Sunday, July 29, 2012

Well It Is A Month Since The NEHRS Launch. How Has It Turned Out?

It is now almost a month since the magical launch day (on July 1, 2012) of the NEHRS / PCEHR.
The scope of the launch had been progressively wound back from what Ms Roxon (the former Health Minister) announced a little under two years ago.
Here is the blog that addressed that issue and the original plan that was published two months ago:
In the broadest terms I would suggest where we are now is as follows:
First the ‘soft launch’ has succeeded in preventing much in the way of public sign up - with only 4,000 or so people having managed to register so far. It is hard to know if this is due to lack of interest or lack of publicity effort. At this rate we will have only 50,000 or so users in the first 12 months rather than the half a million or so projected for the current financial year.
Second the consumer portal is just about a clumsy to access and use as it might be possible to design. Compared with commercial sites with similar levels of security (e.g. banks, maybe even pay-walled news sites and so on) the whole thing is really plain awful - especially for the funds involved. They really could not have tried harder to provide such utterly non-intuitive access.
Third, once logged in, from the consumer perspective the responsiveness of the system is really very poor. Compare the responsiveness and speed, as well as screen design with international sites (Amazon, Facebook, Twitter even Blogger) with vastly more users and further away show just how badly designed / provisioned the NEHRS is.
Fourth, a key challenge for clinical usability is going to be to deliver professional access to Shared Health Summary and other records with a reasonably easy access path followed by PC like responsiveness and speed. On the evidence we have so far that is going to be a major challenge.
Fifth, right now the value in the NEHRS is similar to using a MS Word document to store your medical history and a fair deal cheaper. This can change but right now the precise plans on what is going to happen when is pretty opaque.
Sixth, it is clear the Medical Profession and especially the AMA have not their concerns about the whole system allayed. Unless this is convincingly achieved ‘real soon now’ the whole Program . You can read the AMA President’s concerns here:
and here:
Lastly we have the on-going problem of the system having an obvious error and it having taken over two weeks for no action to be taken. If this is the Quality of Service we are to expect then the sensible thing to do would be not to get involved.
In summary, nothing of any value has been so far delivered, and any real delivery of Program remains an elusive fantasy.
With what is on offer right now it is a total waste of time to enrol in the system. I really wonder at what point this will somehow turn into a ‘change management strategy’ in the same what the HealthConnect Program did some five or six years ago.
It seems likely to me that the outsourcing approach being adopted by DoHA can only accelerate the process.
The goals set are utterly unrealistic and fanciful and lack any clarity as to the resourcing planned.
See here:
My view is that this whole Program is hanging on by its finger nails and may fall off the cliff anytime now.
David.

6 comments:

B said...

re:

Secret report uncovers e-health patient identity problems

http://www.smh.com.au/national/health/secret-report-uncovers-ehealth-patient-identity-problems-20120729-236he.html

when you get a denial like this:

"A department spokeswoman said the report "does not show up problems in relation to security and safety" of the new personally controlled electronic health record system. "And it does not contain matters in any way that identifies patients.""

i.e when the denial does not deny the original assertion - that there are problems with data quality and data matching - you should get the distinct impression that there is a real problem.

As I've said before, the PCEHR is a technical solution to an unsolved problem. The problem is all to do with health information, not technology.

Anonymous said...

Dont ypu worry about that. The new "live testing" method will test the first serious use of the national patient identifiers, as the Gp and hospital systems start to provide clinical data to the pcehr. Me, I will hold off until the system is fully tested. But perhaps they will do this integrated testing before they go live with the next releases? We can only hope. And a report of how this has worked I in the lead sites would be a good thing before going live. But perhaps we doth protest too much, and it is all under control?

Dr David More MB PhD FACHI said...

I feel so much better for that reassurance. Of course you might be fibbing!

David.

B said...

David, I read Anonymous as being sarcastic.

"Design by testing" is not a good strategy.

The consequences are unstable requirements, and you all know what I think of that!

Dr David More MB PhD FACHI said...

Hence my equally sarcastic comment about feeling better about it all being under control - NOT!

David.

Anonymous said...

"A department spokeswoman said the report ''does not show up problems in relation to security and safety'' of the new personally controlled electronic health record system, the PCEHR. ''And it does not contain matters in any way that identifies patients.'"

So why not release it? If this person truly believes that a mismatch in identity is NOT a safety problem, heaven help us this system will ever be trustworthy. GIGO.