21 September 2018

ADHA assures its paid doctors are independent

MyHealthRecord TheHill

The Australian Digital Health Agency has 51 clinicians on its payroll, including one doctor who has received more than $1 million for his services in the past few years, a Senate inquiry has been told.

ADHA officials, including CEO Tim Kelsey, were grilled on contractual arrangements with clinicians at a hearing on Thursday, with Labor Senator Lisa Singh questioning the independence of clinicians in the agency’s employ.

“So, the ADHA is paying doctors to sell the My Health Record?”  she asked.

Mr Kelsey said it was normal practice for public bodies to compensate clinicians for their time, and their involvement was essential to ensure “user-centred design” of the MHR system.

“The way we do that, at least in part, is by enabling clinicians to have the time to help us design those services so they are fit for purpose,” he told the Senate Community Affairs committee.

“These are very senior clinical figures – for example, the president of the Pharmaceutical Society of Australia – and I can assure you … they retain full independence in relation to their opinions.

“We are just inviting them to be part of the co-design process which is vital to the long-term sustainability of technology in health care.”

Senator Singh said she had seen evidence that one doctor had been paid more than $1.1 million by the agency over two years between 2016 and 2018.

In response, Mr Kelsey said that individual was employed virtually full-time by the ADHA in a variety of roles, including chairing a number of steering groups.

“And I can assure you that individual retains absolute independence in the way he provides views on the My Health Record or anything else.”

The ADHA had 51 “clinical reference leads” in advisory roles, representing range of professional areas, including nurses, allied health practitioners and psychologists, agency officials said.

Senator Singh asked whether it was “legitimate” for the agency to present “clinicians’ perspectives” in its submission to the inquiry without clarifying their status as paid contractors.

The agency’s Chief Operating Officer Bettina McMahon said the contracts did not bind clinicians to take or communicate a certain view of the MHR.

“They are absolutely expressing independent perspectives to us when they help us with the design work,’ she said.

“So all of the quotes in our submission were volunteered to us.  No one was strong-armed or required to provide a certain perspective.”

Agency officials cited the MedsView project, supporting real-time information about medicines, and similar work under way for access to pathology reports as examples of digital technology co-designed with clinicians.

Professor Meredith Makeham, Sydney GP who serves as the ADHA’s chief medical adviser, said GPs had described MedsView as a “game-changer”.

Feedback from clinicians would continue to be essential in making improvements in the MHR, she said.

“We’ve been highlighting the importance of clinical being able to input into the development and design of the system.

“But practically speaking, once the system is out there in the real world we very much rely on clinical output back to the agency as the system operator to continue to make improvements.”