Monday’s Wild Health Summit took a close look at healthcare interoperability, the My Health Record, the rise of AI and the Medical Cloud, and the rise of the “connected patient” via the magic that is the Q&A format. Here are some of the lighter takeaways from the day.
1. Tim Ferguson, a Doug Anthony All Star, and Wild Health Summit host (with the most) had this to say on homeopathy
“ As a celebrity with MS I sometimes get tweeted at by homeopaths who invariably tell me that I should try homeopathy to get rid of it. I always tweet back that homeopathy is what gave me MS in the first place. To which always comes the indignant reply, ‘That can’t be true’, and my reply to them is always ‘Prove it then’.”
2. Tim again, with his best medical interoperability dad joke
“Why did the patient cross the road?”
“I’ll tell you when I get the fax …”
3. How do you measure the success of interoperability?
The summit featured a lot of facts and figures attempting to demonstrate progress and success, but only one figure really impressed as potentially meaningful.
Tom Bowden, Founder of major secure messaging provider HealthLink, told the audience that in New Zealand, HealthLink sends more secure messages in the healthcare sector than there are sheep. How many sheep are there in New Zealand? 30 million, or so. OK, we think that’s a lot of secure messages, Tom (in fact they send upwards of 65m secure messages per year). Great work. (FYI, there’s 74 million sheep in Australia – just saying: Ed)
4. Tim again, this time on the NDIS and computers databases
“In their latest attempt to simplify things for me, the NDIS’s latest assessment form asked me this question: “What do you want?’….yep, just those words, nothing else”.
“Your typical male punter, of course, answers this in a variety of ways, none of which has anything to do, ever, with improved care moving forward, and most of which will get you permanently marked in the NDIS database as ‘needs no ongoing help at all, close file’.”
5. “Just a GP” came up a few times in conversation
This prompted one moderator to speculate: “If the GP profession wanted less use of this term, probably it wasn’t such a great idea to put the term in a national ad campaign. I’m not a marketer, but putting ‘not’ in front something you want people to stop saying, and then putting it on buses and airport posters all over the country, doesn’t strike me as a great way to stamp something out.”
6. Just how popular is the Australian Digital Health Agency?
As a gambling person, coming into the Wild Health Summit, I would have taken very short odds on the Australian Digital Health Agency being more disliked than liked. After all, they started somewhere way behind the eight ball after a $1.2 billion mishit by NEHTA, its predecessor, and there are all manner of people sniping about all manner of issues and how the ADHA are handling them. The MyHR Q&A panel, none of whom came from the ADHA, so could not be accused of bias in that sense, voted (well got assessed by the moderator), as voting, four for, one against, and one sitting firmly on the fence, which the moderator somehow calculated as 78% in favour.
The audience wasn’t too happy with this figure when it was mooted and no poll of the audience, of about 200 or so, was actually taken. But the moderator, who senses these things well, guessed that if he’d taken that bet going into the Summit, he’d have done his money. More than 50% were in some way favouring what the ADHA was trying to do. Probably more on the support side because people are starting to see the degree of difficulty the ADHA is facing, and that while the ADHA certainly is not doing it all right, even most of it right, they are trying to move the needle, and quickly. And most of the audience were in agreement that there needed to be someone in the middle co-ordinating that effort.
7. Interoperability … it’s just a dirty word
I used to work for a giant global communications company and one of the values of that “communications” company, I kid you not, was “boundarylessness”. Needless to say, this value was the subject of much mirth among the 10,000 or so employees, and its purpose, which I guess was just to get us all to think a bit more about collaborating more (we were a siloed organisation), was for ever lost in that mirth.
What’s that got to do with interoperability? Well, this is not a word that inspires even mirth. It does say something of course but that something is versions of “don’t go here, this is going to be technical, boring and it’s stuff you just won’t understand – so just move on , forget it, you’re a busy person and you’re going to waste your precious time”. It’s so boring that the organisers of the Wild Health Summit misspelt the word on the cover of the agenda – I think we had it as ‘Interoperabilty’ – and only a last-minute scan by an old school journalist managed to save us from that embarrassment.
Just try to get a GP or a consultant to come to a conference called Interoperability. Hence we called what was largely an interoperability conference, Wild Health. And why one moderator suggested that a possible breakthrough in the crisis of disinterest over this most important of issues for clinicians is to change the word to something people will respond to emotionally far more positively. And which does carry some meaning.
Said word was not discussed, but we at Wild Health would be interested to hear your suggestions. We are going to allow phrases as well, as a single word has a very high degree of difficulty. It doesn’t have to be an existing English language word by the way, in the tradition of, and in honour of, “boundarylessness”. Here are a few suggestions to get you started.
· Healthcare boundarylessness
· Interoperabilty (subtle take on dysfunction)
· From here to modernity
· FHIR ( pronounced of course FIRE! to get people’s attention, not FUR, how it actually reads)
· Data Schmata
Please, join in. You can’t do worse than “Not just a GP”.
8. Yul Brynner meets Gandalf
The ADHA, or whatever they were called originally, never initially intended to get into the game of IT by building a giant centralised EMR that would be the centre of everything. And we all suspect (know) they should never have done it. “One EMR to rule them all”, was the way one panellist described it, and “just don’t do it” (echoes of smoking and Yul Brynner here) was the advice of another many years back that most thought the government would accept as sage advice but didn’t. And now the ADHA is going to need to see it through, at least for this phase of this epic tale. Most agreed that we will put up with it for now, but when the time is right, ADHA should get out of the job of IT and building stuff and back into the game of helping and facilitating others who are actually good at it. BTW, Tim Kelsey has cleverly shifted perception away from the “one ring to rule them all analogy” by seloing the line that the MyHR was never meant to be not the be-all and end-all of health data. He says it’s a pragmatic aggregation of the key 6-8 data points for a patient in the absence of any program or technology that promises to be able to get these points together in a standardised form. “It’s there to facilitate the system and the patients and the tech vendors”, he says. Not to be the centre piece.
9. Ways to affect change in the digital health sector
As described by one panellist from the US: Shaming, Naming, Legislating, Peer Pressuring, Incentivising, only one of which is carrot and the rest are stick. And which works best? Shaming, according to our US panellist. But he does vote Republican.
10. It’s not the technology stupid
Perhaps the most common theme to emerge among all the panellists was that technology was distracting us a fair bit from the real issue – people and culture. Most panellists who went here suggested that at the most technology was 20% of the issue we are facing. The rest is all people and change.