Tuesday, April 23, 2013

It Looks Like The DoHA CIO Is Confirming The View Of Recent Poll Responders Regarding the Value Of the PCEHR.

The following appeared a little while ago.

Govt unlikely to meet e-health sign-up target

Data already delivering insights.

The Government will likely struggle to meet its target of 500,000 registrants for the personally controlled electronic health record (PCEHR) by June, after it was revealed only 109,000 Australians had registered in the last nine months. 
The system, launched last July, has been plagued with issues, including with its online registration system and availability for general practitioners.
Speaking today at a conference on big data in health, Department of Health & Ageing chief information and knowledge officer Paul Madden encouraged attendees to sign up to the program.
He said the $628 million e-health records project had the ability to change the game for health, with significant flow-through data from the records already being gathered.
So far, Madden said, the e-health records of the 109,000 people already registered had delivered 5.4 million Medicare records, 2.9 million pharmaceutical benefits claims, 16,600 immunisation registrations for children over the age of seven, and 23,000 organ donor records.
Only two hospitals are currently uploading discharge summaries to the system. All public hospitals were expected to be doing so by July, Madden said.
More here:
Mr Madden seemed to confirm my view as to what the NEHRS was actually for (Administrative and Departmental Purposes) with the comment that “significant flow-through data from the records already being gathered.”
Interestingly he suggested all public hospitals will be uploading discharge summaries to the NEHRS by July  (without specifying a year). I wonder to all those hospitals know they will be doing this in only a little over two months’ time. Equally I wonder what steps have been taken to have the data quality of these summaries improve beyond the state of those typically produced by interns and what will happen in those public hospitals who do not have full time resident staff.
I look forward to being proven wrong but I preserve some healthy scepticism on that specific claim!
David.

4 comments:

Paul Fitzgerald said...

Given that many hospitals don't have a discharge summary at discharge, and the coding for raising a bill or providing a DRG is not done for weeks after discharge, what value does this bring?

Anonymous said...

” Only two hospitals are currently uploading discharge summaries to the system. All public hospitals were expected to be doing so by July, Madden said.”

Public and private hospitals, states and territories, 2009-10 (AIHW)
Public hospitals
Public acute hospitals - 735
Public psychiatric hospitals - 18
Total - 753
Private hospitals
Private free-standing day hospital facilities - 293
Other private hospitals - 280
Total - 573

Total ALL - 1,326

So with a BIG “2” Hospitals providing Discharge Summaries up to the PCEHR, and an “unqualified” 2x at that, then hospital PCEHR participation rates are somewhere in the order of:

Public hospitals
Public acute hospitals - (0.27%)
Public psychiatric hospitals - (11%)
Total - (0.27%)
Private hospitals
Private free-standing day hospital facilities – (0.68%)
Other private hospitals – (0.71%)
Total – (0.35%)

Total ALL – (0.15%)

Oh yeah baby, this PCEHR thingamajig is an undeniable phenomenal success in the Acute sector, approx. 10-months in operation!

For DOHA’s sake, let’s hope they’ve picked 2x “Public psychiatric hospitals” to enable the spinning of an 11% participation rate.

Paul Madden obviously has every right to be excited about the magnitude of taxpayer funded ehealth largesse for little to no outcomes of any seriously measurable note and still be collecting his substantial tax payer funded pay-check.

Here’s a suggestion, how about redirecting some of the millions paid to and received by Accenture in this PCEHR wet dream and have Accenture conduct an analysis and produce a report using their proprietary Public-Sector Value Model on the value of the PCEHR?

They should not get a red cent more of taxpayers monies and an analysis and report of this nature would be a potentially very entertaining, enlightening and maybe somewhat embarrassing read for some high profile bureaucrats and the author of the report. Just a suggestion.

Anonymous said...

"5.4 million Medicare records, 2.9 million pharmaceutical benefits claims, 16,600 immunisation registrations for children over the age of seven, and 23,000 organ donor records".

Without a similar comparison to those who DON'T have a PCEHR for the same period of time, these figures are just useless. But they are big, so they look great!

Bernard Robertson-Dunn said...

I updated my "registered users" spreadsheet with these new data.

In nine months there have been 109,000 registrations. To achieve their target of 500,000 this financial year there needs to be about 130,000 registrations per month.

I don't like their chances.

There is a claim that the average Australian visits their GP four times a year.

Does anyone know if that is the average (number of visits to GPs divided by four) or is it the mode (the most common number of visits by Australians, per year)? Same for scripts, dentists and specialists visits?

This is a critical number when calculating the value to the community of the PCEHR.

It should also be remembered that the PCEHR is unlikely to add much value to a patient who regularly goes only to the same GP, who already has their full health record.