Tuesday, October 25, 2011

It Seems The NEHTA Pussy Cat Teams Are Actually A Bit of a Farce! It Is Not Clear Just Where They Fit and What the Rush Is.

The following appeared today:

New body to manage risk in e-health record system

RISKS to patient safety arising from new clinical systems being installed as part of the national e-health records rollout will be managed by a new oversight body.
Health department chief information officer Paul Madden said a project governance group was needed to flag errors, and it should be able to assess and mitigate clinical risks detected by users or software makers.
Mr Madden said some technical specifications for the $500 million personally controlled e-health record system should be "signed off as ready to build" from October 31, with the rest finalised by November 30.
These specifications are being drafted by fast-track "tiger teams" set up by the National e-Health Transition Authority in response to pressure to meet Health Minister Nicola Roxon's deadline for a July 1 start.
"At this stage, the tiger teams are confident those dates will be met, but we're not going to put out a shoddy product on the basis we're out of time," Mr Madden said. "We do have to make sure we've got quality to the right level.
"But we are looking to make these specifications available so that vendors at least have the opportunity to start reading and to understand how this whole thing fits together.
"Wrapping that up in a change control process will give software makers certainty and stability.
"We'll support the specification as if it were a standard for a two-year period." Last week, Mr Madden told a Senate estimates hearing that the technical specifications "would be guaranteed not to change" in the short term, except in the case of system errors.
He later told The Australian: "If applications are thought to have a newly discovered patient safety risk when they are being built into clinical systems, then we would flag that as an immediate change.
"We're looking at an implementation governance body that can determine the intensity of a risk and assess how quickly we need to resolve it. There have been times where we've said, we'll have to stop this (application) because there's a clinical risk, but when you do a full assessment some of those risks are not found or they're considered to be easily mitigated."
More here:
The most important bit - from the perspective of what is being done in Australia is the last five paragraphs.
“Mr Madden expected these (tiger team) specifications would complete the Standards Australia publication process by the middle of next year.
But the entire national e-health record infrastructure build -- outsourced under contract to an Accenture-led consortium -- has been ruled out of scope.
Asked if the consortium would deliver its version of a core infrastructure based on existing and available standards in the marketplace, Mr Madden replied: "Correct.
"There is a review process for the Accenture specifications and design involving people external to Accenture, and external to Nehta as well," he said.
"But there's no intention to turn PCEHR specifications for the portal, the call centre systems, the B2B gateways, the core services and templates, into Australian standards."
So what is being delivered by Accenture is a US product based on current US standards. Given the Wave 1 and 2 sites are working to the still to be finalised NEHTA specifications I leave it as an exercise for the reader to work out how the US Standards based core - which does not seem to be changing - and the newly developed Wave products will integrate. Also it seems what is going into the PCEHR sites are not to become Australian Standards, if I read what was said correctly. This is all pretty confusing!
One also needs to ask just what all the carry on and rush is all about. That will become clear I guess in due course!
Of course having some clinical risk monitoring function is a very good idea. I wonder who will serve, how the function will work and what teeth the function will have to make sure its advice is followed? That needs to be publicly released and explained and fast!
Late Update - Just confirms what a mess all this is!

E-health 'tiger teams' yet to meet

  • by: Karen Dearne
  • From: Australian IT
  • October 25, 2011 3:46PM
THE so-called tiger teams expected to draft and complete new technical specifications for the $500 million personally controlled e-health system by November 30 are yet to hold their first meetings.
The National e-Health Transition Authority established the plan to fast-track delivery of critical standards needed for the PCEHR infrastructure build and by the lead implementation sites, ahead of next year's July 1 start date.
Health department chief executive Paul Madden has told The Australian the tiger teams are confident they can sign-off the first round of specs "as ready to build" by October 31, and have the rest finalised and reviewed by the end of next month.
But a leaked document calling for participation by members of Standards Australia's expert IT-014 committees shows only three teams have been established to date - Repository Services, e-Health Interoperability Architecture and Consolidated View.
A second View team is expected to be operational by the third week in November, according to an updated list of PCEHR tiger teams released on Monday.
The Repository team has its first meeting on Friday, Interoperability will meet next Monday while the View team has listed November 7 for its first session.
More here:
Just amazing!
David.

7 comments:

Anonymous said...

Do you recall the song .............

I'm forever blowing bubbles,
Pretty bubbles in the air,
They fly so high, nearly reach the sky,
Then like my dreams they fade and die.

Karen Dearne reported on 25 October 12.00 AM quoting Mr Madden that Nehta's internal tiger teams had been working on the documents "for months", but Mr Madden had no details of participants or expertise.

And as one software industry source said:

"Essentially there's no real proposal on the table, it's just handwaving at this stage, as is the whole process". The tiger teams have not eventuated.

Anonymous said...

The "B2B" Tiger Team met last Thursday.

I would not really call what happened a Tiger Team. I would instead call it an early review of a draft specification. A number of issues were identified.

There do seem to be different lists of Tiger Teams being sent to different organisations and participants.

Anonymous said...

Are the tiger team minutes going to be public?

Dr David More MB PhD FACHI said...

Dream on I fear - we shall see!

David.

Anonymous said...

We shall see - indeed we will.

Tiger Teams scattered far and wide "being sent to different organisations and participants".

It's a classic scam straight out of the textbook. Make it look as though something is happening here, there and everywhere.

Then, they'll give us more time to make something happen.

Anonymous said...

INSANE. This is insane, completely and absolutely insane. It matters not one jot whether these ‘Tiger Teams’ plan to take one week, one month or even six to deliver their specifications.

They know and so does everyone else who has anything to do with health computing that it is impossible, quite impossible, to contract down to a few weeks work that in any other circumstance would take years to deliver.

No one anywhere in the world has been able to demonstrate a capacity to provide meaningful and useful detailed ehealth specifications that quickly. If it were so, ehealth would be well and truly widely embedded into healthcare already.

The arrogance, the stupidity and the blatant irresponsibility and disregard for safety in health is beyond belief.

The legal implications for the whole of health are terrifying in the extreme. Surely somewhere, some one in authority has enough common sense to draw the line and put a halt to this insane behaviour.

Anonymous said...

"Surely somewhere, some one in authority has enough common sense to draw the line and put a halt to this insane behaviour"

Uh? That's the *source* of this insane behaviour.