Nicely in time to throw a tiny spanner in the Gillard Election Plans we have the following:
NEHTA, vendors lock horns over HI service
- Karen Dearne
- From: The Australian
- July 26, 2010
THE $90 million Healthcare Identifier system intended to help save patients' lives is sitting idle as key components do not exist.
And there are no plans in place to make the service available where it is most needed - in GPs' offices.
Doctors and medical software developers are "bitterly disappointed" that it will be years before patients see any benefits from the new HI service, built to support expanded electronic information-sharing across the health sector.
Although Medicare allocated a 16-digit unique patient identity number to every Australian in its database on July 1 to meet a deadline set by Health Minister Nicola Roxon, the number is only available by phone and cannot be used by anyone.
And the National E-Health Transition Authority plans to initially roll-out the system to public hospitals only, with a series of pilot projects underway over the next two years; however, public sector hospitals will be unable to use the identifiers to communicate with other health providers.
Medical Software Industry Association president Geoffrey Sayer said the consultation process was "dysfunctional", resulting in a "flawed" implementation plan devised by the federal-state government-owned agency.
"The real improvements in safety, quality of care and efficiencies will only come when the GPs, specialists, diagnostic services, aged care and allied health professionals are part of the system," Dr Sayer said.
"There is no plan for that despite our repeated warnings to NEHTA, and our willingness to help.
"It's like having a critical vaccine locked up in a warehouse, and not talking to the trucking companies about how to get it to doctors."
Software-makers have been hamstrung in doing the necessary work to interface medical practice systems with the HI service, as technical specifications were not released before the HI legislation was passed late last month, and this work will take some months.
Allocation of HIs to medical providers is also many months away, while the key security component, the National Authentication Service for Health, is not ready.
as well as the following:
Developers warned against Medicare contracts because of e-health safety concerns
- Karen Dearne
- From: The Australian
- July 27, 2010
THE Gillard government is refusing to back the safety of its Healthcare Identifier service, leaving users with liability for system failures.
The Medical Software Industry Association has warned its members not to sign development contracts with the operator, Medicare, under these conditions, and is trying to negotiate changes with the Health Department.
Association president Geoffrey Sayer said the $90 million identifier service -- intended to support the electronic exchange of patient information across the health sector -- may sit idle for years, as key components did not yet exist.
The association also rejects the National E-Health Transition Authority's plan for a soft launch over two years to public hospitals only, saying patients' lives would be lost due to delays in getting the system into GPs' hands.
"Nehta has had more than 18 months to prepare for the July 1 go-live date, but has not yet begun developing a rollout plan for the wider community," Dr Sayer said.
"There's no sense of urgency, despite the fact this system will actually help save patients' lives."
Dr Sayer said the identifier project, managed by Nehta, had been a debacle, and it was "incredibly frustrating" to have patient identifiers that could not be used.
Many more details here:
Now for the regular readers of this blog none of this will come as any surprise.
We already knew that the National Authentication Service for Health (NASH) was not anywhere near ready and also knew the difficulties with the National Registration Scheme was likely to have an impact.
See here for that article.
Additionally I have been saying for ages that implementation of the service to a useful stage was going to be a long process.
What is new here is that direct from the ‘horse’s mouth’ we are hearing of a serious fracture between the Medical Software Industry and NEHTA. No doubt there will be all sorts of denial and spin put on this report and I can assure you – knowing those involved – that they would not have made these comments to the Australian unless the levels of unhappiness were pretty extreme.
Note that there is a bit of a chicken and egg problem here. Unless NEHTA comes down from the mountain and really works to co-operatively and comprehensively clear the various issues raised by the Medical Software Industry Association (MSIA) it will all go nowhere for the foreseeable future. That would be really sad – recognising that key to all this is to have the implementation done collaboratively with both the Software Vendors and those who are expected to use the identifiers.
I have also pointed out previously that I have some concerns about the quality of the identifying information on which the Health Identifiers are based. You don’t need much of an error rate when the system is in actual use to potentially cause mis-linkage of patient records. The risks of that sort of outcome are obvious. Hence my suggestion we really do run some pilots at scale to make sure these risks are imagined and not real.
As an aside it is probably only weeks before the bitter divisions on the Standards for Electronic Transmission of Prescriptions also break into the public domain as we see more and more of NEHTA’s agenda unravel and delivery time-tables slip. All I can say is watch this space!
In the context of the election my comments of a day or so ago stand – with the addition that both sides need to come clean and explain just what they see as the future for NEHTA and what they plan to fix the obvious dysfunction. Dreaming I guess!