Tuesday, July 24, 2012

This Really Awful Headline Appeared From The Australian Today. Talk About Political Expediency Trumping Common Sense.

The following great read appeared earlier today.

E-health records system went live despite known bugs

THE Gillard government knowingly launched the national e-health records system despite warnings from its own e-health agency that it had more than 60 high-severity and critical bugs.
The personally controlled e-health system was pushed live and accessible to the public without a back-up system that would have ensured patient data was available at all times.
The consumer portal, where people enter personal information, medical history and medication details, contained hundreds more bugs of different severity levels as the system went live, The Australian can reveal.
About two weeks before the launch of the personally controlled electronic health record system on July 1, the National E-Health Transition Authority told key government stakeholders the system had more than 200 high-severity and critical bugs.
NEHTA warned that going live with the unstable system was highly risky, according to PCEHR test results seen by the Department of Health, NEHTA, the contractor Accenture and other stakeholders.
The results show that about a week before go-live the high-severity bug count had been reduced to just more than 60 items, mainly because of a "reprioritisation" of defects to future releases, but NEHTA issued the same warning to delay the launch.
It is understood the Health Department and other stakeholders had been aware of the roadblocks for months.
Sources close to Health said the government was told specifically "NEHTA has not had a window of more than two days without an outage or functionality impact, and as such NEHTA has concerns regarding stability of the production environment.
"Due to these concerns, NEHTA has requested a full root cause analysis for these issues from Accenture which has not yet been provided. As such, assurance cannot be given that these types of issues will not be experienced in production."
The production environment refers to a live, online system. Accenture is the main contractor for the taxpayer-funded PCEHR program.
A spokesman for Health Minister Tanya Plibersek said that, based on advice by the Health Department, the Minister rejected claims the system had problems before launch.
"No critical defects remained at the time of the release," he said.
Yesterday, Ms Plibersek said: "As we've said before, the system will roll out in stages over time. This is the sensible way to deliver the reform.
"The release was appropriately an operational matter for the experts in IT and cyber security overseeing for the project.
"The system went through rigorous testing, defect resolution and assurance processes prior to release, including tick-off by IT and cyber-security experts at the Defence, Finance and Attorney-General's departments."
As reported by The Australian, Accenture failed to detect a hacking incident for several months while the system was being developed. The company was awarded about $108 million for the e-health program.
As reported on July 3, a Health spokeswoman insisted Accenture had finished building the system, which met "all of the requirements of the National Infrastructure Partner contract".
"Those requirements have been completely built and the majority of those requirements are delivered as at July 1," she said.
But although the system had been built, it had yet to be fully tested and hence was not completely functional.
NEHTA warned there would be major ramifications such as the e-health system crashing if the launch were not postponed. There was not sufficient time to fix all the bugs, sources said.
Read more of the safe here:
Now everyone knows any computer system that is at all useful will have a few bugs:
As Murphy correctly states:
Every non trivial program has at least one bug
Corollary 1 - A sufficient condition for program triviality is that it have no bugs.
Corollary 2 - At least one bug will be observed after the author leaves the organization.
Refer here for all of Murphy’s comments on the nature of computational life and reality.
That said the NEHRS is pretty functionally trivial to be so bug infested!
I have now had the time to closely observe the consumer portal in its present form and it is really hard to give it anywhere near a passing grade.
It is difficult to access, agonisingly slow, laid out in ways to hide needed buttons and clearly buggy.
It also suffers from the problem of having been ‘designed for consumer use’ and so is really, really annoying for anyone who wants rapid responses, information rich screens and minimal context flips (i.e. the clinician).
I have shown the system to some system / web designers who were stunned at the cost of the system - suggesting $50 million at the absolute outside as what it should have cost.
At some point quite soon we are going to have to face the facts we have been given a lemon.
Equally the ridiculous rush to respond to political deadlines is just a joke and shows management which simply does not have the courage of its convictions. That really is not good enough either. Why did NEHTA simply not say "it isn't ready and this is not happening until we are confident it is"?
David.

15 comments:

Anonymous said...

Uh, NEHTA did - but it's DoHA's project and they made the call. Read the article again...

Cris Kerr said...

It is a great article.

Still only two journalists at the Australian who are knowledgeable enough and confident enough to cover this topic in any detail.

I'm a little more hopeful now that consumers might soon be cautioned to wait.

Dr David More MB PhD FACHI said...

All they needed to do was go to the Minister and say we are worried. That easy!

David.

Anonymous said...

The clear inference at the end of this article is that the DOHA spokesperson who said that the pause post launch was planned and for testing purposes *lied*. There was no pause - the system was pulled off line because it fell over, as warned by NEHTA. Is lying by a public servant in such circumstances agains the law?

Anonymous said...

So, perhaps NEHTA is only guilty of not effectively managing upwards, as opposed to complete incompetence...though the amount spent still beggars belief for what has been delivered!

Anonymous said...

How about Department of Health and Ageing Secretary, Jane Halton’s comment at the CRC Forum (see Karen Dearne future of Nehta funding article today).

Halton said "a language for accountability" was needed "that extends beyond the experts and engages the public".

With language like that anyone could lie their way to heaven and no-one would be the wiser. Poor Tania Plibersek, a pawn in the Secretary's game, now who can she blame and hold accountable? Next episode can't be too far off.

Dr David More MB PhD FACHI said...

Remember NEHTA was the 'Managing Agent'. Surely cost was part of the brief?

David.

Anonymous said...

Halton said "a language for accountability" was needed "that extends beyond the experts and engages the public".

I think "Jane Halton" is signalling or Dog Whistling that this whole affair and PCEHR debacle is the PUBLICS fault and we need to find some words or language that informs the Punters they’re "accountable".

Which in some twisted public service spoken Orwellian point of view is actually very very true!

Hon Plibersek, as a voted representative of the accountable Public and the reigning Health Minister, please sack Jane Halton for crimes against Healthcare so we may discharge our Public accountability.

Anonymous said...

"At some point quite soon we are going to have to face the facts we have been given a lemon."

Look on the bright side - When life gives you lemons, make lemonade!
Innovative uses of the PC EHR while we are waiting for it to get some real data in it: e.g. use it to store and share your recipes online (use the consumer notes section) - your recipes will be cyber-secure!

Pat D said...

I am watching the comments to measure the cliches. So far, not too bad. Waiting for - "at the end of the day" - so I can say; "night falls".

Anonymous said...

Next week we have Halton speaking at HIC.

Going to be very interesting what is said or not said.

Anonymous said...

Perhaps at HIC,Ms Halton will explain about eHealth overboard?

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Dr David More MB PhD FACHI said...

These 2 comments have been removed - but the sentiment of having Ms Halton actually justify what she has done is more than valid in my view.

David.