Sunday, July 01, 2012

Well - As Predicted - We Now Have A NEHRS Registration Fudge. Aggressively User Hostile Does Not Really Cover It!

You can go here to read all about it. (It appeared about 6pm +/-)
Here is the page.

Register

You can now register now for a personally controlled electronic health (eHealth) record.
To register, you can phone 1800 723 471 or visit your nearest Medicare shopfront.
You can also apply for an eHealth record in writing, and an application form is provided below. Send the completed form and all supporting documentation to:
Personally Controlled eHealth Record Program
GPO Box 9942
In your capital city
...or drop your form into your local Department of Human Services service centre offering Medicare services.

eHealth Registration Booklet

Please make sure you have read this booklet before registering for your eHealth record.
This booklet is available to help you understand the eHealth record registration process. It contains important information and explains the terms used, your eHealth privacy safeguards, details about how your information is handled, and where and how you can apply for an eHealth record.

eHealth forms

Register a new eHealth record for yourself and/or a person you are authorised to represent (i.e. your dependant).
----- End Page.
This really is just rubbish - it will guarantee no one will register and has utterly turned a bad idea into a just absurd one.
Explanatory glossy is all of 20 pages - and the form to apply - which would make the Tax Office proud - is all of 12 pages! It even looks like a Tax form!
So much for opt-in. Can you really believe anyone will bother?
Just download the forms and see how motivated you might be!
Guess what? - there is still no on-line registration! So they are actually porky central sadly. They promise and they just don't deliver. Where are the sanctions etc. for not meeting targets?
And remember there is still no substantial content behind the system once you register.
Almost a billion dollars - at least - for a 20 page explanatory document and a 12 page registration form.
This remains an incompetently managed fraud on all of us.
David.

17 comments:

Anonymous said...

And what time did that appear today?
It certainly wasn't there the last time I looked at 4pm!
So much for the grand unveiling at the start of the day - AKA 12AM

Anonymous said...

Interesting. You can create a record, or the Medicare lady can do it for you, but there is nothing in it, and noone can see it, not you or your doctors. Not even the Medicare lady. So therefore does it exist? It's not personally controlled and it's not a record, so what is it ? It must be an EH?

Anonymous said...

Senates Estimates Hearings?

Be prepared to be well and truly let down and disappointed by your elected representatives and senators "supposedly" holding the bureaucracy to account.

Tax payers dollars mean nothing, and all those inside the tent treat every living morsel outside the tent with nothing but contempt!

$467M, not counting what’s been digested by NEHTA since 2005, and this is the reality every Australian tax payer at best, and healthcare patient at worst, suffers at the hands of the incompetent management and governance of Australia’s ehealth sector.

Good thing the past Health Minister is now the Governor General, as all levers and powers of law to hold the “guilty” accountable, will be forthright and fastidiously dismissed and neutered to the benefit of the tax payer funded party raging inside the establishment tent.

Keith said...

The real disappointment is that online registration is not ready on time. I don't think anyone would accept that going online to download a form constitutes "online registration". David, the form itself is not unreasonable, and is certainly not "aggressively user hostile"; IT'S THE WHOLE IDEA OF A PAPER FORM AS A SUBSTITUTE FOR ONLINE REGISTRATION THAT IS OUTRAGEOUS! The form, if one is making a simple application to register, takes two pages; explanatory material and the inclusion of space for up to four dependants swells that to 12 pages. Part A (the personal application section) would take even less space if it omitted the options for including or excluding MBS and PBS data. Given that these elective items and a whole lot more can be changed once a person logs in to the online portal, their inclusion on the registration form is a bit strange.

Incidentally the form opens OK in Adobe Reader but fails to open in Apple's Preview. Oh, also the explanatory booklet says that one CAN register online, and has a footnote stating that all information is correct as of July 2012. Well, almost.

Dr David More MB PhD FACHI said...

Anything that looks like a Tax Form causes me to have that reaction

David.

Keith said...

David, you'll have to work on some desensitizing therapy!

Surprising that the Consumer portal has not been enabled this morning - that was the one thing that I thought they had ready. Perhaps not quite?

Keith

Anonymous said...

Keith,

I would go further and say that the lack of any online registration process for a system that is online is an epic fail.

It gives you immense confidence in delivery of the rest of the system, not.

B said...

Item 9 is interesting

The Chief Executive Medicare may hold information about you
which can be included in your eHealth record over time.

This information may include details that indicate diagnosed
conditions and illnesses. If you do not want to have such
details visible in your eHealth record, you should not consent to
the inclusion of this information.
You can withdraw your consent at any time, in which case no
new information will be provided to the System Operator for
inclusion in your eHealth record.

Importantly, however, if an
item of information was indexed in your eHealth record before
you revoke your consent, the full item may be made available
to the System Operator at any time, even after you revoke your
consent. You should refer to the Registration Booklet for more
information about this process.


So, you've got complete control over the information in your health record - as long as you don't put any in it.

Anybody any idea what the procedure is to correct mistakes, e.g where the wrong tests get allocated to your PCEHR?

Or have they assumed no errors? If so that's very brave, IMHO.

Anonymous said...

"Importantly, however, if an
item of information was indexed in your eHealth record before
you revoke your consent, the full item may be made available
to the System Operator at any time, even after you revoke your
consent."


So if something is added to your record that is wrong or you do not agree with what has been added then there is nothing you can do after the event?

B said...

David,

Re the behaviour of the NEHRS regarding withdrawal of consent and information always being indexed once it is in the system.

I've just had a look at the ConOp document <110912 Concept of Operations.pdf>

This behaviour of the system is not mentioned at all.

My guess is that it is a characteristic of the Singapore system they've bought and they either can't change it or can't change it in time for their deadlines.

It does suggest that the ConOp document is less than useful and that there are other aspects of the system that haven't been announced - and more importantly, haven't been agreed by stakeholders.

Anonymous said...

No need to guess ..... the Singapore system is what you are getting. That's it. NEHTA is just the sideshow from the old days - Girl in a Fishbowl stuff - what you're told is not what you'll get, what you see is not what is.

Wait till the Munchhausen patients get signed in to the system. One of my patients can't wait to register hundreds of conditions and operations. He says it will make him feel a lot better when he can see how many things he has had wrong with him and can show his family and friends. He thinks he should then be able to convince them his conditions have been real and they should have given him more sympathy.

juanita said...

I simply don't see why anyone would want to register for health and wellbeing purposes - it isn't as if a clinician will be able to use the PCEHR. Do parents have to un-enrol newborns whose information is compulsorily added to the system from yesterday? How does one opt out today before the operator controls their information if you are unfortunate enough to be opted in without consent? The paperwork is really complex to work through and I cant see opt out mechanisms or complaints options either.
The PCEHR system that has gone live looks like really expensive spin to me.

Andrew Patterson said...

To be charitable, an EHR with non-deletable, yet hide-able documents is not that strange. The System Operator is generally under obligations to both be able to say at any point in time - this is what _would_ have been seen by someone using the system - yet also meet privacy obligations by removing information from the system when requested. And those two things are not really compatible.

So the general approach is to allow documents to be blanked out, removed, hidden on request - so that no ordinary user in the system could ever encounter it - but to still retain the document somewhere such that the System Operator etc could reconstruct / audit things about the document.

So you have to extend some level of trust that the System Operator is not sitting their trawling through peoples deleted documents - but you kind of have to have that level of trust anyway before putting anything in the system.

And really, there are so many other problems with this system, worrying about rogue System Operators should probably be a fair way down the list.

Keith said...

B said: "It does suggest that the ConOp document is less than useful and that there are other aspects of the system that haven't been announced - and more importantly, haven't been agreed by stakeholders."

The Concept of Operations is just that - a concept document, not a specification. Whether specifications exist for all aspects of the PCEHR I do not know - certainly not in the public domain. The ConOp document is useful - just don't expect that it tells the whole story.

B said...

@Andrew Patterson

All you said could well be valid, but is it explained in the registration booklet or on the registration form?

I don't think that NEHTA/DoHA have achieved anything like the degree of trust needed for a workable eHealth system.

IMHO, the best thing about the system is that it is opt-in. It can safely be ignored.

Anonymous said...

"IMHO, the best thing about the system is that it is opt-in. It can safely be ignored."

Can it be safely ignored? I reckon it might be safer to check if one has been automatically or accidentally created for you while you were safely ignoring it. And it may be empty now, but one day it may just start to suck up your most embarrassing secrets into clinical documents, and hang them out like dirty washing for all to see! Worse still, it might be accidentally sucking up other people's secrets! Forget the sharing and caring - you owe it to yourself to get a record and keep it as empty as possible!

Anonymous said...

Anonymous said "Can it be safely ignored? I reckon it might be safer to check if one has been automatically or accidentally created for you while you were safely ignoring it."

Especially true given this:

'those registering have to provide only a Medicare card number and names and birth dates of family members to verify their identity. Security experts say answers to the identity verification questions are so widely known it would allow a person to set up an e-health record for someone else by telephone if they wanted to access that individual's health details, such as medication or medical procedures.'

http://www.theaustralian.com.au/australian-it/government/answers-to-identity-verification-questions-not-sufficiently-secure/story-fn4htb9o-1226415088490