Tuesday, October 09, 2012

NEHTA / DoHA Run Off On A Just Amazing Frolic. How Sad Is This?

The following e-mail appeared a few days ago.
From: NEHTA Industry Communications
Sent: Tuesday, October 02, 2012 1:04 PM
To: NEHTA Industry Communications
Subject: PIP eHealth Incentive - New requirements and Vendor Support
Dear All,
The Commonwealth Department of Health and Ageing has now released the five requirements for the new Practice Incentives Program eHealth Incentive.  Letters and requirements to practices will be distributed by mail today and we attach a copy of this correspondence for your information.  We expect all practices to have received this within the next few days.
Your customers may be contacting you shortly to ascertain your intention to list your product(s) on the PIP eHealth Product Register. You may wish to consider contacting your customer base to indicate your companies’ intentions in relation to product conformance in order to reduce the impact of calls from practices on your business.
The purpose of this email is to introduce the support material that is now available to you via the PIP website  www.nehta.gov.au/pip:
PIP Implementation overviews
The purpose of these documents is to give practices information and guidance about the Practice Incentives Program (PIP) eHealth Incentive requirements and to provide links to more detailed sources of information. The checklist items below are intended to help establish eligibility against this Requirement and should be read in conjunction with the PIP eHealth Incentive Guidelines available at www.humanservices.gov.au > Health Professionals> Incentives and Allowances> Practice Incentives Program (PIP)
(Note this is found here:
PIP eHealth Product Register
Software vendors must declare the conformance of their products to be included in the PIP eHealth Product Register. The requirements to demonstrate software conformance for the PIP eHealth incentive are provided on the Software Vendors page.
Software vendors
This section will provide you with some information about how to demonstrate software conformance for PIP and how to list your product onto the PIP eHealth Product Register
FAQs
This section should answer any questions you may have.
Contacts
Useful contact details for additional support.
Please do not hesitate to contact us should you have any questions.
NEHTA Industry Communications.
Attached to this e-mail are some Human Services Documents and a letter which provide similar information to that found at the link above.
Here is the link to start exploring.
The e-Health Program is introduced thus:

E-Health Incentive Introduction.

The eHealth incentive aims to encourage general practices to keep up to date with the latest developments in eHealth to assist in improving administration processes and enhancing the quality of patient care by, for example, by supporting the capacity to share accurate electronic patient records.
The Australian Government announced as part of the 2012-13 Budget that new PIP eHealth Incentive requirements had been developed in order to support the delivery of current eHealth initiatives particularly the personally controlled electronic health (eHealth) records system.
The new requirements and associated dates are:
Integrating Healthcare Identifiers into Electronic Practice Records
1 February 2013
Secure Messaging
1 February 2013
Data Records and Clinical Coding
1 February 2013
Electronic Transfer of Prescriptions
1 February 2013
PCEHR
1 May 2013
----- End Extract.
The very best bit is provided under each area:

Additional Reference Material

The product register is currently empty and the Desktop User Guide is a 40+ page document.
Here you are informed that (Page 5):
----- Begin Extract
This version of the User Guide is applicable for general practices and covers the following currently available eHealth functionality that is built into conformant Desktop Software:
·         Healthcare Identifiers; and
·         Clinical Document (CDA6) Viewing.
Further versions of the User Guide will be developed to align with future releases of NEHTA specified eHealth functionality (listed below), and for other community-based healthcare professionals, e.g. private specialists and allied health professionals.
The national eHealth program will enable the delivery over time of major new nationally agreed standards based eHealth services such as:
  • Shared Health Summaries, Event Summaries, and access to the national personally controlled electronic health (eHealth) record system;
  • Secure Message Delivery, and improved security, including e-Signatures;
  • e-Referrals, e-Discharge Summaries, and e-Specialist Letters;
  • e-Medication Management, including Electronic Transfer of Prescriptions and       improvements to e-Prescribing; and
  • e-Diagnostic Services, including e-Requesting and e-Reporting for pathology and  diagnostic imaging.
----- End Extract
So we are sure to see versions 1 to n over the next weeks and months.
I strongly suggest you download and browse this document. Having done that just reflect what all those in two and three man practices with 2 secretaries and a bookkeeper are going to make of what they are reading.
I hear the sighs of horror and resignation. They have neither the skills or the resources to manage all this are provided with a long set of links to add to their reading list to try and work out what is needed.
Nowhere are the services provided to help in any form I can see.
I think many will just throw in the towel and move on seeing a few more patients to make up for the money they lose.
It seems the Australian Medicare Locals Network (AMLN) but sadly Google does not seem to find a website for this lot.
My guess is that this fiasco will be the end of any GP co-operation with the NEHRS / PCEHR.
DoHA has always wanted to reduce the cost of PIP and this will certainly do it!
David.

18 comments:

Anonymous said...

They could give my GP all the incentives under the sun but no amount of money would ever convince this little black duck of a patient to ever get involved in this debacle. They could never pay me enough to be a victim of the whole charade.

Anonymous said...

Dear little black duck taxpayer,
Unfortunately I think you have already paid.

Anonymous said...

There's the rub! DoHA SES $1.5 -$2 mill salary per annum+ same for EL2level + that again for EL1 staff. I wonder what % of current incumbents have a competive CV for a health IT implementation project or real world health services delivery/clinical experiences? Good general public servants they may be but given ehealth worldwide has challenged most of the best trainedspecialists think the aust tax payershould expect their high risk ehealth $$$ to be in experienced specialist hands. lets hope the proposed senate committee evaluation takes a good hard look at both nehta & doha personnels appropriateness to their roles

Anonymous said...

And I want my money back - and then some!!!

Roll on the next election.

Little Black Duck.

Anonymous said...

You people are missing the point. DOHA is a policy maker - it sets policy. It is not an implementer of policy that is for another department like DHS or NEHTA or MEDICARE but not DOHA.

Setting Policy is great - if it doesn't work it;s because the implementers failed to deliver properly - nothing wrong with the Policy Minister.

Dr David More MB PhD FACHI said...

"You people are missing the point. DOHA is a policy maker - it sets policy. It is not an implementer of policy"

Many of us think that the fact DoHA thinks they are implementers is a major part of the problem. They are clueless but are trying to micromanage the implementation.

For lack of expertise in implementation this Government takes the biscuit - think BER, Pink Bats etc etc.

BTW their policy ideas are also nonsense.

David

Keith said...

Lots of quacking but not much in the way of serious comments!
First of all, David, the register is not empty: last time I checked there were 8 entries in total. Four of these were for "ETP", which is curious because we don't have the infrastructure in place for electronic prescriptions. All prescriptions are currently paper documents. Unlike the other categories in the register there is no CCA requirement for ETP - the software vendor just has to confirm that its software can send a "prescription" to one of the exchanges. This is going to cause some confusion when real ETP is introduced (after we have a national ETP standard and a NASH).

Although the HI service has been running for 2 years and 3 months only two vendors have software approved for the HI service. The failure to promote the HI service to doctors and to the software industry over the last 2 years represents a huge lost opportunity.

Only one vendor, HCN, has an accredited SMD compliant product in Medical Director 3.14. This is very strange because MD is not a messaging product, although it contains an optional messaging module in MD Exchange. However many MD users turn off MD Exchange and use a different messaging product, so there is likely to be much confusion here. It seems extraordinary that none of the dozen or so messaging products on the market have appeared in the register yet! Another anomaly is that MD3 can be accredited for SMD but not for HI. The HI service is meant to be a prerequisite for various other services including SMD. In fact most of the 40-page "eHealth Clinician's Desktop User Guide Ver 1" is devoted to explaining the why and how of setting up to use the HI service. It's a pity that it's two years late and completely out of touch with life in the trenches. It's full of consultant speak like performing "process mapping" and "engaging the team". I don't think it's going to wash with GPs, especially things like suggesting that they probably will have to enter their 16-digit HPI-I's manually or that they should regularly review the accuracy of the demographic data on all of their patients.

Dr David More MB PhD FACHI said...

"First of all, David, the register is not empty: last time I checked there were 8 entries in total."

Goodo. It was empty when I wrote this.

BTW - the HI Service is not fit for purpose when even after 2 years it can go down for more than 24 hours.

Keith I am sorry but your comment really points out just what a mess all is. As we all know the whole thing is just not being managed by grownups.

David

Anonymous said...

You couldn't find AMLN because no such organisation exists - it's AMLA!They have funding to support Medicare Locals to implement eHealth initiatives as will the MLs themselves. And the registers aren't empty - I can see vendors listed when I click on the links. Not sure what this story is about - you don't like the user guide?

Dr David More MB PhD FACHI said...

"You couldn't find AMLN because no such organisation exists - it's AMLA!"

Thanks for the information on AMLA.

Google does not seem to find them.

AMLA - Welcome
www.amla.org.au/Share
The Australian Medical Laser Association's primary responsibility is to promote and facilitate the advancement of laser medicine, photobiomodulation, and allied ...

Is there a reason for that? Please post a link!

I have already explained when I looked on the weekend the registers seemed empty.

And the Guide is so spectacularly unfit for its intended purpose as a guide for GPs it is amazing.

David.

Keith said...

Dr David More MB PhD FACHI said...

"BTW - the HI Service is not fit for purpose when even after 2 years it can go down for more than 24 hours.

Keith I am sorry but your comment really points out just what a mess all is."

I agree entirely; the only discrepancy I was pointing out was the appearance of some entries in the register. Other than that we are in complete agreement - it's a mess and one that will be hard to undo.

Keith said...

Anonymous said:

"You couldn't find AMLN because no such organisation exists - it's AMLA!"

Here's a clip from a ministerial press release of 7 Feb 2012:

"Health Minister Tanya Plibersek today announced that AGPN’s proposal to form the Medicare Local national body, to be called the Australian Medicare Local Network, has been accepted by the Government."

Anonymous said...

AMLA's web-site is http://amlalliance.com.au/

Dr David More MB PhD FACHI said...

Thanks for that. The Alliance is clearly a work in very early progress with an interim CEO and an empty CEO blog - but a seemingly large cohort of administrators!

I really look forward to a credible evaluation of the effectiveness of MLs.

David.

Anonymous said...

Medicare Locals are not equipped to drive eHealth uptake. Look at the diversity of agencies they have to deal with - medical practices, allied health professionals, residential aged care facilities, community pharmacies, community health services, shire councils,etc, etc. etc. Added to all that there is a wide variety of software vendors servicing this extremely diverse group of health providers.

Can any tell me how a Medicare Local with their limited resources are going to sort all this out when DOHA and NEHTA have made such a mess of it notwithstanding all the resources they have had available - money, people, experts of every kith and kind?

Anonymous said...

"$50 million for Medicare Locals to help rollout eHealth records" see http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr12-tp-tp047.htm

with 60 odd medicare locals, that's about 1 million each - so you can buy a lot of scratches with that!

Anonymous said...

50 million dollars you say. Mmmm - well here are two intelligent questions looking for two equally intelligent and compelling answer.

What do you think each Medicare Local spend its $1 million on?

What will be the end result, the actual deliverables on the ground, after an expenditure of 1 million dollars?

Anonymous said...

AMLA will be spending the $50m on PwC