As the year draws to a close so has Tim Kelsey's time at the Australian Digital Health Agency. Mr Kelsey is off to do something exciting in analytics at HIMSS, best known for its digital adoption maturity models, but he will remain living in Australia so we expect him to pop up now and then in Pulse+IT.
In a sign-off email, Mr Kelsey said he was proud of what had been collectively achieved at ADHA, including that Australia has a national digital health strategy which all its governments have agreed to. Mr Kelsey was predominantly responsible for writing that strategy and it's quite a good one, with defined steps and timelines that might be achievable with the right will.
It has taken well over a year but it appears that the Australian Digital Health Agency's plans to allow mobile apps to access the My Health Record are getting back on track.
The agency closed off new entrants to the mobile gateway in August 2018, at the height of the drama over the first opt-out period. At that time, one of the four apps with portal operator status, Tyde, was forced to re-evaluate its business model when changes were made to legislation to prevent insurance companies from handling My Health Record data.
This week the Australian National Audit Office released its much-anticipated report into the effectiveness of the implementation of the My Health Record by the Australian Digital Health Agency and the Department of Health.
The audit mainly looked at the implementation over the opt-out period rather than the distant days of the opt-in Pecker (PCEHR), and apart from a few security stumbles, the ANAO gave it a pretty clean bill of health.
Pulse+IT had a whale of a time consorting with assorted hobbits this week at the HiNZ conference in Hamilton, which managed to attract a remarkable 1440 attendees and over 100 exhibitors. No offence to Hamiltonians but its proximity to Hobbiton and the conference venue are two of the main things likely to tempt people to visit the town so it's a good thing that HiNZ is returning there next year.
NZ Health Minister David Clark and Ministry of Health deputy D-G for digital Shayne Hunter showed up and both seemed pretty confident that the business case for a national health infrastructure platform (nHIP) would get up and begin a roll out later in 2020. Mr Hunter confirmed that the idea touted by the previous health minister at HiNZ in 2015 for a single, national electronic health record would not go ahead.
As expected, the roll out of electronic prescriptions in Australia will not be as fast as health minister Greg Hunt was spruiking back in July, but this week we have seen substantive moves towards a national ePrescription system with the federal government gazetting the legality of eScripts alongside paper scripts in federal legislation.
The Australian Digital Health Agency has also published the solution architecture and conformance requirements for prescribing and dispensing software, which it has co-designed with the medical software industry and healthcare provider organisations. It will be another year at least before consumers are using the capability – ADHA told us this week it is targeting June 2022 for a full implementation, as per the national digital health strategy – and there are hopes for a small start early next year in a rural and a metropolitan setting.
The most popular story this week on Pulse+IT was our chat with some of the medicines safety team from the Australian Digital Health Agency, who fleshed out the expected structure of the new electronic prescriptions network that should begin in earnest in the new year.
The plan is for a small implementation in one rural area, probably in Tasmania and probably involving Fred IT, before the roll-out gathers pace and eScripts eventually become business as usual. The network will use existing infrastructure such as the two prescription exchange services eRx and MediSecure, but the ADHA team was keen to emphasise that it expects the new capability to attract new entrants into the market, as well as a proliferation of medication-related apps.
The one-word title of the interim report of the Royal Commission into Aged Care Quality and Safety is stark: Neglect. The report is a sobering read for those working in and around the aged care system and details much higher levels of poorly managed continence, malnutrition, overprescribing of psychotropic drugs and actual physical abuse than previously thought. Dental health is bad, wound care is worse, nutrition is abominable.
The report details a litany of problems with the sector, especially workforce problems, but unfortunately a lot of them start when older people and their families first begin to investigate their options for care. Their entry point is My Aged Care, a system that was recommendation of the Productivity Commission's Caring for older Australians inquiry in 2011. The My Aged Care website went live six years ago and the contact centre and client record about four years ago, but according to the commissioners, it is not delivering the vision the Productivity Commission outlined of seamlessly allowing people to navigate the system, and does not seem to be delivering much at all.
