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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