Tuesday, November 08, 2011

The Spin Just Oozes Out Of This Clap Trap. The Claims Are Really Not Mostly Supported By Fact!

The NEHTA Annual Report has been released for 2010-11.
On Page 5 (CEO’s Report) we read the following summary of all the goodness that has flowed from the work of over 250 staff.
“This year we have seen significant progress.
We can now correctly identify individuals and organisations in the health system and make sure the right information is attached to their health records:
Since July 2010, more than 23 million Australians have been allocated healthcare identifiers and by 30 June 2011 more than 1 million identifiers had been downloaded to support more accurate patient administration.
We can now conformance test new types of medical software systems that use Healthcare Identifiers:
In June, the National Association of Testing Authorities accredited the first two laboratories to test conformance of secure messaging services and software systems that will access the Healthcare Identifiers Service.
We now have a standard clinical language for Australian health professionals and it’s being put into action:
SNOMED-CT clinical terminology has been adapted for local conditions and is being progressively implemented. Australian Medicines Terminology is now in use in several clinical environments.
We can enable secure communications between health professionals:
NEHTA’s conformance test specification and automated open source test tools help software developers implement secure message delivery.
We are working towards national standards for electronic prescriptions:
Standards Australia have commenced consideration of Electronic Transfer of Prescriptions version 1.1 national specifications.
We can ensure the right communication gets to the right person:
The National Authentication Service for Health will support strong access control and audit trail mechanisms for the personally controlled electronic health record. This year we began working with IBM on design and build.
We are supporting greater continuity of care:
Our specifications for the eDischarge Summary developed in consultation with industry will enable GPs to receive timely information about their patients leaving hospital.
We are moving towards standardised eReferrals:
We released specifications that help standardise this very common healthcare communication by defining clinical content, business requirements and technical solution.
We are implementing eHealth on the ground:
Through our work with lead eHealth sites and jurisdictions around Australia, we are seeing eHealth foundations in action.”
It is really astonishing just how much distortion is here This is really just a huge wish list by an large.
NASH is nowhere near being used, NEHTA confuses working on or having a specification with delivering a working solution (there is a BIG difference), imagines SNOMED and the AMT are actually being used much and has no secure messaging as it lacks both NASH and any live end-point location service as far as I am aware.
Most of the ‘success’ listed here they have been saying has been a success for years but nothing has really changed on the ground.
A good example of exaggeration is found on page 16. The National Product Catalogue now apparently covers 359 companies. I leave it as a task for the reader to consider just how many companies actually supply the public health sector (Hint: 1000’s).
On page 20 we read:

Measuring the benefits of eHealth

“NEHTA’s Benefits Realisation framework was further enhanced this year to assess the impact of all NEHTA products, to ensure the benefits are fully understood and measurable and we can formally assess their capability.
During the year, NEHTA developed a Benefits Realisation Framework in partnership with IBM and the first wave of lead eHealth sites. The information on benefits achieved was fed into the second wave of lead eHealth sites and helped identify expected high level benefits.
In addition, NEHTA commissioned a best practice analysis comparing 12 shared electronic health record sites in Australia and contrasting these findings with other current large scale international programmes.
These findings informed the lead eHealth sites implementation plans and the Personally Controlled Electronic Health Records programme.”
One question - so where are the reports we can all read and see what has actually been achieved. State Secrets I guess!
The last thing that caught my eye was this (Page 20):

“Bringing NEHTA values to life

The NEHTA values were developed in consultation with staff across the organisation and during 2010-11 were further embedded in daily work through our performance and development review process. They are:
NEHTA people are ACCOUNTABLE
Clarify to confirm, confirm to commit, commit to deliver
NEHTA people are NURTURING
Learn to communicate, communicate to educate, educate to deliver
NEHTA people have INTEGRITY
In everything we do and deliver we demonstrate credibility and substance
NEHTA people COLLABORATE
Consult, listen, agree to take action and deliver”
I guess these values are so fully implemented that we have a staff turnover rate of 30% and reports of investigations into bullying.
Go here to read all about it in full.
One tiny last point. It is interesting that for most of the reporting period the (former) NSW Health Director General only turned up for 2 out of 6 possible Board Meetings!
Bottom line for close to one Billion Dollars we are still actually to see a life saved because of all this as far as I know. Let me know when you spot the investment in NEHTA actually making a difference to patient outcomes in Australia - which is the purpose after all - isn’t it?
David.
p.s. I will leave it to clever financial heads to assess the financial statements but I would wonder why NEHTA’s cash holdings have doubled to $44+million (and operating surplus was almost $33 million) when mostly the public sector is expected, within prudent limits, to spend what it receives (and yes I know there are some contracts where all the bills are not in!). I also note (Page 54) that despite all the cash there is a claimed Operating Deficit. Presumably that will be made up by next year’s income when the bills actually need to be paid!
D.

6 comments:

Anonymous said...

Well at $50 per capita spend you can't expect them to have achieved anything much of note.Can you?

On the other hand with 250 staff averaging a spend rate of $4 million per staff member you might expect to see something impressive working somewhere on a national basis. Wouldn't you?

B said...

Re:

"We can now correctly identify individuals and organisations in the health system and make sure the right information is attached to their health records:
Since July 2010, more than 23 million Australians have been allocated healthcare identifiers and by 30 June 2011 more than 1 million identifiers had been downloaded to support more accurate patient administration."

The logic seems a little faulty here.

The assumption seems to be that, because people have been allocated healthcare identifiers, they can be correctly identified. I'd like to see this justified.

Oh, and according to the Bureau of Statistics' Population clock, the population of Australia as of 9 November 2011 was less than 22.8Million. If they have allocated over 23 million identifiers then who has been given them?

http://www.abs.gov.au/ausstats/abs@.nsf/web+pages/population+clock

Accuracy doesn't appear to be NEHTA's strong point.

Anonymous said...

People have died since June 2010 so it is likely the current population is 22.8M but the total number of people that have lived since June 2010 is over 23M. So long as at least 200,000 people have been born or moved to Australia in the last 15 months,NETHA figures at first glance look accurate.

Anonymous said...

The annual report is an awesome product of the spin doctors......

Sad that it misses the real world completely!

Anonymous said...

The problem is that the gentlemen who ran the NEHTA strategies during the boom years for Accenture and others, is now running the PCEHR, I am not sure looking at the state such a clear cut program has become, I would have a guess this is almost a record for creating uncontrolled disasters from nothing. He should not be allowed to continue, nor should the managers responsible to the rubbish currently being submitted to teh tiger teams in support of IT14. I am sure it will not be long before other 'Deals he setup' come unstuck and we foot the bill for gross mis-appropriation of funds and the health effects it results in to NEHTA staff and the Australian public. Were is ANAO and AGIMO when you need them?

Anonymous said...

Yes, well he looks impressive on au.linkedin.com if you google .... was first name second name with nehta and accenture.