Sunday, April 17, 2016

This Really Shows Just How Badly The Government Is Doing In E-Health And The myHR. Just Too Stupid!

This article appeared a day or so ago.

Dead people given e-health records in latest bungle for $1 billion government program

April 16, 20167:00am
Sue Dunlevy News Corp Australia Network
EXCLUSIVE
THE federal Health Department is setting up My Health records for people who have been dead for over two decades in the latest bungle to beset the troubled $1 billion project.
It comes as a major international technology company CSC last month warned medical practices not to use the My Health Record because of a glitch that meant data for one patient “may be saved against an incorrect patient record”.
And as the Australian Medical Association calls for a major overhaul of the records to integrate them into existing medical software because just 300 GPs are using the records each week.
Four years after it was launched only 75,000 records are populated with a patient health summary that makes them useful to doctors.
As the project to drag health care into the digital age flounders it has emerged the government is setting up My Health records for people who are no longer alive.
Alison McLaren says her family was shocked and upset to receive a letter from the Department of Health in February informing them a My Health record would be established for her nanna Muriel Stratton who had passed away 20 years ago.
“It was a real shock to mum because it was so close to the 20th anniversary of Nanna’s passing and was strange to get this letter out of the blue,” said Ms McLaren.
“I support e-health but what concerns me is if they are using information that old and getting that wrong, what else are they getting wrong?” she said.
Roger Grearly says his wife Lillian passed away 23 years ago but he received a letter recently informing him a My Health record would be set up for her.
“It bought back a few memories and was a bit emotional,” he says.
He says another Facebook friend also received a letter informing her a My Health record would be set up for her 19-year-old son who had passed away.
“Whether it’s blundering or carelessness it’s pretty pathetic,” he said.
The Department of Human Services says it sent letters to people who were deceased because it did not have a date of death recorded against their customer records.
“The department is aware that of the one million letters sent about the My Health Record trial, a small number have been sent to deceased individuals,” a spokeswoman said.
 “The department sincerely apologises for any distress this has caused.”
The department says it is notified of a death from family members and other authorised persons such as health professionals, funeral directors and, in more recent years by data-matching with Birth, Deaths and Marriages registrations.
“If the department is not notified, a date of death will not be recorded on a customer’s record,” it said.
Minister for Health Sussan Ley offered a direct apology to any family affected by the ‘unfortunate’ administrative error.
“What I find disheartening is Labor are quick to use this as an excuse to attack the Government’s IT and payment systems when something goes wrong, but are also actively blocking our attempts to upgrade them so they are more accurate and convenient for patients.”
A spokeswoman for the Department of Health dismissed CSC’s warnings about the possibility of one patient’s health details being mistakenly filed on another person’s My Health Record.
“Advice being provided by CSC is about organisations using a very specific combination of software products and versions “practIX with HIE suite 2.1 or less”, not the My Health Record,” the spokeswoman said.
The My Health Record lists a person’s medications and allergies, doctors can upload a health summary about the person’s health problems, eventually the system will include X-ray results, pathology results, hospital discharge summaries and other data that for the first time can be shared between medical practitioners.
One million Australians will automatically have their personal health information uploaded onto the internet in such records from July as the government trials switching the My Health Record to an opt out system.
There is a lot more to read on this nonsense here:
The issue here is that it is virtually certain the names for the letters and to create patient registrations were almost certainly derived from the Medicare Customer Database that also supports the Health Identification Service which provides Individual Health Identifiers.
That names can remain on this database for 20 years and not be noticed is really a worry - and is certainly indicative of there being all sorts of other errors in this really crucial database.
Given patient identification is crucial to assembling a patient record from diverse sources the Government just pretending that all is well is a joke. Worse still is the fact that the Minister thinks that their attempts to fix things are being blocked - rather it is actually true they are happy to see an error rate in the Medicare Database (because it would cost big time to fix it).
The letters to the dead are a canary in the coal mine regarding data quality in the Medicare Databases.
The letters to the dead are also a symptom of the Government’s haste in pushing a patient record  on a million unsuspecting patients (who may be alive or dead or demented or not etc.). The trials and their risks have not been properly thought through - it is as simple as that - and now we see the first evidence of that fact emerging.
A careful rethink is really required before an even bigger mess is created.
David.

12 comments:

Anonymous said...

Not a good look for health coming into an election. No doubt there will be more to come. I can't understand why the Department doesn't bite the bullet and freeze the entire project, step back and maybe (heaven forbid) put a strategy together that is teeny weeny bit less ambitious. If the Government is worried about a backlash now is the time to cut and run.

Anonymous said...

This is a perfect time for the Prime Minister to demonstrate leadership. The bureaucrats can't suspend the project because they'd be paralyzed at the thought of doing so.

The Prime Minister and the Health Minister together can. They can say My Health Record can be an invaluable enabler of the health system but it needs to be developed and deployed more cautiously because there have been too many problems which haven't yet been fixed. Everyone has to live within their means and so today I am announcing a suspension of the My health Record Project and I have called for a new eHealth strategy which is less ambitious and more affordable. Thank you.

Anonymous said...

When they came to Government I thought they'd see sense and can the whole thing and save a whole lot more millions. That white elephant will never be a useful tool to anyone. So many $ that could be spent elsewhere instead of going into the pockets of software services companies.
At the very least, if you are going to propagate records for people, so they can opt out, surely you would check to see that the data you have for them is current (within certain timeframes, less than 2 decades), thereby doing away with the risk of creating records for people that have been dead for nearly 25 years!
Probably that sort of analysis is a bit too hard for our compatriots and it was just based on name, address, DOB and - from what the minister said - the fact you weren't dead.

Anonymous said...

The truly dead people are those in charge of the My Health Record project. Brain dead first because they didn't think hard enough about risk minimization. IQ dead second because they have shown they lack the intelligence to understand what is wrong with the project. Dead asleep third because they keep dreaming about how clever they are.

Anonymous said...

As David said, the fault with this particular problem is at the feet of the data provider, who is, without a doubt Medicare. Their raison d'etre seems only to be to save money, not to improve healthcare. On that basis, I doubt we will see any activity to clean their up their data. I'd love to be proven wrong.

Anonymous said...

> Their raison d'etre seems only to be to save money, not to improve healthcare.

It is probably fair to say once a patient is dead Medicare may struggle to improve their health outcomes no matter how much they spend.

Seriously, get a grip people. There's a large database of people - millions in fact - and in a small number of cases Medicare seem to have missed a death notification. I'm sure the families of the deceased will recover from the trauma of receiving a letter.

Anonymous said...

David
It's fair to say 11:07 AM there were only a small number of cases of dead people being resurrected so it's an unfortunate accident and probably to be expected; but its no big deal unless it becomes a widespread problem which is probably unlikely.

It's also fair to say that if this the only significant problem then people should get a grip (as 11.07 says) and get in behind and start supporting and using My Health Record unless these deceased people are part of a bigger cemetery of problems that have not yet risen to the surface.

Anonymous said...

Dear April 18, 2016 11:07 AM, re my comment April 18, 2016 9:44 AM, you miss the point. If your database basically manages money related issues, then the requirement for accurate, up to date data is far less critical than for a database that is managing clinical information. An error in the first may cause an over/under payment. An error in the second may have significant clinical ramifications. I wonder if Medicare has considered this difference and are they doing anything to address cleaning up their data?

Terry Hannan said...

Anonymous I am in full accord with your comments to which I add "if I cannot see the need for change then how will I know that I must change?"
Tis debacle reminds be of the regular NEJM reviews of a correlation between pre-morbid diagnosis and post-mortem findings (usually poor) where is in not uncommon to find that a patient has had a full post-mortem and is walking around, alive in in the community!
The whole process of accessing the DoH, MyHealthREcord (PCEHR) and other relevant is like trying to get into the White House-almost impossible (or impossible for our governing bodies).

Anonymous said...

No, I get the point re: the diff between clinical and billing dbs - I was indulging in some facetiousness.

I get annoyed by newspaper stories that severely underestimate the difficulties of accurately accounting for 1 million+ records without making a mistake. And then the conga line of families blathering on about receiving a letter 20(!) years after someones death (but close to the anniversary of them dying!). Lazy 'journalism'.

It was like Joe Hockey railing against stimulus cheques to dead people (value ~ $100,000) when having the tax office send a letter to everyone tax payer and asking them "are you still alive since you submitted your last return" would cost a million bucks.

It's holding 'bureaucrats' up to a completely unrealistic standard and then beating up on them because they can't fight back.


Anonymous said...

The data sources obviously don't share a unique identifier (or combination of data) that has been verified and made reliable. Name, address and DOB pulled from GP or hospital records don't seem to match correctly with Medicare nor with reality. Any automated system that then relies on that information is then not reliable. I've had GP's and hospitals record the wrong information despite my best efforts but as long as they have a Medicare number attached then they don't care to much about it. People go by different names, someone miss-enters the DOB, different name attached to same Medicare card. All the systems used by Australian Governments (federal and states) and the health etc. organisations need to use a unique identifier that the person was given and can verify (don't rely on later name & DOB matching).

Anonymous said...

Don't worry, if you don't want a record to be created for your great aunt Flo, may she rest in peace, then you can opt her out. All you need is her current driver's licence or passport….