Tuesday, September 04, 2012

Somehow Things Just Seem To Be Getting Worse And Worse The More We Know. I Wonder Who Is Telling The Truth Here?

The following appeared today in the Australian.

Document proves defects in e-health

THE national e-health system was riddled with critical or high-severity defects just days before its launch, casting doubts on the Gillard government's claims that it was pushed live without faults.
The Australian can reveal that the personally controlled e-health records (PCEHR) system, which was taken offline for more than 24 hours for maintenance at the weekend, was affected by 68 critical and high-severity bugs.
Although the government has stood by its insistence that the system was fault-free when it was launched on July 1, the decision to go live was made despite warnings from its own e-health agency, the National E-Health Transition Authority.
The Australian revealed on July 24 that the government knowingly launched the PCEHR with more than 60 high-severity and critical bugs. As previously reported, two weeks before the launch NEHTA told key government stakeholders that the system had more than 200 high-severity and critical bugs. That was reduced to 68 after a "reprioritisation" of defects, sources close to Health said.
This same approach was applied a week before go-live.
The findings were denied by a spokesman for Health Minister Tanya Plibersek and by her department.
As reported, the spokesman for Ms Plibersek said that, based on advice by the Health Department, the minister rejected claims that the system had problems before launch.
"No critical defects remained at the time of the release," the spokesman said.
A spokeswoman for the department concurred. As recent as last week, she said: "The national infrastructure (for the PCEHR) as implemented is complete and live and has signed off for clinical safety, and was implemented with no critical or high-severity system errors or defects. There are no outstanding critical or high-severity defects from any previous releases."
The Australian can now reveal that internal NEHTA documents refute claims made by the government. The PCEHR test document prepared on June 23 -- days before the system went live on July 1 -- details risk descriptions and mitigation strategies for the system.
The document outlined six items, but the most important entry and marked as "high" under residual risk severity was labelled PCEHR 663. It said: "With a total of 68 open severity 1 & 2 defects that are Category 1 functionality, and with one week remaining till 1 July Go-Live, it is highly likely that the system will go live with high volume of defects that includes Severity 2 defects."
NEHTA's suggestion for a mitigation strategy was to "postpone the 1 July go-live delivery date".
The Health spokeswoman yesterday said: "The risk report and other reports that The Australian continues to refer to are for a period prior to the final go-live decision. As we've said before, the system released was safe and secure, as confirmed by the IT and cyber-security experts at the Defence, Finance and Attorney-General's departments. No critical defects remained at the time of release. Any suggestion otherwise is completely wrong." Asked if the minister was sure the PCEHR system went live with no critical or high-severity errors, she said: "This has been answered before. The minister was advised by the department that there were no critical defects."
Extracts from e-health test results on June 23

First 5 issues omitted - available at link.
Risk description: With a total of 68 open severity 1 & 2 defects that are Category 1 functionality, and with one week remaining till July 1 go-live, it is highly likely that the system will go live with a high volume of defects that includes Severity 2 defects
Likelihood: Highly likely
Impact: Major
Severity: Critical
Mitigation strategy: Postpone the July 1 go-live delivery date
Residual risk severity: High
The full article with all the gruesome details is here:
To me what emerges here are two key themes:
First from the paragraph in italics it is totally clear the DoHA is incapable of ‘lying straight in bed’ and the way they spin and are ‘economical with the truth’ is really astonishing. Saying they told the Minister all was fine when their ‘managing agent’ was saying we need more time is a serious governance breakdown.
Second what it revealed is that not only is DoHA ‘calling the shots’ but that they clearly do not know what they do not know. That NEHTA should be just ignored like this suggests the relationship between NEHTA and DoHA must be rather ‘pistols at 20 paces’ like.
These two themes make it utterly clear the long term success of this Program is simply doomed. The pin needs to be pulled and sooner rather than later!


Anonymous said...

Consider the following - Minister Plibersek acted in good faith on advice received from the Health Department and in good faith rejected claims that the system had problems before the launch. NEHTAs internal documents clearly contradict the advice given by the Department to the Minister.

The only reasonable conclusions one can reach are that:
1. NEHTA truthfully advised the Department.
2. The Department ignored NEHTA’s advice.
3. The Department and the Secretary knew the truth.
4. The Minister was not told the truth.

Anonymous said...

Re "Consider the following -"

I agree with those conclusions. NEhTA has its faults but it seems to be the department that is the weakest link.

So, what has Minister Plibersek said in parliament about all this?

Because of the winter break has she been lucky in not misleading the parliament?

That's far worse (although it's not as bad as it used to be) than misleading press statements.

She needs to be very careful from now re what she says and where she says it.

Anonymous said...

The white lies are bad, and it was obviously really risky to go live on 1 July. But so far, apart from a 'buggy' system, they have managed to patch it up during long down-times, and because they don't have any real clinical data there yet, and no one is using it clinically, no one except perhaps blog-readers here, seems to care what was delivered on July 1, ready or not.
But given all of that - we are all just a bit wary now - can we trust them to take and act on sensible advice?

Anonymous said...

Simple Political expediency by the Health Minister and her Department of Health overruling unbridled fear and anxiety expressed by NEHTA’s unhinged staff.

This plane has not yet taken off or this shuttle has not yet been launched, whatever risky metaphor you choose to adopt for the PCEHR Launch, which is why they went "live" when they did in the condition they did, as they undoubtedly knew no-one was going to die as a result and there was absolutely ZERO chance of this being used in anger by any clinicians and putting any patients at risk without question.

Which makes a mockery of the $467M tax payer funded spend for the PCEHR as we literally have the electronic version of the Hospital with No Patients! “Yes, Health Minister”.

At least the Spruce Goose actually achieved lift-off, which fortunately can't be said for this NEHTA/DOHA PCEHR Love-child to-date.

Question is begging, does Mr Gonski treat shareholder funds of the publically traded organisations he currently Chairs with the same contempt he’s treating tax payer funds laundered through NEHTA's coffers from DOHA and COAG, or does he accept the same abysmal performance levels of the management teams he appoints and governs in those publically listed companies as he does with NEHTA’s?

Shame the Tax Payers can’t vote for a spill and fill of NEHTA’s Board as that would certainly help ameliorate some of the dysfunctional behaviours and paucity of meaningful outcomes in Australia’s laughable eHealth space, incompetently engineered by DOHA and NEHTA’s management teams.

Anonymous said...

What you want to see is a report/review conducted after the 1st July that lists what previous defects were fixed and what defects remained. Compare with the late June report to see which defects had been reclassified eg. made non-critical. They had the last week to fix or hide the problems. Hide the problems by downgrading defects severity or disable module/functionality.
--Tim C

Anonymous said...

Mr Gonski's recent report is the platform for education reform yet his incredible talents do not seem to being applied to NEHTA or eHealth accountibility with the same visibility as they for education, business or the arts. Is Mr Gonski's talent unable to be applied to Health or he is not interested?

Anonymous said...

If it is the case that Mr Gonski is not "interested" in eHealth, then he should resign his NEHTA Board Chairmanship effective immediately.

As Mr Gonski seems to omit NEHTA from his publicised list of Board Chairs, maybe he has already resigned and the remaining NEHTA Board members have failed to accept his resignation?

Anonymous said...

9/05/2012 09:22:00 PM such conjecture and needling is futile and of no value. The Health Minister's office will confirm Mr Gonski's status - give them a call.

Anonymous said...

"9/05/2012 09:22:00 PM such conjecture and needling is futile and of no value. The Health Minister's office will confirm Mr Gonski's status - give them a call."

It's pleasing to see Mr Gonski's PR machine gracing this ehealth BLOG's presence so the posts are far from futile. Please read a lot more information contained here while you’re here as you'll get a far more informed view than what's available in NEHTA's Board minutes around the state of Australia's ehealth.

Maybe the Health Minister can drop us a note directly here herself and clarify Mr Gonski's NEHTA Chair status and performance?

You unfortunately didn't leave Hon. Plibersek's direct number so unable to give her a call to validate Mr Gonski's NEHTA Board status (and performance) directly?