L for licence to operate
Health Minister Greg Hunt had the conspiracy theorists in a bit of a tizz last week when he lodged a little piece of paper authorising that the opt-out model for the My Health Record begin some time next year. Everyone thought he'd already done this but it turns out it is a three-step process, with the actual date for the three-month opt-out period yet to be announced but most likely to begin in mid-2018.
That didn't stop the tinfoil hatters, though, who insisted that the three months actually began on the date he lodged the rule, namely last Thursday, and that the government was tricking us all into getting a MyHR without our knowledge. The horrors that lie within the MyHR are such that only by conning us will the government get anyone on board, they reckon.
That story was our most popular in what was a quiet enough week in health IT, our others being a progress report or two on eHealth in NSW and Queensland and an update on the story that keeps on giving: the interesting adventures of Waikato DHB's former CEO and his large expenses bill. One that also was of interest was our brief report on plans by the RACGP to investigate whether it would be a good idea or not to develop a minimum set of requirements for software used in Australian general practice, and what exactly these requirements would look like.
The RACGP says this is something that members had long been asking for but it's still a matter for debate about whether the college should step down this road or leave it to some other organisation. There is still a bit of disquiet in the industry about the college's technology venture RACGP Oxygen and how that body comes to endorse certain products, and what that endorsement actually means.
New Zealand had a go at providing this guidance at one stage through an examination of practice management systems on the market and how they ranked against each other through a couple of PMS reviews, first carried out in 2012 by Patients First. That exercise was enormously controversial as it gave a poor result to Medtech32, which at the time was used by about 90 per cent of Kiwi practices. The argument goes that Medtech must have been doing something right or practices wouldn't have bought it, but in the end, the exercise was modified for the second PMS review in 2014 and the rating system was dropped.
The question for the RACGP is whether a medical college should involve itself in this sort of thing or if it should be left to the Australian Digital Health Agency or the Therapeutic Goods Administration. It can be an absolute minefield of conflicts of interest, as our stories on the comparative matrix for Health Care Homes care planning software has shown.
After our whinge last week that the Medical Software Industry Association's matrix had not yet materialised, suddenly it did on Sunday night. The main players in shared care planning tools all make an appearance, as does Telstra Health with its MyCareManager platform, but as one of the listed vendors told us, the matrix feels like a bit of a marketing tool rather than an independent ranking such as the one developed by the South Eastern Melbourne PHN.
With the TGA still working through its role in the regulation of software as a medical device as part of the International Medical Device Regulators Forum perhaps it could take a stronger role in evaluating clinical software, or perhaps that is something that ADHA might want to pursue.
ADHA itself is developing a set of interoperability standards that will give healthcare providers a “licence to operate”. The agency has actual powers to set and enforce technical standards, which as far as we're aware NEHTA never did, so it will be interesting to see what this exercise brings up and how that can support the RACGP's minimum set of requirements.
We've taken it upon ourselves to ask this question in our poll this week: would you follow the RACGP's advice on clinical software?
Last week's poll asked whether you thought specialists and allied health will use secure messaging services without an incentive. Our readers were split on this one: 56 per cent said yes, 44 per cent said no.
Next week will be our last weekend edition for the year and we officially shut up shop for month on December 18, but before we go we'd like to invite everyone to have a think about what the new year will bring our industry, from new products and technologies to government policy and international trends. Send us your thoughts and we'll publish them in the new year.