Back to the new normal

As the saying now goes, the coronavirus has brought the digital health sector 10 years of change in 10 days, but this week also brought us a reminder that some things haven't changed all that much. We refer to a return to the old normal, in which state health departments regularly struggle to procure and implement clinical IT systems large and small, as the repeated tendering for a statewide chemotherapy prescribing system in South Australia has shown us. It did it again this week.

Significant under-investment in IT systems and holding on to legacy platforms for far too long is also a constant refrain. This week, the New Zealand Ministry of Health released a current-state assessment of NZ's health assets, including buildings, infrastructure and IT, and it's not a pretty sight. The ministry is estimating that the DHBs will need $2.3 billion over the next 10 years to fix some of their legacy problems and reap the benefits of digital health systems, although even that seems a bit unambitious.

Back to the future and in telehealth, we are still watching the figures for use mount up as clinicians and patients embrace this new way of working. COVID-19 is seeing telehealth taking off around the world and many are talking about how remote consults will become the new normal. There are examples here from Canada and from the US where discussions are underway on how to maintain the momentum for telehealth in the future.

Some are taking telehealth even further. We really liked this idea from a US start-up called Abridge that is working with the University of Pittsburgh Medical Center to allow patients to receive a summary of their telephone consult after the visit that outlines their doctor's instructions or new medications. The app also lets patients record video or in-person consults to replay later if they forget something. UPMC is thinking about adding the after-visit summaries to the healthcare organisation's EMR.

Video recording functionality is already being used in the UK through Babylon Health's app, but the company remains somewhat controversial and did its reputation no favours this week. As reported by the BBC, a user discovered that he had mistakenly been given access to about 50 video recordings of other people's consultations with their doctors. Babylon's excuse was that it was a coding error that was accidentally introduced when a new feature was added that lets users switch from audio to video part way through a call. It has been fixed, but it's hard to imagine a more obvious breach of privacy.

One of our top stories for the week concerned doubts raised about the usefulness of Bluetooth-based contact tracing apps like Australia's COVIDSafe. The future of New Zealand's app under level 1 restrictions is also a matter of hot debate. In the UK, there was much controversy this week as it was revealed that the British government had signed agreements to share public health data with private tech companies like Google, Microsoft and Palantir, the latter of which has a somewhat dubious reputation. The lack of clarity over what is going to be done with COVID-19 tracing data after the pandemic is over is creating real consternation.

And speaking of dubious reputations, check out this story from the US: it appears that three of US president Donald Trump's inner circle, known collectively and hilariously as the Mar-a-Lago crowd, had a hand in evaluating Cerner's $16 billion contract to replace the Vista system for the Department of Veterans Affairs. It's a fascinating yarn in which even Captain America makes an appearance.

That brings us to our poll question for the week: Are you satisfied with your government's assurances about the deletion of tracing data after the pandemic?

Vote yes or no here and feel free to comment below.

Last week we asked: Do you think ePrescribing will be taken up enthusiastically? Most respondents were positive: 84 per cent said yes, 16 per cent said no.

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