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Saturday, 9 December 2017

I Am Getting The Feeling Things Are Not Going Well With The Roll-Out Of The myHR and The ADHA.

Why do I think this?

First the poll published earlier today makes it pretty clear that the confidence of the savvy audience in this blog that the myHR will be a success has pretty much evaporated.
See here:
Second we are seeing furious defensive reactions of the ADHA CEO to critical articles in the popular press, which are based on interviews with AHDA staff, being published. I am told this correspondence is being circulated to virtually every editor in the country while some odd claims are being made.
See here:
The letter does not seem to me to be 100% accurate.

As an example of probable error, from the letter:
�My Health Record requires each clinical professional to have unique identity credentials as well as conformant clinical software to open a My Health Record. This is not available to any medical receptionist. �
Last time I looked many practices used practice wide certificates that allow virtually all practice staff access to the myHR and that the Department has no real way of knowing who in a particular practice is accessing the myHR via that credential.
This is confirmed here:
Yes. The staff at your Healthcare Provider Organisation can access My Health Records as long as they are authorised users, even if they do not have an Healthcare Provider Identifier-Individual (HPI-I) identifying them as a healthcare provider. The My Health Record system entrusts a participating organisation to grant access to �authorised users.� An authorised user must be an employee who has a legitimate need to access the My Health Record system as part of their role in healthcare delivery. When authorised users without a HPI-I access the My Health Record system, they are only permitted to access the records of patients with whom they are involved in delivering healthcare services. All access to the My Health Record system is with the patient�s initial consent and is audited. Authorised users without an HPI-I cannot be listed as the author of a clinical document submitted to the My Health Record system.�
Here is the link:
So anyone a practice authorises can access relevant records.
Also note that the myHR is internet connected (be it open or closed � whatever that means) and is so subject to breach � security experts say when not if. I tend to agree with the experts.
As for this:
�My Health Record places Australians in control of their healthcare and gives authorised healthcare providers secure digital access to key health information at the point of care, wherever that may be. Benefits include reduced hospital admissions, reduced duplication of tests, better coordinated care, and better informed treatment decisions.�
We have been waiting for evidence that this is true for 5 years and just saying it does not make it so!
Third was are seeing all sorts of non-technical people lined up to assist with getting more users.

Consumers� voice drives digital health

7 December 2017Media release
Health consumers are central to the design and delivery of a digital transformed health sector and the ongoing development of My Health Record, a digital system that enables improved safety and quality of patient care.
A Memorandum of Understanding signed between the Australian Digital Health Agency and the Consumers Health Forum of Australia (CHF) will ensure that digital health solutions are consumercentred and advance the efficiency, quality, and delivery of healthcare in Australia.
�Our unique partnership with the Australian Digital Health Agency will ensure health consumers have a real voice in developing Australia�s digital health capability. �Importantly, the MoU supports the national effort to promote increased use of the My Health Record system by consumers and carers,� CHF CEO Leanne Wells said.
More here:
Note the sentence I have bolded.
Fourth there is increasing recognition that the current myHR is close to being past its use by date in its present form and will either need to be expensively re-developed / replaced or abandoned.
Last it is becoming clear that the roll-out of opt-out is only likely to be completed around the same time as there are cheaper and better ways to provide patient access to their data in the next 2-3 years rendering the entire effort redundant. (Think maybe the NBN and 5G). Also think the movement of GP Systems to the cloud.
To me the myHR is an idea (now 7 years old) whose time has passed.
What do you think?
David.

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