Sunday, July 01, 2012

The Naiveté Of Political Optimism In E-Health Is Pretty Sad. Just Why Is That? Ignorance Of The Complexity and Of The Time Needed For Real Change Is The Key.

Well here we are at the launch day of the NEHRS  / PCEHR. So far - as of 4pm (posting time) there is not a great deal of evidence of much happening.
A check of www.ehealth.gov.au gives is the following.

Welcome to eHealth.gov.au

eHealth.gov.au is your gateway to Australia’s personally controlled electronic health record system, linking you to information about eHealth records and the system itself.
From July 2012, people seeking healthcare in Australia will be able to register for their own personally controlled electronic health record – an eHealth record.
Your eHealth record will be a secure online summary of your key healthcare information.
You will control what goes into your eHealth record, who is allowed to access it, and who can see which information.
Over time, an eHealth record will put you where you belong — at the centre of your own healthcare.
----- End Extract
As far as on-line registration is concerned we would seem to be still waiting.

Registration

Coming soon

From July 2012, Australians will be able to register for an eHealth record.
Sign up now to receive regular updates.
----- End Extract.
As far as I am concerned whether we move to actually being able to register later today, in a week or so or whenever matters little. We all know that behind any registration there will for the next year or two at least be very little do and very little clinical value offered.
Astonishingly as late as Friday morning it has not been decided whether on-line registration would happen. What sort of national IT system could possibly be being implemented in such an uncontrolled and nonsensical fashion. You would laugh if you were not sobbing hysterically with horror at the incompetence and stupidity of those who would let things get to a state like this.
See the audio found here:

Electronic health records begin Monday

Broadcast: Friday 29 June 2012 6:36AM
From Monday, Australians will be able to record and access their medical history electronically. The system is called PCEHR - Personally Controlled Electronic Health Record. It is based on the premise that centrally stored health records can provide health professionals with all of your relevant medical information online. But only you can decide who can access the files. The initiative is backed by federal and state governments, but critics say it has been launched prematurely.

Guests

Dr Nathan Pinskier, Deputy Head of the Clinical Unit of the National e-Health Transition Authority
----- End Extract
The point I wish to make is that this has all been an example of technical overreach with absurd commitments being made to senior technical managers to politicians about just what is possible and in what time-frames.
It was never going work as planned:
A year ago I wrote:
“As far as I am concerned this just seems to be getting sillier and sillier. What we now have is unseemly haste to implement a slightly tweaked set of systems which were designed to be used by healthcare providers for their use and provider to provider communication to be pressed into service and used by consumers. We all know how well software designed to solve one problem works when attempting to solve a different - and ill defined - problem.
Of course all the Standards used will not be the NEHTA ones, but whatever is easiest and quickest for Accenture and partners, so there may just have been a fair bit of wasted time with all this work. We will all see pretty soon!”
See here for the full blog.
Let me say again - sensibly implemented Health IT is, I believe and unequivocally good thing Sadly those responsible for delivering this project - and their sadly information deprived political leadership - are giving it very bad name - which I fear will last for decades.
This really is a dreadfully sad day.
David.

4 comments:

Anonymous said...

Hey registration is now 'available now' !!! Excitement plus! Although the online bit seems to be only by Medicare staff.

Anonymous said...

Nicola Roxon admitted as much when she, Gillard, Crean, Swan etc recently went on the attack against Rudd and ruined his comeback.

She admitted that their mode of operation is pure thought bubble and 2 page press release stuff.

Roxon must have skimmed through the Bennett Report one night on the can and highlighted the Personally-Controlled buzzwords and thought: "I AM GOING TO LOOK LIKE A GENIUS TOMORROW!"

Well have a look where we are now.

Roxon is responsible for this waste. Deloitte, NEHTA and DOHA have merely been the underpaid spruikers (Deloitte) and the shoddy implementers (NEHTA and DOHA).

Everybody who read the PCEHR RFT knew that the timeframe was unachievable - and I am 100% sure there will be no penalties incurred by Accenture and their subbies for non-delivery.

We will see what they eventually deliver, whether it is usable, whether the data is fully-populated and whether the poor Australian Healthcare IT vendor community will have rescued this godforsaken stuff-up.

The magnifying glass is now focused firmly on NEHTA and like an ant it is going to fry under the heat.

Anonymous said...

Oh it's lonesome away from your kindred and all
By the campfire at night where the wild dingoes call
But there's nothing so lonesome, morbid or drear
Than to stand in the bar of a pub with no beer

Now the publican's anxious for the quota to come
And there's a far away look on the face of the bum
The maid's gone all cranky and the cook's acting queer
Oh what a terrible place is a pub with no beer

Then the stockman rides up with his dry dusty throat
He breasts up to the bar and pulls a wad from his coat
But the smile on his face quickly turns to a sneer
As the barman says sadly the pub's got no beer

Then the swaggie comes in smothered in dust and flies
He throws down his roll and rubs the sweat from his eyes
But when he is told, he says what's this I hear
I've trudged fifty flamin' miles to a pub with no beer

There's a dog on the v'randa, for his master he waits
But the boss is inside drinking wine with his mates
He hurries for cover and he cringes in fear
It's no place for a dog, 'round a pub with no beer

And old Billy the blacksmith, the first time in his life
Why he's gone home cold sober, to his darling wife
He walks in the kitchen, she says "you're early my dear."
But then he breaks down and tells her the pub's got no beer

Oh it's hard to believe that there's customers still
But the money's still tinkling in the old ancient till
The wine buffs are happy and I know they're sincere
When they say they don't care if the pub's got no beer

So it's lonesome away from your kindred and all
By the campfire at night we'll hear the wild dingoes call
But there's-a nothing so lonesome, morbid or drear
Than to stand in the bar of a pub with no beer

Anonymous said...

I'm looking forward to seeing Julia et al in the queue at Medicare signing up for their NEHRS tomorrow! should make for great television....
on-line, my arse! this is a complete travesty. As David says, Health IT properly implemented is a wonderful tool for improving healthcare. This is like the episode of "Yes Minister" - the clean hospital, no patients at all, but very clean Minister! Please!