Tuesday, August 18, 2015

Is This Madness Or Arrogant Hubris? I Have No Idea! Either Way Someone Has Really Lost the Plot!

This appeared last week:

MyEHR to National eHealth Record Transition Impact Evaluation

Created on Tuesday, 11 August 2015
At the COAG Health Council meeting in Darwin on 7 August 2015, Health Ministers received a presentation on an evaluation of NT’s My eHealth Record service undertaken by the National eHealth Transition Authority.
My eHealth Record has been operating in the Territory for ten years and as such, provides a unique opportunity to analyse the operation of an eHealth record in the Australian context. Like the national personally controlled electronic health record (or PCEHR) system, My eHealth Record captures summaries of information from healthcare events in an electronic record that is under the control of the healthcare consumer and is able to be accessed by providers that they later visit.
For the first time in Australia, we have strong evidence of the benefits of eHealth records in bridging the gaps in information that occur as patients move between different healthcare providers in the public and private sectors. The evaluation provides a clear case in support of the national PCEHR system.
The evaluation showed that eHealth records reduced the time clinicians took to find information, and supported improved clinical decision-making and continuity of care for patients. The evaluation also provides insights into how an eHealth record evolves and is taken up by the community and by healthcare providers. These are valuable learnings for the national PCEHR system.
Here is the link to the release
Now the evaluation shows the NT system is working well. So what is NEHTA’s plan?
They have a transition project to move away from the working and useful system - that has taken 10 years to really work to the unproven PCEHR.
Here is the slide from the presentation!

M2N Transition Impact Evaluation project

  • The MyEHR-to-National (‘M2N’) Transition Project is transitioning the existing MyEHR Service over to the National eHealth Record System (PCEHR)
  • At the request of the M2N Project Steering Committee, NEHTA is conducting an evaluation of the impact of the transition
  • A pre-and post-implementation evaluation approach is being used
  • Phase 1 has been completed prior to transition; it comprised qualitative analysis of n=94 in-depth interviews, and quantitative analysis of close to 15 million system transactions covering 10 years
  • This presentation is an overview of phase 1 results
(Slide 5)
The reasons for doing this are found in the first paragraph :

Implications for the M2N transition

Transitioning to the national eHealth record system offers a number of advantages, e.g.
·         Cross jurisdictional data exchange
·         Additional functionality, with atomised data
However, there were some issues raised that require consideration:
·         Anxiety about the transition, including re-registration
·         Concerns about effect on clinical workflow, e.g. arising from policy differences relating to identifying individuals and accessing records
·         PCEHR system not yet having equivalent breadth and depth of content
These issues are capable of being mitigated by current change management activities
(Slide 45)
So we have a working system that is being migrated to a vastly more expensive unproven non-working system. We also see the benefits seem trivial at best!
I wonder just what geniuses dreamt this up - especially before the PCEHR is proven to be successful.
Surely you leave the working system in place until the PCEHR catches up - if ever - and then plan a migration?
The present plan seems like utter madness to me!


johnd said...

MyEHR is causing NEHTA embarrassment. NEHTA hierarchy would see two things that need to happen. The first is to reign in this upstart as soon as possible. The second is to subsume it, and then ultimately, cannabalise it and take credit for the remaining working parts.
Sorry, but I have no doubt that NEHTA will screw this up, just as it has every other thing it's touched.

Bernard Robertson-Dunn said...

It all sounds rather suspicious to me.

NEHTA is to be closed down. ACEH is supposed to be taking over responsibility for eHealth. Any decision to transition MyEHR to the PCEHR, or whatever it's going to be called, should be made by ACEH.

I would have thought.

Unless there are things going on, about which we have not been told.

So much for transparency, democracy and trust.

Anonymous said...

But perhaps it is all a sneaky plot. Get the proven working NT system to swallow up, digest/excrete the DUD system. Then the whole thing might work.

Anonymous said...

We are in danger of becoming a cargo cult country. There is management, pdfs, presentations and action plans, not to forget the important change management! What we don't have is any solutions to the problem. The managers have done every thing right, they are sure of that. Now why is there no "Cargo" appearing? Shame they didn't pay any attention the underlying problem or employ people with an deep understanding of the problem. They just cause trouble after all.

Anonymous said...

How do you transition the data from a functioning system (the NT MyEHR system) into a system (PCEHR) that "does not yet have equivalent breadth and depth of content".

1) you dumb down the NT MyEHR system to less
2) You fix the PCEHR so that it can accommodate the breadth and depth of the NT MyEHR system.
3) You keep paying expensive consultants to write silly reports.