Thursday, May 03, 2012

The Canadian Medical Journal Suggests the NEHRS (PCEHR) Is A Crock. The World Is Starting To Notice.

The following appeared a few days ago in Canada.


April 30, 2012

Bloom fading from e-health golden wattle

It sounded like a great idea in 2010: a personally controlled electronic health record that would allow Australians to access and share medical records in a nationwide database. The system, it was argued, would support better medical decision-making, reduce errors and save time and money.
To that end, the government set aside A$467 million and targeted an ambitious launch date of July 1, 2012.
Medical groups such as the Australian Medical Association lauded the notion, asserting that a shared electronic health record would help doctors deliver better care as they’d have access to a patient’s full clinical records no matter where he was treated. Health and consumer advocates were equally effusive. The proposed system would yield improved health outcomes, reduce medical mistakes and provide confidential health records.
But as details emerge and the launch date nears, the supposed charms of a Personally Controlled e-Health Record (PCEHR) appear to be fading, much as the bloom eventually withers on Australia’s national flower.
“E-health in general is a good idea, but you need some other infrastructure and you need it to be comprehensive,” says Robert Wells, director of the Australian Primary Health Care Research Institute. “In my view, it’s a complete waste of money and I’m not sure what they hope to achieve from it.”
What has changed so dramatically in a few scant years?
As now envisioned, patient interaction with the system will be much more limited. The federal Health Department has admitted there will be privacy risks in the transfer of patient data. And a recent Senate inquiry indicated that the software, as well as the architecture that will allow patients and clinicians to join the network and share data, may not be ready on time.
“There is still some very significant development work to be done on the PCEHR functionality,” Rosemary Huxtable, deputy secretary with the Department of Health and Ageing, told parliamentarians.
Because of that lack of “functionality,” the Australian Medical Association and the Health Care Consumers’ Association have expressed consternation about the timing of the system’s rollout, while a coalition of senators is urging that the venture be delayed for 12 months.
As for privacy concerns, Australian security experts are warning that insufficient security protections could leave the system open to hacking.
The health department insists clinical data will be encrypted during transmission but acknowledges that it could be compromised at the personal computer level. To combat that, the department says it will issue instructions to users as to how to protect themselves from security threats.
Others are now struggling to comprehend whether the system, as currently envisioned, will have any benefits.
An ideal e-health plan would reduce costs for funders, reduce liability risks for physicians and bolster a patient’s ability to share in the management of his health records, says Klaus Veil, vice president of the Australasian College of Health Informatics.
But as currently configured, the personally controlled electronic health record that will become operational in July is not capable of “doing the job,” Veil says. “Core bits are missing. We don’t know if and when this functionality will actually be in the PCEHR.”
— Tanalee Smith, Adelaide, Australia
Full article is found here:
Looks like the news is starting to turn on the NEHRS as more and more local expert decide to speak out to point out the legion of flaws they now seem to be seeing in the PCHER.
In December 2010 this blog was pointing out a major set of issues:
See here:
and here:
and even earlier we had more here:
Funny it seems to have taken so long for people to realise just what a crock this is.
Indeed see here a full 18 months earlier:
“I previously provided a Submission on the PCEHR proposal to NHHRC in May, 2009 and the views expressed in that submission remain my position despite the work undertaken by DoHA and NEHTA since.
This submission is available here:
Sadly they stubbornly pressed on and now we see the result. Next Tuesday (Budget Night) will tell us all just how stubborn they will really be!


Anonymous said...

If the author Tanalee Smith is still Senior Media Advisor to South Australia Health one would have to wonder - either for how long will she continue to be Senior Media Advisor or, alternatively, does this indicate that SA Health has little faith in what DOHA and NEHTA are doing and don't intend to keep putting good money after bad?

Anonymous said...

What is the underlying motive for a a Media Advisor to South Australian Health to regurgitate previously reported facts of the PCEHR in the Canadian Medical Association Journal? Most odd indeed. There is something more to this than meets the eye.

Anonymous said...

Klaus Veil said - as currently configured, the personally controlled electronic health record that will become operational in July is not capable of “doing the job,” -

NEHTA and DOHA will be pleased to know that.

Enrico Coiera said...

"underlying motive"?

I wonder, why can't today somebody say what they think, and just have their thoughts discussed to see if they have merit?

Maybe she wanted to say something to an international audience that she thought would be interested. After all, Canada has had a challenging e-health journey too, so the Australian experience might give them some comfort that they are not alone in finding it challenging.

Maybe its worth listening to an experience health informatician like Klaus with decades of real-world standards experience? You don't have to agree with him, but you certainly shouldn't denigrate him if you don't.

What is it with today's level of discourse that motive is more interesting than content? That playing the man is easier than playing the ball?

I personally fear politics has corrupted our capability to have hard discussions. It's all about which side you are on rather than the issue at hand. If you are not on anyone's "side" you get put in one anyway no matter how much you refuse. I know!

Sad if we allow all walks of human endeavour to regress to the political "mean", in this case regressing both to the statistical and attitudinal meanings of that word. Is trust in each other now so low that we always presume there is a "spin" behind everyone's comments?

Anonymous postings are meant to allow those who need to be careful to say what they cannot if they were identified, not attack people who can't respond to you directly.

It's a hard discussion as it is for all sorts of genuine reasons, so let's not make it harder!

Anonymous said...

I agree with Enrico. I also think on reviewing the above comments no real criticism was intended. My take on it is that the commentator was probably thinking that if a high flying expert like Klaus can make such comments at this late stage why on earth were people like him not standing up and shouting the message from the rooftops over all those years that they were happily receiving their consultant payments.