Sunday, September 29, 2013

Senator Boyce Gets The Most Recent Collection Of Non-Answers From NEHTA at Senate Estimates From June This Year.

There were five interesting responses among about 30 provided.

Subject Outcome: E-Health 10.2

Agency: NEHTA
Issue: NEHTA – Standards/Functionality of the PCEHR
Name of Senator: Sue Boyce
QUESTION: 21
Senator Boyce asked:
Given the safety implications did NEHTA issue any form of warning alert? If not why not?
Answer:
The information provided within the AMT fully describes and accurately identifies medicines. The descriptions listed in the AMT are correct. These are based on current Editorial Rules and accurately describe the products. The major issue relates to the different representation of the order of ingredients within the AMT Medicinal Product and Medicinal Product Pack descriptions which do not match the order on the product packaging. These are generic concepts and are not intended to reflect actual product labeling. Examples exist where different brands of the same set of ingredients have product labels with ingredients in different orders.
The issue or ingredient order for all medicines has been considered on a number of occasions by the AMT Support Group and late in 2012 an alphabetical approach to ingredient order was proposed and agreed. This would then result in descriptions that were clear and consistent. The Support Group is made up of representatives from Pharmaceutical Benefits Division, the Therapeutic Goods Administration, various state health jurisdictions, clinicians, medical software vendors and relevant professional organisations.
QUESTION: 24
Senator Boyce asked:
Is it true that all the stakeholders in Standards Australia - 44 of them - with the exception of DOHA and NEHTA have lost confidence in, or are concerned about, the standards now being applied to electronic prescriptions?
Answer:
This matter should be referred to Standards Australia. NEHTA cannot comment on the Standards Australia’s stakeholder’s confidence levels.
QUESTION: 27
Senator Boyce asked:
Given the importance of transparency in encouraging co-operation, clarity and trust why hasn’t NEHTA/DOHA released PCEHR safety Report Part B and the HI Service pre-commissioning safety report?
Answer:
NEHTA’s Clinical Safety Unit (CSU) works very closely with the Department of Health and Ageing in its role as System Operator of the PCEHR. This includes participation by NEHTA CSU in key committee processes including review by the Clinical Safety Working Group and Clinical Governance Committees. These Committees provide a forum for the safety assessments presented in the PCEHR Clinical Safety Case Report so they can be thoroughly considered in the development, testing and operations of the PCEHR. The reports are released and shared between forum participants. The Australian Commission on Safety & Quality in Healthcare have undertaken two of four audits of the safety of the PCEHR and the methods and processes that determine its creation. The clinical safety case reports are a key input to these audits and include findings noting that partner organisations continue to ensure that clinical safety case reports are shared appropriately between agencies and form a basis for ongoing risk management of the PCEHR. This work will ensure that recommended mitigating controls are being acted against and that existing mitigating controls can be evaluated for ongoing effectiveness.
QUESTION: 28
Senator Boyce asked:
Given the widespread concern expressed by stakeholders in regard to issues of safety and privacy surrounding the concept and construction of the PCEHR why has NEHTA shown continuing reluctance to release PCEHR safety and compliance reports?
Answer:
The PCEHR Clinical Safety Case Report assessments and recommendations are a key input to processes underpinning the continuing development, testing and operations. The report is released in the context of key governance processes important to clinical safety including review by the Clinical Safety Working Group and Clinical Governance Committees. The Australian Commission for Safety & Quality in Healthcare are leading through the audit activities the evaluation of arrangements for sharing the outputs of the NEHTA CSU.
QUESTION: 31
Senator Boyce asked:
It’s also alleged by certain vendors that AMT codes in the PBS distribution appear to be different from AMT codes for the same concept in the AMT distribution. Is this correct and if so what are the consequences if that is not rectified?
Answer:
If the question being addressed is “Do all AMT codes contained in the PBS exactly match codes contained in the NCTIS AMT releases” the answer is no. PBS have on occasion the need to allocate their own ‘AMT-like code’ due to differences in how a product may need to be described for legislation/ reimbursement purposes and the corresponding AMT description contains either too much/too little detail (e.g. inclusion/exclusion of a container type or salt of a substance). In these cases, PBS create their own description and use their own namespace identifier (a 7 digit ID which appears within the full identifier string) to differentiate it from a true AMT code.
NEHTA and PBS will continue to work together to ensure quality mapping processes and alignment between the releases. NEHTA anticipated that there would be a number of questions from vendors around inclusion of AMT codes and descriptions in PBS files and has drafted an FAQ document outlining some of the most likely questions to assist and guide vendors.
You can download and read all the answers from this link:
What we have here, to me, is foot dragging, denial and refusal to be open to potential problems and to have a reasonable sense of urgency in fixing potential issues.
I wonder will the change in Government lead to an improvement in openness and transparency or will Mr Dutton simply get rid of NEHTA.
Place your bets in the comments section.
David.

3 comments:

Anonymous said...

Mr Dutton cannot get rid of NEHTA. He is not a shareholder although his Department is. However his Department is only one of 9 shareholders and all shareholders I think have equal votes. If the State withdrew from being Directors and Members of NEHTA Mr Dutton and hos department could do what they liked. Perhaps them they will not get rid of NEHTA but bring it back inside the DOH and subsume it into the bureaucratic cesspool unloading as many NEHTA employees that it can in the process.

Dr David More MB PhD FACHI said...

See what has happened to the NBN to see what a Federal Minister can do!

David.

Trevor3130 said...

Won't it depend on whether the aims of the PCEHR can be re-framed? I mean, with the (original?) rationale for greater efficiency, safety & cost-effectiveness of health care, no matter how that is sliced & diced "success" means shifting resources and eliminating the inefficiencies. Those loose ends are mostly salaries and profit margins. No matter from where the fat would be trimmed, private or public domain, someone would lose. The losers may be obstructive and resentful of change. Trimming of bureaucratic empires is not a task for the faint-hearted.
The answer is likely to be a good deal of mature reflection, then an inquiry (or two, since the realms of NeHTA and DOH are separate). Inquiries taking up most of 2014-15 will allow the culprits to slip away quietly, to the usual modes of post-APS employment.
In the meantime, it may prove useful to get behind some of the Health-IT goings-on in States. Plenty of money to burn there, by the looks. Whether there's a helpful plum or two to pull out, though, that's another matter.
I'll be looking forward to the day when Mr Dutton is struck by the wonderful powers of the Surface2, and issues a few thousand of them to HCWs as the answer to all his problems.