Tuesday, March 05, 2013

It Seems Others Are Starting To Notice The NEHRS May Not Be A Well Structured System.

This appeared a few days ago.

Opinion: Should e-health be more about relationships?

Placing the consumer at the centre of a consolidated health data repository may not be the right approach
The concept of a Personally Controlled Electronic Health Record (PCEHR) might be the correct political tactic to address ethical concerns around the confidentiality, consent and involvement of healthcare providers in accessing electronic health records.
But the decision to place the consumer at the centre of this national health information repository may not prove to be the right approach.
Last month, it was reported that the Federal government’s PCEHR initiative, developed by Australia’s National E-Health Transition Authority (NEHTA) had failed to reach the expected uptake of 500,000 consumers in the first year.
NEHTA’s consumer-driven model is also facing another potential hurdle with US company MMRGlobal’s claim that NEHTA may be infringing on patents issued to its subsidiary MyMedicalRecords.com. See here:
The firm is investigating whether federal and state governments, through NEHTA, have infringed on two patents that cover a method that enables consumers to access health records through their personal account using the PCEHR system.
This begs the question: Has too much emphasis been placed on an individual electronic health record (EHR) rather than a “shared EHR”, which recognises the importance of the relationship between consumers and their healthcare providers in sharing information?
Should a national electronic health record service place the relationship between consumers and healthcare providers at the heart of the data repository – allowing this relationship to govern the consolidation, contribution and protection of health data?
Relationships with our healthcare service providers govern our interactions with healthcare professionals and the level of care they provide us. Establishing meaningful and beneficial relationships between consumers and their healthcare providers is fundamental to the success of healthcare services.
Service providers recognise the health and financial benefits of providing and maintaining long-term and continued care to their clients and consumers want to receive care from providers they trust.
The long-term value of the relationship between healthcare providers and consumers is what encourages information sharing and the quest for better access to better health information.
Information shared between a consumer and healthcare provider belongs to both parties in joint custody – they don’t need to argue about who owns the information when it is disclosed by a consumer or given by the healthcare provider. The information is contributed jointly to benefit of both the consumer and the healthcare provider.
Lots more here:
What an interesting take. As I have been saying for the last few years the NEHRS is a ‘barnacle on a battleship’ in terms of lacking centrality in both a technical and more importantly a patient - provider sense.
Maybe some sanity is emerging?


Trevor3130 said...

Ecology, or relationships, is one of the several good, succinct points made in the Patrick & Ieraci paper (MJA).

Anonymous said...

NEHTA and DOHA have been disastrous from the outset at establishing any form of community ecosystem for the PCEHR.

To compound this, they have alienated the software vendors that had established relationships with important user groups, clinicians and patients and were capturing useful information that could be shared. The damage has been done. The money has been wasted.

To successfully engage an eHealth ecosystem, you need to be somewhat of an Orchestra Conductor. If you are only capable of communicating with the violinists then you are not going to produce a symphony.

One of the most unforgivable acts in the whole engagement and so-called collaboration process was the sidelining of HCN / Medical Director because of the apparent abrasiveness and arrogance of General Manager John Frost (or perhaps it was just an ivory tower perception of "I know best and you can get stuffed".)

The trouble is, most of the these bureaucrats and consultants have never done this before, or achieved any notable success in eHealth. Nor have they invested their own money into anything that required a return on investment.

Everybody knows that Singapore was botched up by Accenture, Orion and Oracle as well. And Singapore is smaller than Tasmania in terms of reach and it has less jurisdictions to worry about.

I heard some very disturbing things today from public servants about the apparent lack of useful data and usability in the PCEHR to make me wonder if it was in fact a train wreck.

In terms of accountability, and learning from mistakes, a very thorough review of what went wrong needs to take place and then those responsible need to be moved onto another industry with a good dose of public humiliation.

Naming and shaming would be highly appropriate.

Anonymous said...

US firm accuses NEHTA of delays in patent infringement probe http://www.theaustralian.com.au/australian-it/government/us-firm-accuses-nehta-of-delays-in-patent-infringement-probe/story-fn4htb9o-1226590257738

Anonymous said...

In other news, US based patent troll complains that they aren't getting their pay off quickly enough, and they might go bankrupt before the money turns up. Pity that. The Australian should do a little thinking and fact checking before they report this stuff.

What I see is that they're attempting to prosecute this via the press. They made a claim that NeHTA knew about this and had talked to them about it. This latest press release now says that NeHTA must have known about it because they spent lots of money on the system. I'm not sure how that follows at all. Nobody on this blog seemed to know anything about it before they started making media releases.

It looks to me like they keep making claims, then when asked to back up those claims they cannot. Surely it's the job of the fourth estate to hold these guys to account, not to just breathlessly report their claims? Especially given they now have form for making statements that they cannot support.

Very interesting that they're unwilling to share the correspondence with NeHTA but keen to make assertions about what might or might not be in it. That should be a big red flag too.

Anonymous said...

3/05/2013 11:52:00 PM said –
Everybody knows that Singapore was botched up by Accenture, Orion and Oracle.

Someone should tell Jane Halton if she'll listen. Who was responsible for giving it the thumbs up?

Anonymous said...

"Everybody knows that Singapore was botched up by Accenture, Orion and Oracle."

But the good thing for Singapore is that it would have cost a fraction of what Australia paid!

Who made this NEHRS recommendation? How did Nehta manage to spend $150m in 12 months on overseas suppliers for something that was untried, untested and clearly unusable. At 16 clinical documents we are looking at $9m a document as of 5 months operation, what a clear disaster!!

Dear Minister, respectfully, never mind 457 visas, at least those workers spend some of the money here! What about the $150m your department sent overseas for the pleasure of a useless system. There was inadequate involvement of local stakeholders and there remains no accountability for this disastrous mess and lack of stakeholder involvement!!! They still don't get it, watch what happens with the Aged Care tender that DOHA has put out!

At least the schools program got the construction industry working at a really tough time. This program just sent the money overseas, big time, while Nehta managers bragged about $1m a day being poured out ???!

Dear Minister and Shadow Minister, I would be putting a big red cross against anyone associated with this debacle!

Oh, not to forget a big thank you to Accenture, Orion and Oracle! Job done team!