Pulse+IT Blog

A tale of two technologies

The big news this week in digital health was the expansion of Australia's roll out of electronic prescriptions to metropolitan Sydney, following the fast-track implementation in metropolitan Melbourne and then the rest of Victoria as a weapon in that state's battle against the Covid-19 pandemic.

Also this week we saw some rare movement in the secure messaging arena, with a number of clinical information system vendors and secure messaging services now having successfully completed the implementation of new interoperability standards that will hopefully allow clinicians and healthcare organisations to more easily exchange clinical information electronically.

Dodgy data and the COVID response

In last week's blog we took a look at a bit of a bungle over in the UK, where the use of an old version of Excel by Public Health England has been blamed for almost 16,000 positive COVID-19 cases being left off the official list for a week, potentially affecting up to 50,000 people.

The head of the National Health Service's Test and Trace program, Dido Harding, is now being asked to consider her position as the ramifications of the bungle continue. The UK is also struggling with wider aspects of Test and Trace, according to Digital Health News, which reports that just 68 per cent of close contacts of those who had tested positive were able to be reached last week.

England's little Excel problem

England has not come out smelling of roses in its dealings with COVID-19 since the start of the pandemic and it didn't get much better last week when it was revealed that the use of an old Excel file format meant almost 16,000 positive cases had been left off a list and up to 50,000 close contacts might have been missed.

The rest of the UK is looking a bit better, both in terms of infection rate and death rate, but when the numbers are combined the UK still has the highest rate of deaths in Europe due to some shocking bungling by its government and a silly error like the one discovered by Public Health England (PHE) has not helped much.

Cyber utopia and telehealth take-up

Telehealth was again in the news this week with a couple of surveys out looking at patient and clinician views on their experiences with telehealth. While one survey of patients found a pretty good reception from patients and the other of clinicians showing similar, there still remain some technical barriers that are likely to dog telehealth take-up in primary care, specifically video-based telehealth, for the foreseeable future.

There was some criticism of the value of both of these surveys in the comments, and we particularly liked one reader's description of “cyber utopian views” of telehealth that ignore the real problems faced by patients in regional areas and older patients. Her practice uses video conferencing as a last resort, Shona Gallagher says, listing a number of real-world examples of why. Victorian GP Andrew Baird is a student of all things telehealth, and he is keen to hear of other people's experiences with video consultations. We'd like to know more as well, especially if you too have experienced telehealth at Bunnings.

GP telehealth thrown a lifeline

After months of agitation from the doctors' groups and tight lips from the Department of Health, the federal government finally came to the party and announced late on Thursday night that it would extend Medicare-funded telehealth for another six months.

The doctors' groups are still lobbying for the new MBS item numbers to be made permanent, but for the time being they will no longer expire on September 30 but carry through until March 31, 2021. The GP-led respiratory clinics and home medicines delivery will also continue for another six months, although it appears that the subsidy for COVID-related SMSs might expire as scheduled.

Progress on the path to interoperability

The New Zealand Ministry of Health released its roadmap towards interoperability recently with little fanfare, but we think they should have made a bit more of a big deal about it as the plan is pretty good overall.

Refreshingly free of jargon, the document sets out what the current state of play is, what the future state should be, how the health sector will get there and what is probably achievable in five years. The ministry's Health Information Standards Organisation (HISO) calls it a “living document” which will be regularly updated and reports on progress made quarterly.

SMD: scrap it and start again?

A couple of very interesting blogs caught our eye this week, both written by experts in their field that raise new possibilities and go against the orthodoxy. One of those was an op-ed by epidemiologist Raina MacIntyre in the Age and Sydney Morning Herald that poured a lot of cold water on the hysterical reaction to news that contact tracers by and large use whiteboards, pen and paper in what is still very much a manual process.

Victoria is belatedly investing in a common IT solution that is sure to assist this process somewhat but it's not going to solve all problems. People will still need to be interviewed and maps of their movements still need to be made, unless we go down the track of more authoritarian regimes and mandate that the population wears a trackable device. Considering the squawks of horror from the privacy lobby that met the announcement of the nondescript COVIDSafe app, we can't see this happening.

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