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The digital revolution is here ... soon
Analysis
MAKING predictions is a mug ’ s game . Ask any footy tipster , political columnist or gambler with empty pockets .
Or ask all the e-health experts who predicted eight years ago that doctors would soon be sending messages — referrals , discharge summaries , patient events , medication info — to each other via secure systems that were safer than any email .
But with dozens of these systems on the market , all refusing to speak with each other , the Tower of Babel did not fall . A couple of years ago a similar pledge was made .
Antony Scholefield
The government has promised to solve the two most vexing challenges in digital health — developing a secure messaging system for all doctors and resuscitating the My Health Record — in the next few years .
A lot of noise . Then nothing . Doctors were still left searching for the secure messaging promised land .
Not to be deterred , the Australian Digital Health Agency ( the agency formerly known as NEHTA ) is to have another go . It ’ s pledge is contained in the health department budget papers : a national rollout of “ interoperable secure messaging systems ” will happen by 30 June 2019 .
Mark the date in your calendars . Although maybe in pencil , so that you can rub it out .
It is worth pointing out that the agency , headed by
UK journalist turned IT wunderkind Tim Kelsey , has other tasks on its to-do list , such as saving the My Health Record from oblivion .
In the budget , the My Health Record system was offered another life-support intervention in the hope that it will finally deliver on its mission to save lives , reduce medication misadventure and cut the health dollars squandered on pointless duplication .
The intervention being used is familiar to anyone with a passing knowledge of the IT industry — an infusion of vast quantities of cash .
This time , it ’ s a $ 375 million cheque from the taxpayer , although after rummaging through the budget papers and lodging questions with the health department , it is not exactly clear what this hefty sum will be used for .
It is probably connected
Prison work is very satisfying
Doctors of Australia celebrates the diversity and passion of those working at the heart of healthcare . Launched by Australian Doctor , the project includes a website showcasing GPs ’ personal stories .
Dr Penny Abbott , from Western Sydney , shares her story :
WHILE working in prisons and marginalised communities , I try to focus on what practical things I can do to improve people ’ s lives . I have always had a strong belief that healthcare should be accessible to all and quality primary care is a great way of overcoming social inequality .
When I started out , I really wanted to work in Aboriginal health but I worried that , not being Aboriginal , I wouldn ’ t have a lot to offer . So I began my training in normal practice , until one day I read an article in Australian Doctor about a GP who was working in Redfern Aboriginal Medical Service . I was so inspired that I rang up to ask if there were vacancies . They directed me to Western Sydney , where I ended up working in the Aboriginal Medical Service for many years .
I also became interested at that early stage in working with people who had been involved in the criminal justice system . Four years later , I walked into a prison for the first time . People worry about that , but security there isn ’ t an
PHOTO : Dan Luke
issue . Instead , what I really struggled with initially was recognising the sad realities that many women in prison face . But prison healthcare is incredibly satisfying . The work is challenging and you can
www . doctorsofaustralia . com . au
make a difference . You really do feel valued by the people you treat in prisons . They want the healthcare you are offering and being there through the long haul for them is something I find very satisfying . in some way with the fact that on December 2018 , patients will be automatically signed up with the system unless they specifically opt out .
An evaluation report for two recent opt-out trials , which ran in NSW and Queensland , provided the government with some ideas ahead of the change .
It suggested funding promotional campaigns so that patients know the system exists .
Doctor database of pharma largesse stalls
BRETT EVANS THE pharmaceutical industry is struggling to set up a centralised database that enables patients to check if their doctor is receiving payments from drug companies .
Under transparency reforms introduced two years ago , the financial links of thousands of doctors have been made public under Medicines Australia ’ s code of conduct . They include payments , travel or accommodation for attending educational events , speaking at conferences , and working on advisory panels .
But patients have to trawl through the websites of more than 40 different drug companies to check whether their doctor ’ s name is listed .
When the ACCC approved the code of conduct , the regulator said Medicines Australia should make “ reasonable endeavours ” to create a centralised reporting system . That system is yet to emerge .
In a progress report released this month , Medicines Australia warns that any such system risks publishing “ inaccurate or incorrect information about a healthcare professional ” if proper safeguards are not in place .
“ The work of developing the
And it also recommended a digital revamp , including streamlining the registration process for GPs , a better interface so patients and doctors don ’ t get headaches reading their records , as well as a quick summary view and better search functions .
With an app or two thrown in , because that is the age we live in .
Among the questions to be asked is why none of this stuff has been done before or if it was , why it didn ’ t work ?
However , maybe the most important question for the My Health Record and its possible future remains the same as the one asked when it was first launched .
Will it offer genuine clinical usefulness to GPs in their day-to-day work — usefulness sufficient to justify the huge time and effort the system continues to demand ?
The digital health agency may have a lot of money to play with , but ultimately , it still has to convince GPs that the system has real value to justify the $ 2 billion that has already been spent on it .
description of requirements has reinforced the considerable complexity of managing personal information .”
The report says Medicines Australia continues to “ consider these important issues ”, and has hired an information and communications technology consultant to help .
Dr Justin Coleman — who represented the RACGP on Medicines Australia ’ s transparency working group — is not impressed .
“ It ’ s been an inexplicably long time coming and the underlying reason is there is no external force pushing for it to be done in a timely manner ”, he says .
“ I actually think is a fairly simple thing to happen because the data is all there , held separately on the [ corporate ] websites already .” “ One technician working on it for a short period of time could easily have come up with a centralised database ”.
However a Medicines Australia spokesperson said : “[ We ] are committed to ensuring we have the right systems in place , and that means putting in the due diligence .
“ These have particularly related to data ownership and data sharing .”
12 | Australian Doctor | 2 June 2017 www . australiandoctor . com . au