Australian Digital Health Strategy Question
On the subject of replatforming the MyHR, the Australian Digital Health Strategy has this to say:
Every healthcare provider will have the ability to communicate with other professionals and their patients via secure digital channels by 2022. Patients will also be able to communicate with their healthcare providers using these digital channels. This will end dependence on paper-based correspondence and the fax machine or post.
I’m doing some consulting to the Agency around Secure messaging, and I’m thinking about this. I haven’t heard any discussion about this anywhere – what would it look like?
- Would patients have to communicate through a MyHR portal? Or could they choose to use their normal Email? Or should there stringent security requirements?
- Would doctors ask patient’s for the email id? or would the register it via their MyHR?
- Would patients get a Doctor’s email from their website? Or would they look it up in the national healthcare directory?
- What kinds of workflows would you build on top of that? Care plans? Scheduling?
Here is the link:
http://www.healthintersections.com.au/?p=2772
Looking forward to some useful comments.
As an opening question where will technology be in 5 years and what sort of impact will that evolution of tech have on any imagined futures? 2022 is a fair way off in technological terms I reckon?
David.
10 comments:
As much as I wish to stay positive and with the greatest respect it will be years before the ADOHA or what form it takes in the future to be in a position to hold such discussions and be taken seriously. Turning a fax server into an mail exchange server is daft. As for what technology looks like in five years? Who knows, communications is just something that is, and people naturally communicate and we have devised tools to enhance our communications in some aspects at the cost of the other more important but less visible ways. Perhaps it will crash and people will revolt against the current trend.
The objective statements are sound, I have no issue with them, centralising things is not where things are heading. I am pleased to see OMC recognising this and have taken the time and effort to develop a climate for emergent agreements and solutions to evolve and co-exist.
The ADHA needs to recoil at itself and think what it wants to really be, recent email evidence demonstrates it has some soul searching it does not present a picture of a national leading entity, one that fosters its people and become and ideas place.
@ Jan 09, 11:51PM. I agree with the sentiment concerning ADHA readiness and maturity. It is well known privately and public ally that to have alternative views at ADHA is career limiting. The recent posting indicating possible very extreme bulling and just simply poor if not weak management does not bode well. If those we wish to engage are unable to have opinions, alternative views or free to explore new ideas then what is the point. In response to the posting:
- have this undertaken through a Standards body like Standards Australia or IHE or even OMG.
- forget about it, MyHR is moving to opt out, with 24 million citizen data housed in there, are we confident the system could change without mishap?
The big question is ‘why’ what problem are we solving? Would the money be best spent paying our healthcare workers more?
What are the health care benefits out of such an initiative? The scope of the problem seems to be the conduct of health care as a business, not health care itself.
In total agreement with the perception of ADHA, which saddens me, I really believed it would be a turning point, just not the dark direction it appears to be. In response to the posting I suggest keep working with ADHA regarding secure messaging, FHIR holds the potential to influence change. That change will come through the vendors and driven by their customers not the ADHA at this moment in time. DoH is key if policy change is needed to support this and other standards.
@ 8:51 I really believed it would be a turning point
Why? The same people with the same blinkered views are doing what they have always done. Ignoring anything that disagrees with their own ideology and alternative facts.
There are mini-versions of The Donald running around unchecked in the Department of Health and its associated agencies.
New technology or not, there are a large number of issue that still need to be resolved.
Digital channels need to be able to uniquely identify each person and ensure that sensitive information is not shared with e.g. the wife of the patient - or their children.
Also consider that, even if new technology DOES exist in 5 years, not everyone will be using it. The landscape will always be a mix of new, mainstream and obsolete tools. Any useful design must take this into account. Consider the age of cars on the road - just because a new model has air-bags doesn't mean the road designers can assume a particular safety standard.
Finally, there is an assumption in many customer databases that an email address can uniquely identify a user. This ignores potential relationships between customers. Consider, for instance, a family all of whom use the same email, who live at the same address and may have the same name (e.g. Sr/Jr).
so, "there are a large number of issue that still need to be resolved." but it's been live for nearly 6 years.
Once you've built a system with unresolved issues your problem is now that much bigger.
And considering the system was designed to be opt-in and not to be relied on (as it says in myhealthrecord.gov.au) and they are now about to make it opt-out and are trying to make it clinically relevant, that means they will need to upgrade it to high-availability 24/7 - a hugely expensive task.
Which is probably why there is talk of moving to cloud technology. Someone's probably got it into their naive little head that cloud technology equals high-availability 24/7. It doesn't.
And none of all that will address the content issues such as the "need to be able to uniquely identify each person and ensure that sensitive information is not shared with e.g. the wife of the patient - or their children.", the lack of usefulness/completeness of the data, and the biggie - that the governments gets to keep it all for itself.
As David's pointed out, there are simpler and better solutions based upon existing Health Information Exchange technologies.
Having just returned from holiday, reading a backlog of comments it is clear to me that conversations around the future for HIT in Australia needs to be facilitated outside of and away from ADHA. By all means invite them into the conversation. Why is this unfortunately a changed view?
1. They are not solution/product neutral. Everything leads back to ‘all problem must be solved using our product’
2. The now public insight into how they treat staff and willingness to do whatever it takes to save ones hide, that is not an organisation I could trust.
A shame, perhaps the AHHA knows this and more which is behind the drive for a new entity outlined in their blueprint
The timing for change might be right. Visited my GP yesterday, the practice has for sometime been quite supportive of MyHR, having little pictures of it scattered about. I noticed they were all gone yesterday. Asking the receptionist about this change, she replied the doctors no longer believe it is of any use and had the posters removed and asked that patient are only advised on MyHR if they ask about it.
The now public insight into how they treat staff and willingness to do whatever it takes to save ones hide, that is not an organisation I could trust
Even that does not reflect the depth of the problem a couple cause. I am not even in the same office building but we dread them turning up. Bully is to polite.
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