Tuesday, April 03, 2012

What On Earth Is Happening With the National Authentication Service for Health? SFA Is Seems.

It is now over a year since we had this announcement.

National Authentication Service for Health

The National Authentication Service for Health (NASH) is a key foundational component for eHealth in Australia. It is essential that the identity of people and organisations involved in each eHealth transaction can be assured, and this requires high quality digital credentials. The NASH,  Australia’s first nationwide secure and authenticated service for healthcare delivery organisations and personnel to exchange sensitive eHealth information, will provide this.
In March 2011 the contract to design and build NASH was awarded to IBM, and NEHTA began working with stakeholders to develop its Concept of Operations and solution design.
The service will issue digital credentials, including digital certificates managed through the Public Key Infrastructure and secured by tokens such as smartcards. These credentials will validate identity when used to access eHealth systems that are enabled to use NASH authentication.
Specifically, NASH will:
  • provide a governance approach that would allow health sector participation in the operational policies and services NASH develops
  • establish the standards framework for national tokens/smartcards in healthcare delivery
  • establish a national supply of digital credentials available to all healthcare delivery entities in the health sector, allowing the traceability of eHealth transactions to trusted identities
  • allow healthcare communities to issue and manage authentication credentials locally, supported by national infrastructure
  • support software vendors in transitioning their products to use nationally recognised digital credentials
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Here is the link:
Here is the release that is mentioned above:

NEHTA Selects IBM to Secure the National E-Health Agenda

1 March 2011.  IBM awarded $23.6M dollar contract to develop nation-wide authentication system for electronic health records. 
 IBM (NYSE: IBM) today announced it has been awarded a $23.6M dollar contract with the National E-Health Transition Authority (NEHTA) to design and build Australia’s National Authentication Service for Health (NASH) project.
The NASH will provide the first nationwide secure and authenticated service for healthcare organisations and personnel to exchange e-health information. The project will act as a cornerstone in transforming Australia’s health system including the establishment of a Personally Controlled Electronic Health Record (PCEHR), and will help drive the smarter use of data, information and communications in healthcare delivery.
Under the agreement, IBM will utilise its combined hardware, software and services capabilities to manage the project delivery of the NASH system for Australia’s healthcare providers. This includes industry and technology consulting expertise, security and access management technologies, and IT infrastructure management services.
In order to facilitate the rapid adoption of NASH by the healthcare software community, NEHTA is providing a software development kit (SDK) that will allow existing healthcare systems and deployments to quickly and seamlessly integrate with NASH. This SDK will also ensure that transactions are properly authenticated and audited in accordance with Australian standards.
Together with clinical terminology, messaging standards and unique healthcare identifiers, the NASH will provide one of the fundamental building blocks for a national e-health system, as well as providing security credentials for use at the organisational and local level.
“Our agreement with IBM enables NEHTA to build a system that will give healthcare professionals timely and secure access to appropriate patient information,” said Peter Fleming, Chief Executive Officer, NEHTA. “In turn, the NASH program will take us one step closer to broader healthcare access for all Australians.”
Andrew Stevens, Managing Director for IBM Australia and New Zealand, said the agreement represented a vital step in promoting the broader take-up of e-health, enabling a more patient-centric healthcare system and improved health outcomes for Australians
“This programme will benefit over 600,000 Australian doctors, nurses and allied health providers and accelerate the delivery of smarter healthcare across the entire healthcare system,” said Mr Stevens.
“By partnering with IBM, NEHTA gains access to IBM’s deep healthcare industry expertise and proven record in delivering complex business transformation projects,” Mr Stevens added.
IBM’s work with NEHTA is another example of how IBM is building powerful new systems around the world that improve the delivery of healthcare. IBM is creating smarter, more connected systems that deliver better care with fewer mistakes, predict and prevent diseases, and empower people to make better choices.
This includes integrating data so that doctors and patients can share information securely, seamlessly and efficiently. IBM also helps clients apply advanced analytics to improve medical research, diagnosis, and treatment to improve patient care and reduce healthcare costs.
NEHTA was established in 2005 by the Australian federal, state and territory governments to identify and develop the foundations necessary for an e-health system.
-ENDS-
There is only one problem with all this. Where is it? Where are the progress reports, plans, overviews, cost estimates, implementation timetables and so on? Not a ‘dicky bird’ on the NEHTA website and deathly silence from IBM.
Those familiar with the present status are telling me that the whole thing is delayed yet again.
This is hardly the first time:
Here is a quote from an April 2009 blog.

Outcome statement of the Stakeholder Reference Forum March 18, 2009

Opening by the CEO

NEHTA CEO Peter Fleming opened the meeting and advised that six Reference Groups had been formed and that the first NEHTA Reference Group Co-Chair meeting took place on Tuesday 17 March 2009.
· Diagnostic Services Reference Group:
· Medications Management
· Identification and Access Reference Group
· Continuity of Care
· Terminology Services
· Architecture and Technology
In an operational update he said by the end of 2009 the IHI, HPI, HPI-O and the National Authentication Service for Health (NASH) would be technically sound. Work has also begun in conjunction with Jurisdictions regarding the National Product Catalogue.
Three years later zilch is working etc.
Given the centrality of NASH to the National E-Health Record System (NEHRS) one really wonders just what is going on.
My suspicion is that they are struggling to work out how to fund the identification, credentialing, token issuance and ongoing maintenance of a system of this sort for 600,000 people. A dollar fifty will simply not cover it. That issue is, of course, separate from all the technical issues which they also seem to be struggling with.
Different I know but I found this amazing. Looks like Indonesia is a better implementer than NEHTA and the IBM!

Ministry tells city administration to expedite work on e-ID program

Andreas D. Arditya, The Jakarta Post, Jakarta | Fri, 03/30/2012 11:57 AM
With only a little over a month left before the deadline for the completion of the electronic identity (e-ID) data collection, the Home Ministry has asked the Jakarta administration to step up its work.
Home Ministry spokesman Reydonnyzar Moenek said on Thursday that the administration had only been able to collect identification data from less than 5.5 million people from a target of around 7.4 million.
.....
The central government has targeted to establish a single identity number for every citizen and distribute e-ID cards to more than 105 million citizens by the end of 2012.
According to the civil registration law, citizens over the age of 17 years or who are married should apply for an ID card.
The card will contain information of marital status, blood type, parent names, employment, physical or mental disabilities, birth certificate, divorce certificate, place and date of birth, biometric fingerprints and a photo.
The government has recently announced its intention to add a health feature to the electronic identification (e-ID) card program, which will store each card holder’s personal health records.
The Assessment and Application of Technology Agency (BPPT) plan to implement an e-health program, which will also coincide with the launch of the second generation of e-ID cards, will use microchips to hold owners’ personal data, including their health records.
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We have to really wonder just what is going with all this. It is really hopeless that NEHTA is so obscurantist and secretive. At what point do we get our money back for failure to deliver?
David.

6 comments:

Anonymous said...

I like the use of SFA, this gives a nice bridge to another area failing dismally, namely the Standards Foundations and Architecture project under PCEHR. The Ken and Cecily show seems to continue towards the waterfall under the blessing of the Head of PCEHR and DOHA but yet I see very little concern over this from the NEHTA Board or senior management, all the while good talent is lost, money and time wasted and we will end up with a repair budget far out stripping in scale anything a billing system in health could ever dream of achieving.

Anonymous said...

under the blessing of the Head of PCEHR ..... that is Mr Andrew Howard. Has anyone told him that the Minister no longer refers to the PCEHR but to the NationalEHR?

If so Andrew Howard needs to update his profile on Linked In because if he doesn't we will find NEHTA developing a PCEHR and a NEHR and we will all get very confused.

Anonymous said...

"It is essential that the identity of people and organisations involved in each eHealth transaction can be assured, and this requires high quality digital credentials."
If you read the PCEHR/NEHRS legislation and rules commentary closely, you will see that 'people' don't enter the equation anymore anyway, only organisations. Hardly secure given the possible size of some 'organisations'.
And let's face it - this is IBM. Why they were chosen in the first place beggars belief. Their track record for delivery in government is not a good one.

Anonymous said...

Is there still a Head of PCEHR, I looked through the Senate enquiries and no Head of PCEHR is present, I would imagine anyone appointed to this role would surely be required to front up? and in fact I don't see anyone with PCEHR after their name attending very much, has it become such an embarrassment that NEHTA is preventing any exposure of those responsible for such a farce, hopefully they have the insight to start bringing on people to replace the current lot come July 1st as we cannot reward the current hierarchy in PCEHR/NEHRS with contract extensions

Anonymous said...

Goodness - someone should tell Andrew Howard - perhaps he's working for another organisation from another age.

Anonymous said...

What is worse than non-delivery is the repeated failure to meet delivery dates. We have been promised that NASH would be delivered "real soon now" many many times. I first remember hearing about NASH at a workshop in Brisbane probably back in 2008.

NASH is the classic boy who cried wolf. No one can believe any more any proposed delivery date.