Sunday, February 27, 2011

The Time Has Come For Some Light To Be Shone into The Dark. Twelve Weeks Waiting Is Long Enough!

This really has become just too silly.

This appeared in early January.

Transparency call on privacy: patient records
8th January 2011
By: Karen Dearne - The Australian

Federal Health Minister Nicola Roxon has agreed to release confidential plans for widespread debate.

The Labor government's "personally controlled" approach to a nationwide system of sharing patients' medical records has caused much confusion since it was announced a year ago.

But Roxon says a draft concept of operations will soon be issued for public consultation.

Roxon is referring to a draft framework developed to give registered bidders for a $55 million funding pot for new e-health initiatives some idea of how the thing will work. It was produced by the National E-Health Transition Authority after "behind closed doors" consultations with selected consumer, medical and industry representatives. Other community groups are frustrated by the lack of openness.

Australian Privacy Foundation chairman Roger Clarke has written to NEHTA and the Health Department complaining about the exclusion of "civil society" from deep-level design consultations conducted secretly under non-disclosure arrangements.

The peak privacy body warns of serious deficiencies in PCEHR proposals to date.

"While we are told there is to be rigorous governance and oversight to maintain privacy, the specifics are yet to be decided," Clarke wrote after a consumer round-table in November.

"The slide-sets shown referred to a predecessor proposal and no documentation has been supplied.

More here:

http://www.theaustralian.com.au/news/health-science/transparency-call-on-privacy-patient-records/story-e6frg8y6-1225983231825

Some 7-8 weeks later has the Minister done as she said she would?

Well not exactly.

Public kept in the dark on e-health record system

  • Karen Dearne
  • From: Australian IT
  • February 25, 2011 12:00AM

THE draft concept of operations for the $467 million personally controlled e-health record contains a "wealth of information" but is not yet ready to be shared with the general public, the federal Health department has told a Senate estimates hearing.

Queensland Liberal Senator Sue Boyce asked why the material had not been released for public discussion when it was being circulated for commercial purposes.

Health deputy secretary Rosemary Huxtable said the draft concept of operations for the PCEHR had not been finalised.

However, she confirmed it had been released to potential bidders for a range of PCEHR contractors.

"It is certainly at a very advanced stage, and it has been provided as part of the documentation at industry briefings," she said. "But there is still work occurring in consultations through the National E-Health Transition Authority's processes.

"The fact (the draft) is not quite finalised is not really an impediment to bidders using it to better understand the government's expectations."

Ms Huxtable said tenders for a national infrastructure partner and other PCEHR programs had been put to the market, but no contracts had been let.

.....

E-Health strategy head Liz Forman said a Victorian Health department report that concluded the new $90m Healthcare Identifiers service patient numbers should not be relied on as a sole source of accurate information had been "welcomed".

"Certainly the team's level of enthusiasm is reflected in them doing such a thorough job," Ms Forman said. "The risk assessment report refers to using the individual healthcare identifier on its own -- it's never been the intention for the number to be used on its own as a form of identification.

"That report is quite a rigorous analysis of a whole lot of possible scenarios for using identifiers, where the risks are and how the system design will minimise that risk.

"Which is actually a very positive thing to do, and we welcomed the release of that material so it can be shared by other organisations looking at adopting identifiers."

Ms Forman said she was not aware of NEHTA doing any similar risk assessment

......

Full article here:

http://www.theaustralian.com.au/australian-it/government/public-kept-in-the-dark-on-e-health-record-system/story-fn4htb9o-1226011639278

There is also comment in Computerworld.

NEHTA anticipates e-health record clarity

Looming release of draft concept of operations will begin wider discussion over e-health record

The Federal Government’s lead e-health agency is anxiously anticipating clarity around the $467 million personally-controlled electronic health record (PCEHR) program, with hopes the imminent public release of a draft concept of operations will catalyse greater cooperation from the wider industry.

Despite promises from health minister Nicola Roxon to publicly release the document, which has so far only been handed to potential bidders on key tenders, a spokesperson failed to respond to questions of exact dates at time of writing.

The National E-Health Transition Authority (NEHTA), unlike National Broadband Network wholesaler NBN Co, is currently exempt from Freedom of Information legislation, preventing parties from accessing the documentation without participating in the tender process.

The draft paper is yet to be finalised, according to members of the Department of Health and Ageing who appeared before a Senate estimates hearing earlier in the week, but will ultimately provide greater information on how the electronic health record will work and which elements will be included.

However, exactly which elements will be initially included in the record is still up for debate, according to NEHTA’s head of clinical leadership and engagement, Mukesh Haikerwal.

Haikerwal said the release of the document publicly would likely signal the beginning of a clarification process over initial elements to be included in the PCEHR, a matter that remains debatable among both health providers and the wider health industry.

“Everyone has a view of what should be in it; that view grows depending on who you talk to and so when you coalesce that you’ve got a massive elephant,” he told Computerworld Australia following his return from the United States.

More here:

http://www.computerworld.com.au/article/377960/nehta_anticipates_e-health_record_clarity/

There is no reason for DoHA and NEHTA to be just sitting on their hands and treating the public like mushrooms. If the entire vendor community and the Standards Australia community can have a copy of this document the why not others who are interested?

Here is the e-mail Standards Australia sent out:

-----

From: Deleted

Sent: Wednesday, 23 February 2011 10:18 AM

To:

26 Recipients

Cc:

4 Others

Subject: PCEHR _Concept of Operations (Con-Ops)

Dear Members of IT-014,

Please find attached useful information on PCEHR and relevant teams to support it in NEHTA. This information is being distributed to you so that you have time to read and understand the contents and how it may affect the work program for 2011/2012 with regard to a national focus in this area. Please bring your valued recommendations to the parent committee meeting on 8th/9th March in Brisbane.

The contents of this email and attachment(s) are confidential to IT-014 Technical Committee Members only at this stage. Therefore do not forward this email, it is for your information only.

Please be advised that any breaches regarding confidentiality and non-distribution of this document will be acted on accordingly by Standards Australia.

Kind Regards

Deleted.

----- End E-Mail

What the e-mail says it that anyone who gets it will be doing the wrong thing if they indulge in “non-distribution”! Presumably that was meant was ‘on-distribution’ (grin). Don’t you just love the warning red and hollow threats etc!

Anyway I am happy to comply and distribute (I was not on the distribution list) as my feeling is that this nonsense has gone far enough.

Go here to download the apparently current draft as this is what SA is passing around.

http://moreassoc.com.au/downloads/PCEHR%20Concept%20of%20Operations%20V0.9.30.pdf

(About 4.3 Megs) (Right-Click is the easiest way to download in Windows)

The SA file name is different (AS-NZS 31000-2009.pdf) but the version is identical as far as I can tell

Enjoy and comments welcome!

Before closing I have to highlight this:

“E-Health strategy head Liz Forman said a Victorian Health department report that concluded the new $90m Healthcare Identifiers service patient numbers should not be relied on as a sole source of accurate information had been "welcomed".

"Certainly the team's level of enthusiasm is reflected in them doing such a thorough job," Ms Forman said. "The risk assessment report refers to using the individual healthcare identifier on its own -- it's never been the intention for the number to be used on its own as a form of identification.”

Just amazing spin and in front of our Parliament! As a mate said ‘She deserves an Oscar!’

David.

8 comments:

Anonymous said...

"Haikerwal said ...... “Everyone has a view of what should be in it the PCEHR; that view grows depending on who you talk to and so when you coalesce that you’ve got a massive elephant,”.

Is he saying that because of the elephant we should start developing the PCEHR with a contained core application upon which we can subsequently build?

Now, I seem to recall Adam Powick at Deloitte suggested the same thing in the Deloitte National eHealth Strategy.

So why don't we do just that?
What is the problem?

Anonymous said...

Sunday, February 27, 2011 3:26:00 PM said “What is the problem?”
The problem is market forces – Government-controlled versus free-market forces. DOHA, NEHTA and Medicare pay lip service to free market forces but only in so far as they can eventually determine the outcome leading to a Government-controlled market.

This leads to demise of small vendors and software developers and their collapse or acquisition by stronger players. They in turn get seduced by Government-forces, only to find themselves frustrated at every intersection by Government-forces unclear on what to do to maintain their relevance and influence in their pursuit of market control.

Anonymous said...

As far as I am aware the latest version to be provided to industry tendering for the infrastructure partner bid has not been released, despite what was said in estimates (which is technically true as it has been released in the v9.3 form for site bidders.

I am told that the draft is now up to v11.x k two major revisions on from what is now circulating.

Dr David More MB, PhD, FACHI said...

We can all look forward to a new and improved version soon then we can all hope!

The one we have is close to rubbish!

David.

Anonymous said...

what do you mean 'close to rubbish', it is rubbish!

Anonymous said...

If the current version is 11.x, why are Standards Australia going to debate version 9.3 in a weeks time? A little pointless?

David: Have you had a knock on the door following your publishing of the Concept of Operations?

Dr David More MB, PhD, FACHI said...

With almost 100 downloads to all ends of the earth not much they can do.

My understanding is that 'leaking' is only an issue if national security etc is threatened or compromised.

This hardly gets there!

David.

Anonymous said...

Hope you have not been to Sweeden lately.

Napolean