This blog is totally independent and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Monday, August 13, 2012
What Can We Learn From The NEHRS Failure And Outage On The Weekend. A Very Great Deal I Would Suggest.
I find it very interesting that there has been no media pick up on the NEHRS / PCEHR failure that I, and others I am sure, witnessed on Sunday afternoon.
It seems the Fourth Estate just does not want to know when there are problems in e-Health systems - but have an outage at a bank and it leads the technology news for a day at least.
For those who missed the details here is the link to the blog with a description of what happened.
Essentially what we saw for four hours was an exceptionally ungraceful ‘crash’ when the individual attempted to access their NEHRS record - with a worse than useless error message you can see repeated in the blog linked above.
To me there are strategic, design and operational issues.
At a strategic level we see the outcome of deciding to operate to political rather the real deadlines and we see the impact of failing to properly test a system which for incomprehensible reasons was made available nationally - rather than in some local areas for a gradual roll-out.
It certainly seems that NEHTA/DoHA/ Medicare are as good as their word in not adopting a cautious approach. (It is not clear who is responsible for this to me - which is a problem in and of itself.)
Some PCEHR bugs will be fixed after go-live, says NEHTA
August 01, 20122:39PM
NEHTA chief Peter Fleming at the 2012 Health Informatics conference panel session in Sydney. Picture: Richard O'Leary Source: Supplied
PEOPLE with hyphens in their names had to wait for days to register for the personally controlled e-health record system, National E-Health Transition Authority chief Peter Fleming confirmed.
Testing and remediation would be done after PCEHR features and functionalities were pushed live for the public to use online, according to Mr Fleming.
"It's one of the reasons why we're slowly pushing this out into the market to have a look, address the problems immediately and that hyphen (issue) was well and truly fixed within days of being identified and made sure that that's appropriate so that's on the hyphen side," Mr Fleming told participants during a panel session yesterday at the 2012 Health Informatics conference in Sydney.
"This is a major program so there are many, many components," he said.
Certainly the unusual “test after go live” has been on full display just recently.
At a design level it seems clear that both error handing and error messages have simply not been thought about. This is always a risk when you are passing users between systems but seems to have been rather poorly executed on this occasion.
Operationally what we saw was a total lack of customer support. There was no place to go on the failed screen and it is difficult to notice a minute ‘Contact Us’ right at the bottom of the log in screen. Clearly this needs to be easier to find.
Additionally a failure of the type I witnessed should have been instantly noticed by any properly designed system and there should have been a fail-over to an explanatory screen saying that there were system problems and to come back a little later. At the same time there should have been notification of the failure to relevant managers and staff.
Such error handling is routine in most significant systems.
Of course we won’t even explore the implications for a patient if the system was actually being used for some clinically relevant purpose - like allowing someone to see what medications the patient thinks they are taking. I guess the total lack of information in the system makes it safer to test in such a bizarre way! I hope no one was actually trying to see what their patient had recorded.
All in all and at every level this really an appalling incident - that I note we have not even had any acknowledgement that it actually occurred and what was being done to prevent a recurrence.
Not good enough for close to a billion dollars! We all deserved a lot better than this. I wonder when we will start to hear denials that there was ever a problem?