Monday, March 19, 2012

Outcome Of the Senate Inquiry Into The PCHER Legislation. Split Decision On Rate of Proceeding and NEHTA Takes A Whack from Both Sides.

Here is where you can find the full report.
A few fun quotes (I will read more closely tomorrow). Italics (mine) on some NEHTA quotes.

Majority Report:

Selected quotes

Page 14:
2.17 Throughout the course of the committee's inquiry concerns have also been raised about the effectiveness of the National eHealth Transition Authority (NEHTA), the corporation responsible for the design and roll out of the PCEHR system. As these issues do not go to the substance of the bill they will not be covered in the committee's report. However, the committee considers that the level of criticism warrants attention.
Page 16:
2.22 The Medical Software Industry Association (MSIA) also 'believes the System Operator (as described) is impossibly conflicted with roles as System Operator, System funder, and NEHTA Board Member.'
Page 28:
2.56 The committee takes the view that issues of safety are critical to the success of the PCEHR system's implementation. The committee notes the concerns that were NEHTA explaining the processes that have been implemented to ensure that issues of safety are addressed in the design and deployment of the PCEHR system.
2.57 The committee considers that the information it received throughout the inquiry suggests there is a level of confusion among stakeholders. The committee appreciates the information that it has received to clarify these issues throughout its inquiry, and recommends that the Commonwealth and NEHTA ensure that this information is fully available to stakeholders.
Committee view
2.84 The committee is supportive of the aims of an eHealth system and recognises that effective implementation will improve patient outcomes, particularly for consumers in rural and remote parts of Australia. The committee acknowledges the magnitude of implementing the PCEHR system. It asks the government to consider carefully the evidence received during this inquiry, particularly in relation to NeHTA's capacity to deliver on the timeframes that have been set.
Recommendation 3
2.85 The committee recommends that the bills be passed.

Dissenting Report by Coalition Senators

Page 41:
1.5 Further evidence about patient and systems safety and about NEHTA's overstatement of delivery was presented to Committee members in the final week of the inquiry. The information will be made public once responses to adverse comments in the evidence have been received. This evidence further deepens the Coalition's concerns about this Government's ability to deliver a functional and safe e-health system.
Page 43:
NeHTA Structure and Transparency
1.17 Coalition senators accept evidence that the very structure of the project manager, NEHTA, is inimical to transparency, good governance and responsiveness to consumer and stakeholder interests and proper engagement. As NeHTA is not subject to the standard Government accountability processes, including FOI, this has led to perceived culture of secrecy and a lack of responsiveness to key stakeholders around strategic issues.
Page 50:
Conclusion
1.47 That so many fundamental issues are yet to be resolved a little over three months from launch after six years of development and the expenditure of between $467 and $750 million must be a matter of great concern.
Recommendation:
1.48 Coalition senators recommend that the PCEHR legislation be delayed until July 1, 2013, in order to satisfactorily address the many issues raised during this Inquiry, especially those relating to governance, patient risk, privacy and interoperability are resolved.
----- End Extracts.
The bottom line is as I predicted. The Government wants to steam ahead, the Opposition wants some delay and rethink and the Greens also want some tweaks.
That both Government and Opposition say  NEHTA’s capacity needs careful review and watching is very interesting indeed. Clearly NEHTA is not satisfying both sides as best one can tell.
David.

5 comments:

Paul Karen said...

Quite disappointing from a GP perspective - no recommendations re PIP and/or GP incentive payments for the financial costs involved in setting up the PCEHR for patients. In addition, I would be interested to hear the MDOs opinion on the bills. Last I heard, they were not recommending doctors to partake in the programme as it stands to date. Their sanction, I believe, will be the main lynch pin in determining whether or not GPs take up the challenge of the role of the main nominated healthcare provider. IMHO, let the chemists and midwives et al at it if they so wish!

Anonymous said...

"The committee appreciates the information that it has received to clarify these issues throughout its inquiry, and recommends that the Commonwealth and NEHTA ensure that this information is fully available to stakeholders."

That's because the politicians aren't able to perceive the gap between the gap between the stakeholders real concerns and NEHTA's responses.

Anonymous said...

It's a far from optimistic result. It reinforces what most doctors are saying to each other in divisional meetings. NEHTA is not worth bothering with.

To my mind the saddest thing is that the intense hyped up marketing campaign and publicity thrust by NEHTA and the national roadshow of its PCEHR is only serving to further undermine any possibility of fixing the problem. All it is doing is destroying the last semblance of credibility that might be left and leaving health workers and the public in a total state of dissillusionment about why has so much money been wasted promising the earth and achieving nothing.

Credibility destruction was a masterly outcome of DOHAs last attempt with HealthConnect (before NEHTA). When you keep doing things the same way you keep getting the same result.

There is no value pushing a promotional message at the public and doctors when there is no substance behind the message. A tragic case of flip, flap, flop.

Anonymous said...

You deserve a medal for providing this information David. The whole eHealth situation in Australia makes me despondent and it’s a very useful service to have as I feel like ignoring this bunch of drongos and waiting for the whole affair to fall over. Having someone on drongo watch at least provides a painless way of knowing how our taxation is being squandered.

Anonymous said...

The level of 'interest' in NEHTAs PCEHR Roadshow was evident at the launch of the National PCEHR Road-show last Sunday outside a medical practice in Altona when only 22 people (including staff turned out.