Tuesday, August 20, 2013

The National Press Club Health Debate Next Tuesday Might Be Fun. Looks Like E-Health Is Seriously On The Coalition Radar.

This release appeared late last week:

Labor’s $1 billion E-Health Debacle

16 August, 2013
Labor’s implementation of an e-health patient record is a $1 billion disappointment.  With nearly $1 billion spent on the program, it has failed to deliver anywhere near what the Labor Government promised.
The e-health program has been shown to be more about politics than about policy and more about spin than about outcomes for patients.
“Australian Doctor has reported that there are only 4,000 e-health records in existence.  At a cost of $1 billion that works out at $250,000 per record,” said Peter Dutton.
“This latest development proves this government is incapable of delivering on e-health.  It speaks volumes about Labor’s incompetence,” he added.
Apart from the very low take up rate, the system itself is deeply flawed.  The Government has been throwing good money after bad, spending money getting Medicare Locals to sign people up to a program that does not yet have basic clinical protocols in place, let alone support from clinicians.
“The Coalition continues to provide in-principle support for e-health, but shares the concern of many in the sector about Labor’s incompetence in managing the process,” said Mr Dutton.
The previous Coalition Government achieved significant improvements in the computerisation of general practice, from 17 per cent to over 94 per cent, by working with the profession and implementing effective policy. 
“If elected, the Coalition will assess the true status of the PCEHR implementation and again work with health professionals and the broader sector to provide real results on this important reform for patient care,” Mr Dutton said.
The e-health debacle follows a pattern of waste and incompetence from the Labor Government.  It joins the ranks of catastrophically mismanaged programs such as pink batts and school halls.
It also follows Labor’s failure to deliver on its much promised GP Super Clinics and the 16 Early Psychosis Prevention and Intervention Centres which never materialised.
The release is found here:
There is some commentary and background here:

Coalition slams Labor’s “$1bn e-health debacle”

news Shadow Health Minister Peter Dutton has taken a pickaxe to the Federal Government’s Personally Controlled Electronic Health Record (PCEHR) scheme, claiming the costly project was “more about spin than about outcomes for patients”.
The project was initially funded in the 2010 Federal Budget to the tune of $466.7 million after years of the health industry and technology experts calling for development and national leadership in e-health and health identifier technology to better tie together patients’ records and achieve clinical outcomes. The project is overseen by the Department of Health and Ageing in coalition with the National E-Health Transition Authority (NEHTA).
However, last month the Government revealed it had failed to meet it initial 500,000 target for adoption of the system, with only close to 400,000 Australians using the system at that point.
At the time, University of Western Australia software academic David Glance severely criticised the scheme. “… even if the government had met the target of 500,000, it would have been a meaningless gesture,” Glance wrote at the time. “The vast majority of those who have signed up, if they ever get around to logging in, will be greeted with an empty record.”
“Given the lack of active participation on the part of GPs, as well as the lack of public hospital systems to integrate with PCEHR, there’s little evidence to suggest that this is going to change any time soon … GPs still struggle to see the benefit of spending time curating shared records when the legal liabilities are still unknown but are potentially severe.”
Just last week The Australian newspaper revealed that NEHTA had lost a number of senior executives, including clinical lead Mukesh Haikerwal.
“The question is simply: If these experienced clinicians and e-Health ‘experts’ thought the PCEHR was a winner would they be bailing out at this time?” wrote prominent Australian e-health blogger David More in response to the news. “Surely they would want to be around for the kudos and rewards that would flow from a successful program?”
“The answer is really easy. Those who are leaving know vastly more than you about the program and its risks and benefits – and yet they want out. It makes it totally clear this is a lemon on which no more time should be wasted by you or your colleagues until [The Royal Australian College of General Practitioners] and the [Australian Medical Association] are convinced – and say so and it is properly redesigned and fixed, so that the PCEHR is now both useful, safe and fit for purpose.”
More here:

Election 2013 Health Policy Debate

The Hon Tanya Plibersek MP Vs the Hon Peter Dutton MP

August 27, 2013

11.30am - 1.30pm

Here is the link:
Both Sky News and ABC News 24 typically carry these events live.
See here for example:
It will be great fun to see what is actually said on the day.
Given where the betting markets are at present on the outcome of the election I suspect what Mr Dutton has to say will be pretty important, given the press release above.
David.

12 comments:

Anonymous said...

3 years before the shadow minister actually has said something about the PCEHR.

Must be election time.

Anonymous said...

When big poorly conceived projects like these fail it must be tempting to try and rescue them, but that is a money pit. I don't think the fundamentals of this project are solid enough to rescue it. Its someones idea of applying the social networking movements ideas to eHealth and ignoring the workflow issues that make or break a project.

The reality is that the tortoise wins the race and no one has bothered to hone and refine what we have working and incrementally improve the foundations of eHealth to a point where something solid and useful can be built on them. This is an "announceable" in true Modern labor fashion. A thought bubble quickly inflated with 2 billion dollars of other peoples money. Anyone stupid enough to try and keep it inflated will end up with it all over their face. The UK managed to spend 12 Billion pounds, does Tony Abbott what to try and beat that figure but trying to keep a failing Labor announceable alive? If they do they are no better than Labor. As health Minister he smelt a rat, but created Nehta... Lets hope he cleans this mess up enough to eradicate the infestation that has been chewing on taxpayers dollars from the inside.

Bernard Robertson-Dunn said...

By most, if not all accounts, the PCEHR has not been a roaring success.

My guess is that the current government will now sell the PCEHR as eHealth infrastructure which will enable future initiatives to be delivered.

However, IMHO, the PCEHR fails on two counts as infrastructure.

The first is that, for something to be useful as infrastructure, it must do what it is supposed to do efficiently, effectively, reliably and in such a way that it can easily be incorporated into a variety of other initiatives which themselves deliver high value outcomes.

I don’t think the PCEHR does anything particularly well, in fact it seems to create more problems than it solves. It is also not obvious what other high value health initiatives it might enable.

Second and more importantly, it must be supported by other infrastructure - very little, if any infrastructure exists in isolation.

As an example, think of the electricity generating infrastructure. The number of uses of electricity is enormous. It is used to power machines, to generate light and heat, in communications devices, to smelt aluminium etc, etc.

Electricity is also part of larger ecosystems - coal mining and transportation, solar and wind power industries, transmission, control and automation systems, communications and metering systems, etc, etc. All these other things are just as much infrastructure as is electricity generation.

Compare electricity generation with the PCEHR. What are the other systems that will use the PCEHR? There may be some, existing or proposed but I'm not aware of any. The PCEHR looks very much like a simple replacement of existing record keeping systems.

If the PCEHR is infrastructure, what is and who has the budget for the rest of the ecosystem? I suggest that an infrastructure component would integrate into a larger ecosystem that costs between two and ten times that of that component.

Where is this other infrastructure into which the PCEHR will integrate? What is it? Who will create and runs it? How much will it cost to deliver and operate?

It looks to me as though it is wishful thinking to consider the PCEHR as infrastructure. The claim is being used as an excuse to justify the enormous expenditure on something that is not delivering improved health outcomes and which does not seem to have the capability of doing such a thing.

I’ll be watching to see if the “PCEHR is infrastructure” argument gets used in any political debate. And the reaction to it.

Anonymous said...

IMHO
Unlike the schools program, which helped to invest in and crank up local business at a grass roots level, the PCEHR debacle has almost destroyed local business.

The fat cat overseas consulting companies have creamed off hundreds of millions here for a classic unconscionable no-delivery of nothing more than a content management system!

This is a disgrace of "payroll proportions" with hundreds of millions of our money being wasted.

The rats have left the sinking ship! I wonder where the million dollar a day man is these days?

What an absolute disgrace, shame on you DOHA!

Anonymous said...

What about the dopes at DOHA who have been providing the labour Ministers with daft ideas? I think you would find the Ministers were sold this by public servants juiced up by expensive consultants. I would put NEHTA in that bag as well. The top at the CEO and Board level should be held to account. At least through elections we get rid of politicians. The same can't be said for high ranking public servants and the NEHTA CEO and Chairman.

Anonymous said...

"The rats have left the sinking ship! I wonder where the million dollar a day man is these days?"

He's off working with the mob that were awarded the PCEHR contract of course -

http://www.itwire.com/it-people-news/people/59804-orion-health-brings-in-public-private-sector-e-health-veteran

Anonymous said...

""The rats have left the sinking ship! I wonder where the million dollar a day man is these days?"

He's off working with the mob that were awarded the PCEHR contract of course -

http://www.itwire.com/it-people-news/people/59804-orion-health-brings-in-public-private-sector-e-health-veteran"

And is it true that before he went to Nehta the million dollar a day man was working for Accenture?

Anonymous said...

"And is it true that before he went to Nehta the million dollar a day man was working for Accenture?"

Only for 15 years.

Anonymous said...

Let's not forget the interim interloping as the CIO of DHS Victoria including the complicity with the VIC HealthSmart debacle, and not to mention the interlude as NEHTA's Acting CEO where the plans and business case for the SEHR/IEHR/PCEHR were hatched!

Embezzlement of the taxpayer of the highest and most deceitful order.

Anonymous said...

Is it possible or feasible that the PCEHR be taken over by a private consortia?

Anonymous said...

"Is it possible or feasible that the PCEHR be taken over by a private consortia?"

not unless you want to change the Act's.

And it's all oracle, orion, accenture so no choices really other than those ones.

DOHA would never give up the thing.

Anonymous said...

Why would they do a silly thing like that?

Only feasible if they're either:

1) Foolish enough to be parted with their funds by a very bad investment; or
2) Looking for a very BIG capital investment loss to offset a really large Tax bill

Safe to say this eHealth Lemon is well and truly rusted-on to the forsaken and downtrodden NET Taxpayer!