Tuesday, November 27, 2012

It Looks To Me Like Those Operating The NEHRS Are Not Very Good At Their Job. Additionally No One Is Using It.

This very revealing article popped up today in The Australian.

More bumps in e-health road

THE Gillard government's personally controlled e-health record system is facing more bumps in its rollout following frequent disruption to its software vendor testing environment.
In the past seven months, only five vendors have passed the requirements for their software to be connected to the live e-health production platform. There are more than 250 software vendors who need their 300-400 products certified for the PCEHR.
The PCEHR is intended to be a secure electronic summary of people's medical history that is stored and shared in a "network of connected systems".
Software used by hospitals, GPs, allied health professionals, dentists and radiologists is often custom-made and needs to be compliant with the web-based national PCEHR system.
The longer it takes to test the systems, the longer it will take to roll out the software to hospitals, GPs and others who need to use it.
Sources close to the e-health project told The Australian the test environment had been going offline two to three times a week. This included planned and unplanned outages. The Department of Health and Ageing declined to comment on the outage frequency.
However, a spokeswoman said: "Obviously the test environment exists so things can be trialled before going live in the main system. That's the normal way IT systems like this operate the world over."
As recently as last Tuesday, the test system was offline for nine hours, but the spokeswoman said the test environment was stable.
She declined to provide reasons for unplanned outages.
The test environment had been available to software vendors since April this year, she said, adding that unavailability of the test environment had no impact on the live system.
"Software vendors are not permitted to connect to the (live) production system without passing testing in the software vendor test environment," the spokeswoman said.
"The test environment has absolutely no impact on the access to or functionality of the main system -- that is, patient and doctor use of the main system is not affected at all."
She declined to say how many times the test platform had been offline since it became available.
Meanwhile, 19,617 people had registered for an e-health record, the spokeswoman said.
The full article is here:
Looks like the system is unstable and no one much is using it. Worse those who have to use the test environment are being messed about.
As for clinical use this paragraph says it all.
“As of last Thursday there were 16 shared health summaries and one discharge summary uploaded into the PCEHR, the spokeswoman confirmed.”
Amusingly in a separate article we discover the geniuses who are running the program are so worried people might be alarmed about how things are being done that they have blocked the management minutes from FOI. This really shows they have something to hide! See here for article:
All in all this just seems to be going from bad to worse...At this stage it seems to be costing $20,000 per summary. The Return on Investment on all this is a bit dubious to say the least.
David.

7 comments:

Anonymous said...

Oh dear, only a few lonely clinical documents in the NEHRS? But understandable, because the connecting clinical systems can't get their systems going if the test environment is not stable, and/or if the specifications keep changing. The next few months will provide a better indication - if we don't have substantial take-up by mid 2013, then I think the writing will be on the wall for the PCEHRasaurus. What is the benchmark for success? Perhaps 10% of discharge summaries uploaded?

Anonymous said...

Don't quite agree with this assumption that no-one is working on this. There are at least 12 vendors in the process of testing at the moment in the test environment. There have been a few times it has been down due to Medicare services, but overall there is an awful lot of testing required before a product can connect to the health record, as there should be. This is why it has taken many vendors more than a year to get ready for connection. I believe that a measured, steady approach is the safest from a clinical perspective and beats rushing the system into place.

Dr David More MB PhD FACHI said...

"I believe that a measured, steady approach is the safest from a clinical perspective and beats rushing the system into place."

Not that this was what did not happen with the initial 'go-live' but I agree strongly!

Right now it looks like the only ones using and testing are the vendors - not really the public.

David.

Keith said...

Dr David More MB PhD FACHI said...

"I believe that a measured, steady approach is the safest from a clinical perspective and beats rushing the system into place."

Yes, like what is being done with the prescription exchanges? In that case eRx and Medisecure are supposed to come up with interoperable systems in just 26 days from now, without a test environment and without a common specification, let alone a standard. But I forgot - DoHA is throwing money at that problem!

Going back to the PCEHR/NEHRS there is NO incentive for the public to use it until there are some GPs on board. Even then takeup will be slow: if 20% of people register and 20% of GPs, then the people who can get summaries uploaded are only 20% of 20%, ie 4% of the population.

Anonymous said...

Not that this was what did not happen with the initial 'go-live' but I agree strongly!

A convoluted double negative tautological comment. What does it mean?

Remove the negatives - this was what happened with the initial go-live but I strongly agree.

Exactly what do I strongly agree with?

Dr David More MB PhD FACHI said...

You agree with the fact that political imperatives meant issues like bugs and patient safety were treated as very much second or lower order issues at the July 1 'go live' for the NEHRS.

David.

Cris Kerr said...

Other lower order issues are;

(a) no capacity for patients to self-report their health outcomes, i.e.; treatment effectiveness (or not), side effects, etc;

(b) no plan to ensure meaningful use through comparative treatment effectiveness, which would help rein in escalating healthcare costs and shore up the sustainability of taxpayer subsidized healthcare into the future, and;

(c) no indication that Australia has done anything to slow or stop progression toward a US-style private patient user-pays (mortgage your home) healthcare future where the quality of your healthcare will be okay... right up until your bank account has been emptied.

European Crisis Spurs Drugmakers to Pull Back Treatments
http://www.businessweek.com/news/2012-11-27/european-crisis-spurs-drugmakers-to-pullback-treatments#p1