[LINK] Digital Health

[Bernard Robertson-Dunn]

On 19/01/2017 10:30 AM, David wrote:
> On Wednesday 18 January 2017 16:10:55 Bernard Robertson-Dunn wrote:
>> Here's his definition of Digital Health
>>
>> "Digital Health is a disruptive and transformational approach to the delivery of healthcare, with a focus on engaging and empowering patients, activating caregiver networks and understanding that patients are increasingly behaving as consumers of healthcare. Digital Health provides us with a toolbox of technologies and techniques that support the development of new, innovative patient and caregiver-centred models of care, driving improved engagement, accessibility, quality, safety, efficiency and sustainability into all corners of the health system."
> The article seems to me a fine example of its kind: so much consultant-speak, so little meaning.
>
> What on earth is meant by "patients are increasingly behaving as consumers of healthcare"

Dr Henry Marsh, "one of Britain's leading brain surgeons", in an
interview with the BBC world service said a couple of interesting things:

a) Patients are not consumers; It's not like going into a shop and
buying something.

b) The important thing is decision making.

http://www.bbc.co.uk/programmes/p03chc23

I'd add that good decision making means good, reliable data. the
government's My Health Record isn't. And the government tells us so:

"Clinical information you find within your patient’s My Health Record
should be interpreted in much the same way as other sources of health
information. It is safest to assume the information in a patient’s My
Health Record is not a complete record of a patient’s clinical history,
so information should be verified from other sources and ideally, with
the patient."

In other words it is unreliable and potentially unsafe. And if the
government thinks that the patient can verify things like diagnoses,
treatment plans etc, then they are even more naive than I thought.

This admission is well hidden in the FAQ for Healthcare providers under
"How can I be sure information in My Health Record is up to date?"
https://myhealthrecord.gov.au/internet/mhr/publishing.nsf/Content/healthcare-providers-faqs

Talk about transparency and trust: well this isn't it.

> Stand-out omissions in the article are the lack of even a one-paragraph estimate of cost-benefit, and a convincing example of the end-to-end process from patient to doctor.

I'd go further.
There is no  justification/demonstration of how improved health outcomes
will be achieved.
There is no estimate of the full costs (not just the cost of the
technology but the cost of ownership)
There is no assessment of the risks either in healthcare or in loss of
privacy.

An observation:
Health IT usually increases costs (think PET/CT/MRI scans). That may
increase effectiveness of healthcare but reduce costs?

I've seen no evidence and I've asked people who should know.

> It's all arm-waving, long-lunch stuff.

Agree

Bernard

-- 

Regards
brd

Bernard Robertson-Dunn
Sydney Australia
email: brd at iimetro.com.au
web:   www.drbrd.com
web:   www.problemsfirst.com
Blog:  www.problemsfirst.com/blog