at 5:36 PM

The gap between NBN promise and reality

My internet speeds plummeted when I moved house recently. It didn't matter how expensive my broadband plan was, nor the fact I had only shifted a few blocks away.
Rather than being connected to the internet through the hybrid fibre coaxial cable, my new street was still back on the old copper telephone lines.
Adjustments to ADSL technology may have greatly improved speeds over copper lines but given the growing and massive demand for data, the result still seems like putting lipstick on an ageing pig.
Nor is it as if Telstra is too interested in investing much to upgrade either cable or copper given their previous network is being gradually subsumed into the government-owned monopoly of NBN Co, the owner of the national broadband network.
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Fifield predicts 5G revolution for Australia, ignores NBN

Communications Minister Mitch Fifield clearly believes in the slogan that a former Labor prime minister, Julia Gillard, used in her last election campaign: moving forward.
Fifield has moved on to the next phase of his life: yesterday he gave a 2368-word speech at a telecommunications conference in Sydney and did not mention the word NBN even once.
He waxed lyrical about 5G, the proposed next telecommunications standard. You can see the entire speech here.
Fifield said: "I believe that the imminent arrival of 5G mobile technology will be a truly revolutionary event in the telecommunications industry. In fact, the arrival of 5G may well be an inflection point not just for the telecoms sector, but for the entire Australian economy."
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ACCC cracks down on 'misleading' NBN speed claims

Lucy Battersby
Published: July 20 2017 - 6:09PM
Telecommunications companies are misleading customers over broadband internet speeds and the worst offenders will likely face prosecution over dodgy advertising by the end of the year, the consumer watchdog says.
Chairman Rod Sims said the Australian Competition and Consumer Commission (ACCC) would conduct "compliance sweeps" of broadband marketing and telco websites later this year in a bid to keep telcos honest about speeds available on the national broadband network.  
"Right now, consumers are not getting the basic information they need to make an informed choice. Indeed, they are often being misled," Mr Sims said on Thursday.
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  • Jul 21 2017 at 8:28 AM

NBN complaints? We're getting what we voted for

It is probably of some surprise to Communications Minister Mitch Fifield that sentiment is suddenly turning so pointedly against the Coalition-flavoured national broadband network.
The minister did the media rounds this month to trumpet the fact the plan to connect the nation to high-speed broadband is halfway through, arriving for his interviews with the air of a man who feels he is fulfilling his remit to the letter.
There are now about 5.7 million premises in Australia able to connect to the NBN, and about 2.4 million people have signed up, Mr Fifield said the network will be 75 per cent built by mid-2018, and will be finished by 2020. By the government's own narrow definition of success it is in clover, it promised to get the network built quicker than Labor, and it is ... but it is finally being made to realise that this is not enough.
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Enjoy!
David.

ADHA Transparency Watch - July 24, 2017.

Current Board Minutes available on the website are as follows:

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Board Papers

The intent of the Board is to publish as many Board documents as is feasible. Information and attachments to Board documents that are draft, not finalised or sensitive will not be published. An exception is made for draft material already in the public domain (in this instance the Board Advisory Committee Charters released on 16 September 2016).

Board Meeting 4 April 2017 - Board Papers (Download)

Here is the link:

https://www.digitalhealth.gov.au/about-the-agency/australian-digital-health-agency-board/board-papers

Accessed 7:20am 24 July, 2017

I wonder what is going on? Getting close to 4 months since the last release. Surely the board has had at least 2 meetings since early April or is the whole thing (the ADHA) now on auto-pilot and not doing much?

David.

Sunday, July 23, 2017

The Medical Observer Offers An In Depth Interview With Tim Kelsey. Worth A Read.

This appeared a few days ago:

Can this man turn around one of Australia's costliest policy disasters?

20 July 2017

NEWS REVIEW

Can Tim Kelsey resuscitate the moribund My Health Record system?
Time Kelsey doesn’t smile much when you meet him. But then his job probably means he doesn’t have much to smile about. 
He is the man tasked with rescuing Australia from one of the most expensive policy disasters in the nation’s history — the My Health Record system.
Ten months ago, the Federal Government hired Mr Kelsey, a former journalist and one-time Telstra Health bigwig, to head up the newly created Australian Digital Health Agency.
No faceless bureaucrat, the animated and garrulous Brit immediately attracted plenty of media attention.
There were references to his time in the UK when, in 2014, the boss of NHS England posted a parody Downfall video that satirised concerns about patient data being sold off to insurers, casting Mr Kelsey in the role of a manic Adolf Hitler.
There were also plenty of references to his $500,000 salary, which the tabloids were quick to compare with the less substantial pay packet of Prime Minister Malcolm Turnbull.
But there is an argument that Mr Kelsey’s day job is a little tougher than running the country. He took up the post shortly before the government declared that all 23 million-odd Australians would be automatically signed up to a system that doctors long ago had concluded was clinically useless.

Getting GPs onboard

Sitting down with Medical Observer last month, Mr Kelsey laid out his plan to change the medical mindset — and it appears to place a heavy focus on finding ways to inspire GPs, the people who need to create and curate the millions of patient shared health summaries that will form the system’s backbone.
“We are talking about scientists who base their decisions on evidence,” he says of GPs.
“When a clinical professional has reservations about digital healthcare, it’s not because they’re against digital, it’s because the benefits of digital are not evident to them.
“In digital health, the evidence is not always conclusive. In telehealth, for example, it may seem obvious that telehealth may reduce hospital admissions, but hardcore evidence to support that is thin on the ground.”
As the famous line goes, the first step to success is to admit the failures. Mr Kelsey appears to hold no illusions about the lack of enthusiasm GPs have had for the task.
“We have a history, let’s be honest. The system we inherited was clunky and not that useful.
“People are not holding back. A lot of GPs have been clear that it’s not helping them in the way they hoped it would be.”

The big picture

A big reason for sinking endless dollars to prevent the My Health Record entering the crowded graveyard of IT failures has been the belief it will drastically cut medication errors, and along with that, the human misery and substantial cost of avoidable hospital admissions and unnecessary deaths.
The problem? The My Health Record was not actually built to hold a comprehensive list of dispensed medications.
Mr Kelsey has pledged to fix it. And that holds out the possibility that GPs could eventually use the system to monitor real-time prescribing and help deal with the doctor-shopper challenge.
Mr Kelsey says the other “callouts” on the system are the lack of pathology reports and lack of imaging reports.
So, his agency has been spending its dollars to entice pathology providers and imaging providers to upload their results.
The dollars, according to Mr Kelsey are not huge, just enough to cover costs. Two subsidiaries of pathology behemoth Sonic signed on before the agency released an open ‘partnership offer’.
Mr Kelsey claims that this principle — being able to look up pathology, imaging and medication information in one place — is so sound that no doctor has argued against it. Again it’s a way to entice doctors into using the system.
A lots more is found here:


It is an interesting interview with a few slightly new insights into where the myHR is going.

It was interesting to hear the claim of both being evidence based while at the same time saying that in many areas the evidence for the myHR’s value and utility was pretty thin on the ground.

The most important paragraph in this section – in my mind - is this:

“A big reason for sinking endless dollars to prevent the My Health Record entering the crowded graveyard of IT failures has been the belief it will drastically cut medication errors, and along with that, the human misery and substantial cost of avoidable hospital admissions and unnecessary deaths.”

I would suggest that ‘drastically cutting medication errors’ and reducing hospital admissions are outcomes the myHR is uniquely architected NOT to be able to deliver! These outcomes are best delivered by live point of care systems and not a secondary, incomplete Government database.

It is really an evidence free perspective to keep thinking the myHR is a really useful tool that can return even a tiny fraction of the massive billion dollars of funds invested in benefits in the areas cited or, indeed, any others. Benefits for Health IT largely flow from provision of current up to date information at the point of care, supported by interactive decision support. The myHR does not, and never will, provide this type functionality.

More importantly cloud based real-time solutions can do all the myHR was ever imagined to do while adding the missing functions, doing it more cheaply, securely and safely. Time to cut the Government’s losses. In a recent poll most who read here felt the ‘pile of .pdfs’ approach was basically obsolete.

Sorry Tim, the sooner you look harder at the evidence and change course to a more sensible architecture the better. Right now I believe you are on a hiding to nothing! I am also happy to publish any evidence you have that convincingly demonstrates I am wrong. What about it Tim?

David.