Wednesday, December 18, 2013

After Developing The PCEHR For Two Years and Having It Live for 18 Months NEHTA Notices It Does Not Work Very Well!

This appeared a little while ago on the NEHTA Web Site:

Usability Feedback

PCEHR Viewing
Software vendors have implemented the ability to draw down a list of documents available from the PCEHR for a given patient. Each vendor has implemented a process for sorting and filtering these documents. Feedback received from primary care clinicians suggests a common method of presenting this information (called a Health Record Overview or HRO) would be valuable.  The PCEHR infrastructure will be modified to support the HRO. Subsequent to that, primary care software vendors will build the HRO into their software products. This work is underway, with the first software able to display the HRO expected to be available in mid-2014.

Positive feedback has been received from clinicians regarding the prescription and dispense “smart” view available in the PCEHR (and some software products). This functionality allows the user to filter and sort medication, prescription and dispense records within a patient’s PCEHR in a variety of ways. Where software does not include this function, clinicians can still see the records in a static list together with all other clinical documents based on the date of submission of the document to the PCEHR.

Shared Health Summary Uploading
Feedback has been received about the process for populating and uploading a Shared Health Summary, and the way in which some information is handled within the document. NEHTA has worked with representatives from the peak health bodies to provide further guidance for software vendors on these issues. Primary care software vendors can now start incorporating this guidance within their respective products and release the enhanced software to their users. NEHTA will publish a list of software vendors that have released products addressing this usability guidance.
Accessing PCEHR Functionality within Software
Feedback has been received about the way primary care software systems access the PCEHR, where the PCEHR functions are located, and whether or not a patient has a PCEHR. This guidance has now been released to software vendors.

Event Summary
Feedback has been received from primary care clinicians that they are unclear about what information to include in an Event Summary, and in which situations they would use one. NEHTA intends to produce guidance material relating to this in early 2014.
This information is found here:
How astonishingly incompetent are these guys? For years, at least, I have warned about how clumsy and inaccessible these PCEHR is and how much worse that will become as you add more records. Anyone who has a PCEHR record and is on any regular medications would have been aware of the issue ages ago. Because this obvious flaw was not addressed ages ago the vendors have tried to patch an obvious gap, done it in different ways and we have wound up with systems which work different ways.
This and the other issues would have been spotted ages ago had there been proper development,  testing and acceptance processes and some well planned initial implementations to ensure the system was useable.
To have taken 18 months to come up with these obvious flaws is a testament to just how out of touch with clinical reality NEHTA and DoH are.
As far as not having defined and been clear as to what should be in Event Summaries is just a horrible joke!
Again we see the issues that flow from poor communication, leadership and governance as well as implementing to a political time-table rather than a properly planned and tested time-table.
If there is any plan to attempt to fix the PCEHR then we must ensure none of all the guilty parties have anything to do with it.


Anonymous said...

Come on David we can see why the masters of ass covering at NEHTA have suddenly posted this days before the independent review is to be published.

I wonder what other master ass covering will be drip released by them to soften the blow from the review.

Hey NEHTA, incompetent is your name and massive failure is your game.

Bernard Robertson-Dunn said...

Maybe all these things were in the mysterious documents that K has claimed I haven't read, but not told us where they are.

And as for K's question "The problems were ambition, timeframes, conflicting views of the requirements that couldn't be reconciled, and politics. How do you propose to solve these things?"

a) These are things I and others have been pointing out for years but nobody seems to have learned from such feedback. Hence my caustic, but probably true, remark.

b) Do you really think anyone is going to ask me to help solve these problems? And I have offered.

K said...

BRB, ok, most of the documents probably weren't released outside of NDA with NEHTA. I'll add obsessive secrecy as a strategic misfit between NEHTA's mission and goal - and that one is NEHTA's fault, unlike other things.

Yes, these lessons are ones that have been well known for years but this time is always different. I'm surprised anything at all got across the line.

I do think that there was space for more understanding of health informatics, but I think the problems are much deeper than that.

I recently saw a presentation on good project governance given by someone running a somewhat similar project to the pcEHR. Everyone of his "best project governance" check points was checked 100% by the pcEHR - they managed the hell out of a project that missed out on the biggest governance requirement of all: doing something sensible in a sensible timeframe. There's going to many more projects go down the gurgler yet....

Bernard Robertson-Dunn said...

Thank you.

I suspect I agree with just about everything else you say, although we may differ which issue is more important than others.

I especially agree with your comments on governance. Governance cannot make up for a project having no idea about what they are trying to do. Or, as I have quoted before:

“Successful problem solving requires finding the right solution to the right problem.
We fail more often because we solve the wrong problem than because we get the wrong solution to the right problem”
Russell Ackoff 1974.

BTW, It's brd, not BRB.

Anonymous said...

Astonishingly incompetent is kind praise in extremis for these guys.

Obfuscatory rubbish beyond all comprehension – “Feedback has been received about blah blah blah .. .

These academic PhD morons with no first hand grass roots industry experience continue repeatedly demonstrating they know nothing about deploying complex systems, beta testing and proof of veracity.

Can they swan-con Richard Doyle and Steve Hambleton with a little help from the Department’s Mistress swan-con herself leaning on the Minister?


Perhaps Joe Hockey, Mathias Cormann and Tony Abbott will assist the Health Minister to cut this flagrant wastage of public funds once and for all.

Anonymous said...

Yep - sharing this decision is a great idea because no-one can be blamed for terminating this disaster, the Secretary can be blamed for continuing to let it fester along out of control year after year (her use-by date in nigh) and the previous Government can have the dubious honor of having been the instigator of yet another massive failure. Lovely solution all round.