Sunday, June 17, 2012

The Government Terror On The Disaster That Is the NEHRS is Becoming Palpable. This Is Soon Going To Make The ‘Pink Bats’ Look Good.

It really has come time an adult - preferably a serious Federal Auditor - had a really close look at all the Australian National E-Health Program.
What we are now seeing is Government panic precipitated by just how badly the whole NEHRS / PCEHR Program has been run, and the utter lack of delivery and results.
In the big picture take this announcement:

Tanya Plibersek announces $37m boost for Tasmania e-health record rollout

  • by: Karen Dearne and Sue Dunlevy
  • From: The Australian
  • June 15, 2012 3:59PM
TASMANIA's e-health records rollout has received a $37 million boost as part of a $325m "emergency rescue package" for the state's "ailing health system" announced by federal Health Minister Tanya Plibersek today.
The e-health allocation will fund the state's rollout of the personally controlled e-health record to state hospitals, and "enable allied health, pathology and diagnostic imaging services to connect" to e-health services.
With the $37m investment for the Tasmanian rollout, recent e-health budget commitments worth $224m and a further $50m to help Medicare Locals with system training and connectivity, the amount committed to the PCEHR program is now $1.1 billion - more than double the originally budgeted $467m.
While the national system is due to launch on July 1, questions about technical and operational readiness remain.
Just this week, the Gillard government has been forced to back down on medico liability for doctors using the Health department- and National E-Health Transition Authority-designed and built system.
Just a fortnight out from the start, not one medical practice has signed up, citing advice from their indemnity insurers.
Lots more here:
As the article then goes on to sensibly point out this actually means - for the rest of the population on a per person basic  - an expense of an ADDITIONAL $1.6B on what has already been a billion or so.
Then yesterday we had this:

E-health system to launch without key user verification system

THE Gillard government's $1.1 billion e-health records program will launch without the key user verification system in place, with the National E-Health Transition Authority (NEHTA) conceding it has failed to deliver the project on time.
NEHTA chief executive Peter Fleming confirmed that the National Authentication Service for Health (NASH), being built by IBM under a $23.6 million contract project-managed by NEHTA, would not be ready for July 1.
The Australian reported last week that IBM was being pressed to complete the build by June 26 - just days before the due launch date.
But Mr Fleming said the delayed delivery "will have no impact on the launch of the personally controlled e-health system as arrangements have been put in place to provide an interim NASH" available from the Human Services department.
The PCEHR lead sites have been running their pilots using pre-existing authentication solutions, primarily Medicare's public key infrastructure (PKI) digital certificates which were originally implemented to support health sector business transactions such as billing and online claiming.
Mr Fleming said the delay was "disappointing" but that "Australians will be able to register for an eHealth record in July as intended".
"We will work closely with our key vendors involved in the e-health sites program to roll out the interim NASH so the launch can go ahead," he said in a statement released late on Friday.
NEHTA has given no indication when the NASH may be available for use.
Lots more detail is found here:
Here is the official - on Friday as usual - release admitting a total stuff up.

NASH delay will not impact consumer registration for PCEHR

15 June 2012. National E-Health Transition Authority CEO Peter Fleming said today the delayed delivery of the National Authentication Service for Health (NASH) programme from IBM will have no impact on the launch of the personally controlled eHealth records system in July, or the ability for consumers to register for an eHealth record.
Mr Fleming said the eHealth records system does not need to be held up because of the delay in delivering the IBM NASH.
"Australians will be able to register for an eHealth record in July as intended," he said.
Mr Fleming said the delay is disappointing but arrangements had been put in place to provide an interim NASH delivered by the Department of Human Services to enable the eHealth records system to launch and begin operations as planned.
"NEHTA will work closely with our key vendors involved in the eHealth sites programme to roll out the interim NASH to allow the launch to go ahead as planned.
NASH is a COAG funded project, which will provide one of the national foundations for a functioning eHealth system for all healthcare providers in the country.
Media enquiries:
Confirm the nonsense here:
How much does the taxpayer have to pay before there is some serious accountability and head kicking at DoHA and NEHTA?  When are we going to see a review that sorts out what is going on and why and how can it be justified?
Don't you just love the spin - you will still be able to register for PCEHR - but it will do nothing and won't be properly secured.
What is amazing to me is that no-one (external, of course, to those involved in this blog) is pointing out clearly this saga has been going on for years and years and has covered absolutely no-one with glory.
See here:
and here:
and here:
for warnings on all this from almost 3 years ago.
Last here is fun:
Additionally - of course - even if NASH was designed and delivered on time - it still has to be implemented. Issuing certificates and tokens to the 800,000 or so people who are eventually going to need them will take years. We have no idea how long that will take - let alone how it will be funded and so on. This really is a mismanaged debacle all on its own. I am also hearing news on the HI Service and the Secure Messaging are not far away. Of course we also need not to forget the AMT - which is yet to show itself to be fit for purpose.
The people who have mismanaged all this are the new definition of ‘teflon men’ as far as any rational observer can tell.
It just has to stop - and a serious review be called - and very, very soon!


B said...


re: "What is amazing to me is that no-one is pointing out clearly this saga has been going on for years and years [and] has covered absolutely no-one with glory."

You are being unfair - on yourself and this site. You and others have been pointing out the obvious for quite a while.

It reminds me of the old saying - There's no so blind as those who will not see.

Dr David More MB PhD FACHI said...

I was referring to those other than the discerning readership we have here!


Anonymous said...

The politicians of both persuasions and long lasting but insufferable bureaucrats are caught up in a tax-payer funded deadly embrace with nothing but bouquets to share among each other while the rightful and justifiable brickbats are kept well at bay and firmly in the dark.

Until this political dynamic experiences a tectonic shift and accountability is well and truly installed and entrenched, the defrauding of the tax-payer, injustice placed upon dying and suffering patients nationwide will inevitably continue, while the consultants, bureaucrats and politicians feed handsomely from the tax-payer supplied and rorted trough.

Is anyone else reading this BLOG “mad as hell, and not going to take it anymore”?

If not, you should be.

Anonymous said...

It was reported yesterday 8 June in that "NEHTA has detailed how millions of personally controlled electronic healthcare records are already in use."

..... million .... already in use - how can that be?

Dr David More MB PhD FACHI said...

Do the words 'bare faced lies' leap into mind. They sure do for me!

They are off on a frolic in a different universe!


Anonymous said...

We live in a world where central banks create money they don't have to bail out failed financial institutions and everything is to big to be real, let alone fail, and sadly it isn't real.

This is just another example of fools spending billions of dollars of money without understanding what they are doing. This has actually worked for the last 20 years and its the generic management bubble which "solves" issues by blowing up the bubble with more hot air in the hope that they will not be around when it bursts. The turnover of staff at NEHTA suggests that things are getting a bit surreal inside this bubble and there may be a shortage of bigger fools.

Unlike the USA, which is still allowed to do meaningfull use with printed money, this money is real and has come from taxpayers, a lot of taxpayers, and at some point someone will ask the questions, and the sensible answers are in short supply. If I was still in NEHTA I would be looking for the nearest exit, as this has to blow soon!!

Andrew Shrosbree said...

While working for NEHTA, I was keel-hauled two years ago for comments I made that were critical of NASH. Instead of addressing the concerns of its own staff, who could see what a slow-motion train wreck NASH was, NEHTA focused instead on persecuting the naysayers. I was accused of "creating a hostile working environment", told that NEHTA "needs team players, not heroes", and was nearly burned at the stake.

Stand back everyone, this ship of fools is about to run aground.

Terry Hannan said...

Readers of this blog may be interested in the recent publications by Wennberg and Fisher on the issues relating to variation in health care-( Fiona Godlee interviews John Wennberg, and Tracking Medicine (Wennberg). Fisher is Elliott S. Fisher, et al. Trends and Regional Variation in Hip, Knee, and Shoulder Replacement. The Dartmouth Institute for Health Policy & Clinical Practice 2010 [cited; Available from: Fisher suggests that spending less on health care may be the answer-WITH a change in model of care. Health is NOW unaffordable.

Anonymous said...

Here is what all who read this site need to start doing - and it is very simple. On every occassion ask the question - how does an activity and an individual (staff member/contractor/consultant) actively contribute to reducing the cost of health service delivery.

(not add to it - like much IT has or actually really does but we dont say)

Because dear tax payer we can no longer afford our health care system.

welcome to the new normal. If everyone doesnt start asking such questions we are all to blame.

Those projects that can not prove such a thing should be outed and not funded. Those individuals who can not justify their own projects and actions in such terms by definition are part of the problem and should also be outed.

Those that say they can contribute to the affordability of healthcare but do the opposite should be outed as frauds (that includes many who have NEHTA on their CVs, and that includes many from the big consulting houses to name but a few).