Wednesday, July 11, 2012

The Scale Of The Miss On NEHRS / PCEHR Delivery Becomes Clearer Every Day. No Wonder We Got A ‘Soft Launch’ - It Wasn’t Ready.


The following appeared today.

NEHTA knew of PCEHR delays

  • by: Karen Dearne
  • From: Australian IT
  • July 11, 2012 12:00AM
ALMOST all the functionality of the new personally controlled e-health record system is delayed until at least August, the National E-Health Transition Authority's head of the PCEHR program admitted four days before the go-live.
"At the moment, we are in the final stages of the production build-out and final verification testing," Andrew Howard told a vendors' webinar on June 27.
"Everything is on track for a successful launch (of the consumer portal and online registration system) over the weekend."
But Mr Howard said plans for the release of the provider portal were not yet settled.
"We're planning for the August timeframe, and those working with us in the test environments and the lead sites are tracking to that," he said.
"Final contracts will be put in place with (the national infrastructure consortium leader) Accenture this week around the specific date for delivery."
Accenture was awarded a $47 million contract to operate the new PCEHR system on June 26 for the two years to June 2014.
Last week, The Australian reported that Accenture had only delivered 40 per cent of a fully workable infrastructure by the July 1 launch date, while a hacking incident that occurred during the system's build late last year was not discovered for four months.
Mr Howard also confirmed that it is still unclear when the National Authentication Service for Health - which provides user verification, security and audit services - will be available from NEHTA's contractor, IBM.
"IBM has not delivered their contractual commitments as of yesterday (June 26), so we are in negotiations with them around a firm date for delivery," he said.
"So the NASH is not there, but we do have an interim solution for software vendors that will be in place for the August release (of the provider portal).
"The Health department has contracted with Medicare Australia to issue a gatekeeper compliant digital certificate which encompasses the NASH requirements for healthcare provider identifiers and healthcare organisation identifiers."
The plan to build the NASH arose from concerns that existing Medicare PKI infrastructure, used for billing and claiming purposes, was not robust enough for a national system transacting confidential medical information.
"A number of vendors have already tested that solution with us in the software testing environment, and we've also written the same sets of code off our reference platform to test the Medicare solution," Mr Howard said.
"So, with respect to secure connectivity to the PCEHR, we're still on schedule for August delivery as well."
But the state and territory governments have requested a one-year deferral on compliance with Healthcare Identifier provider requirements on hospital discharge summaries, as their systems are not ready.
Read much more of the details here:
Talking to those involved I have been told that this is all true and that it is probable a good many delays and hiccups are still to come.
I wonder when the point will come and we see the Minister summon a few executives in for a little fireside chat to obtain an explanation of just why it is the whole Program is looking rather like a mismanaged shambles.
Interestingly the problems have made their way across the Pacific to the US.
Monday, July 09, 2012

Australia Faces Problems in Rollout of Personal Health Record System

The Australian government has encountered problems with the recent launch of its Personally Controlled Electronic Health Record system, or PCEHR system, the Sydney Morning Herald reports.
The PCEHR initiative aims to let patients use an online tool to consolidate their records on medications, allergies, immunizations, doctors' notes and other health information.
Low Enrollment
The PCEHR project has faced low enrollment. Five days after the initiative launched on July 1, only 320 Australians had registered for the system.
The low enrollment numbers have led observers to express doubt that the program will meet its goal of registering 500,000 users in its first year.
Additional Problems
Users have reported several other problems with the PCEHR system, such as:
  • Consistently busy call center lines;
  • A lack of awareness among government staff that registration was open; and
  • An inability to register names with apostrophes (Molloy, Sydney Morning Herald, 7/9).
It really seems the arrangement of having DoHA outsource delivery of the Program to NEHTA has been a less than good idea. One wonders if the Program  might not have been delivered more successfully if the whole Program (as a whole) had been passed to a private sector ‘managing agent’ with the sort of control and responsibilities needed to have something like this be delivered. Certainly it would have been good to see better governance, leadership and accountability than has now seemed to be the case.
I guess we will never know.
David.

10 comments:

Anonymous said...

I don't understand. If Medicare are now contracted to deliver the NASH requirement, and can whoop it up in a hurry, then why do we need the IBM NASH at all, and have we paid for it twice now? What is the difference between the Medicare version of the NASH and the promised IBM NASH?

Anonymous said...

A very good question. Medicare originally bid for the tender to develop the NASH, building on its exiisting platform and using IBM as its internal systems partner. But no, NEHTA selected IBM as a standalone provider. I think Medicare would have every right to feel miffed over the way they've been treated in this proect

Anonymous said...

7/12/2012 12:04:00 and AM 7/12/2012 08:34:00 AM have highlighted another example of NEHTA's total incompetence.

I woke last night in a sweat dreaming of the 20,000 pages of documentation which NEHTA has assembled. Then I thought of Accenture, Oracle and Orion and wondered if they would ever bother to read all that stuff. I concluded not, because they have their own products to sell and now that they are in the door they don't need to be burdened by NEHTA telling them what to do.

My dream concluded with the political solution lying beside me on the pillow - now that ORION and ACCENTURE have NEHTA and DOHA firmly shackled - all that remains to be done is to bag their heads and send them to Abu Ghraib for interrogation.

Anonymous said...

The facts, for what they are worth. The Medicare PKI solution is not suitable to fulfil all the needs of the health sector for NASH. Medicare are providing a temporary infill which will allow the use of its PKI with the PCEHR only. Health sector needs outside of the PCEHR cannot be met without substantial investment in a new solution by Medicare, at the very least, hence why IBM or others are necessary.

NEHTA do seem to have got the messaging wrong though, by not communicating to the wider market about this and the impacts, or not, on the PCEHR.

Anonymous said...

Well, if the Medicare PKI is not suitable for the job, why is the PCEHR being launched at all?

Anonymous said...

Why is the PCEHR being launched at all? FULL STOP. END OF STORY.

Anonymous said...

well because the minister said it would.

Anonymous said...

NO - it is not because the Minister said it would - it is BECAUSE THE MINISTER WAS TOLD BY HER DEPARTMENTAL BUREAUCRATS, from the Secretary down including NEHTA, that she could be absolutely confident she could say it would. She was blindsided, snowballed and conned and those responsible knew that at the time and knowingly deceived her.

Anonymous said...

To 7/12/2012 01:40:00 PM If that is true then the Minister needs to call it out and employ a group of people the Australian public can trust and who are not too afraid to ask the right questions and who are capable of drilling down to get the right answers then go from there and get everything back on track and fully transparent before it all snowballs.

Anonymous said...

The Medicare PKI solution is not even suitable to fulfil all the needs of PKI for the PCEHR. It will not allow those vendors who act as Contracted Service Providers to obtain certificates to access the PCEHR.