It seems the Government is trying to use confusion and deceit to have us believe that the PCEHR (The Personally Controlled Electronic Health Record) is the answer to a large swag of our Health System ills.
To put it simply this is just bunkum.
I have written enough on this topic to possibly bore some but there are a few things that need to be made crystal clear.
First the proposal for the PCEHR we see from NEHTA just ignores the fact that there is an e-Health system in place in Australia which is providing desktop support for many clinicians and which is facilitating - albeit somewhat imperfectly - secure clinical communications between the various health system participants.
The view offered in the diagram just simply ignores that NEHTA has had a goal since its inception of improving the quality and range of those clinical communications. All this seems to have been just tossed out the window in a misguided attempt to respond to a totally impractical and unachievable political hoax or con.
The diagram I am chatting about is found here if you missed it.
Consider that as a result of what NEHTA and DoHA are doing we now have a totally undignified ‘grab for cash’ from a granting agency that really is not providing realistic guidance as to what it is seeking. This is highlighted in this report.
$55m funding spurs progress on e-health personal records
- Karen Dearne
- From: The Australian
- December 07, 2010
A $55 MILLION pot for e-health projects is creating a scramble among health, consumer and industry groups for a stake in the new landscape.
Health Minister Nicola Roxon is seeking a "second wave" of alliances, offering innovative programs based on the personally controlled e-health record rollout.
"We want demonstrations that cover patients, GPs and other health providers, pharmacies, hospitals and aged-care facilities," Ms Roxon said.
The non-profit Integrating the Healthcare Enterprise, a global standards-based working group that solves real-world problems, said the funding could deliver a "fully functional" personal health record system for Australians by the end of 2012.
This sort of ‘grab for cash’ reminds me of the legendary pink bats program where skills and capacities were promised and not actually delivered. Indeed some died because of it.
Delivering a properly planned, operational, evaluated and sustainable Health Information Exchange is just not possible in 18 months (it needs more like 4-5 years).
What NEHTA is planning to deliver is nothing more or less than an empty, portal based, political fix for a Government either to stubborn or too ignorant to gather good advice, gather good information from the rest of the work and lay out a systematic and well considered plan to meet the goals we all seek.
The risk of ignoring what needs to be done (NEHTA’s original mandate) while spending on this new fantasy is that we get nowhere with either project and waste a vast amount of money in the process.
On a related topic I was considering the example given at the Summit for the utility of the PCEHR discussing a middle aged chronically diseased woman who spent summer in Melbourne, a few months in Sydney with the grandchildren and the winter in Brisbane with her sister. She has 3 GPs - one for each port of call. The PCEHR was going to be a total wonder for her. Not actually so.
Each GP will have a practice management system and when the index service, using the IHI comes calling, it finds 3 different sets of records and results etc. Which is the most valid, most current and most reliable - who knows? The lack of a capitation system in Australia - linked with the use often of multiple GPs (one for the depression and one for the rest etc) means confusion and accidental discovery of information will abound. There are a zillion use cases like this which is why the secrecy and non-disclosure of what is planned needs to cease - or we will all suffer.
The support of clinicians and the place of the PCEHR (if any) needs a serious rethink or it will be a major cause of Labor losing the next election as it is seen to have grossly over-promised and failed to deliver.
As currently proposed the PCEHR is a hoax and a ‘dead man swinging’. It was always ill conceived and based on little more than a political slogan, as developed it is poorly designed, it will not engage clinicians and is highly likely to be rejected by consumers when they see how thin the actual offering is.