Sunday, October 12, 2014

Could It Be True A Proper Audit Of NEHTA and How It / Has Been Performing Is About To Be Conducted?

My various informants who attended to RACGP Conference last week noted that there was a rumour running around that the Victorian Auditor General was soon to be asked to review NEHTA with respect to how it had done and how it was going in terms of providing value to the community and whether it should continue or not. The rumours seem to suggest the review is to happen quickly and not take a long time.

It is worth noting that Victoria, like a number of other States, have not paid their recent contributions to NEHTA's running!
In terms of background we learned last year that the Royale Review had recommended major changes regarding NEHTA with the creation of a new governance entity for Australian E-Health to replace and augment their utility and benefit and improve connections with all of the wide range of stakeholders.
We also know the Victorian Auditor General has a good track record in reviewing Health IT Projects - having done a great (insightful and damning) review of HealthSMART.  
Here is the link:
There is commentary here:
And here:
In case it is true a review is planned - and I have been suggesting such a review for ages - I thought assembling the responses to some of the recent polls on the blog might help the AG understand that, at the least, the relatively interested and expert readers of this blog, think how well NEHTA and eHealth Branch of DoH are performing, might be useful.
Here are the results of a few polls
 AusHealthIT Poll Number 239  – Results – 12th  October, 2014.
Here are the results of the poll.

Have DoH And NEHTA Contributed To The Progressive Degradation Of Australian E-Health Standards Setting Processes?

Yes 91% (218)
Probably 1% (3)
Neutral 0% (1)
Probably Not 0% (1)
No 6% (15)
I Have No Idea 1% (2)
Total votes: 240
AusHealthIT Poll Number 237  – Results – 28th  September, 2014.
Here are the results of the poll.

Do DoH and NEHTA Understand The Issues Of Clinical Safety That May Surround The Deployment And Use Of Health IT Systems?

For Sure 4% (6)
Probably 5% (7)
Neutral 15% (22)
Probably Not 33% (47)
No Way 41% (58)
I Have No Idea 1% (2)
Total votes: 142
AusHealthIT Poll Number 235  – Results – 14th  September, 2014.
Here are the results of the poll.

How Would You Rate The Federal Government's First Year In Power As Far As E-Health Is Concerned?

Excellent 3% (3)
Not Too Bad 2% (2)
Neutral 15% (13)
Not Too Good 22% (19)
Awful 53% (46)
I Have No Idea 5% (4)
Total votes: 87
AusHealthIT Poll Number 233  – Results – 31st August, 2014.
Here are the results of the poll.

Do You Believe The NEHTA Leadership Should Be Held Accountable For The Slow Progress In E-Health Over Almost The Last Decade?

For Sure 48% (79)
Possibly 34% (56)
Neutral 6% (10)
Probably Not 5% (8)
No Way 4% (7)
I Have No Idea 2% (3)
Total votes: 163
AusHealthIT Poll Number 232  – Results – 24th August, 2014.
Here are the results of the poll.

Do You Believe The Present Leadership Of NEHTA and DoHA E-Health Initiatives Will Be Able To Deliver A Successful PCEHR?

For Sure 15% (41)
Probably 4% (10)
Neutral 2% (4)
Probably Not 14% (36)
No Way 65% (172)
I Have No Idea 1% (2)
Total votes: 265
I think that the message that flows from all these questions is pretty clear. E-Health has been a fiasco for the last few years led by NEHTA and DoH. The Poll currently running will be very interesting as well.


Anonymous said...

Was there anything "positive" to come from the VIC HealthSMART review?

Were there any prosecutions for the unconscionable waste of VIC Taxpayers' money??

While there should be prosecutions laid against NEHTA management and NEHTA Board members for their role in this grand Taxpayer theft, the chance of this ever materialising is positively negligible, and they knew this which is why they have and will continue to get away with their grand theft at all our NET Taxpaying expense!

Bernard Robertson-Dunn said...

The Terms of Reference will be interesting.

If there is an audit of the PCEHR project then they will ask questions like: was it on budget? Was it on time? Did they deliver what they said they would deliver?

While these are reasonable questions, they do not get to the heart of the matter.

IMHO, they need to ask two questions:

1. What value does/can/could the PCEHR deliver over and above existing and/or planned state and hospital based systems?

2. Is that value worth the cost of developing, delivering and supporting it?

A review of the benefits realisation plan should provide some of the answers, with the proviso that someone actually values the expected benefits.

Anonymous said...

Sadly I think they will ask 'how many people were persuaded to register for a record' against their planned targets and by this measure they will be 'successful'.

Or they might ask how many documents have been loaded, and it will look like a big number because it includes a copy of all the MBS and PBS claims that everyone has made - a duplication of other databases held by the government.

I don't think there was a clear benefits realisation plan ever formed, because there was not a defined business case. This despite them paying the big consulting companies to do the benefits realisation strategy.

Enrico Coiera said...

If we want a real metric of how well used the system is then we must surely ask for the number of downloads from the system - representing a clinician querying the system. We also need to look at how many clinicians are doing this. If there are just a few heavy users then they will give a distorted picture. I suggest we measure a rate which is n downloads per eligible (registered) clinician.

If we want a realistic metric of outcome or impact then I doubt we will see any change in death rates, admission rates or length of stay. We could in a selected sample of clinicians do a short prospective study of the number of decisions changed per patent PCEHR access, and then estimate the benefit of the changed decision.

Anonymous said...

After the Auditor-General has been appointed I would suggest a chronological log of the most relevant comments, cross-referenced to their respective blog, be compiled and the log then forwarded to the Auditor-General.

Only in this way will the Auditor-General be able to develop a wide-ranging comprehensive perspective of the entire NEHTA / PCEHR fiasco.

Anonymous said...

That's a really smart suggestion October 14, 2014 11:43 AM. Although it's a lot of work trawling back through a few years of comments and selecting the ones that make the most sense and are objective and devoid of emotional overtones. It is also important that the comments are precise and free of clutter if they are to be of any use to the Auditor-General.

Dr David More MB PhD FACHI said...

There would be 9842 Comments to be reviewed from the inception of the blog until now! :-)


Anonymous said...

Rhonda Jolly's Parliamentary Library Summary would also be very helpful to the A-G.