Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Tuesday, March 23, 2010

This Blog and A History of Getting it Close To Right. We Notice Disasters Looming Pretty Well!

It is always fun to go back and look at what was happening on the blog a year or so ago and see how we are going at getting things right and wrong. Note dates of articles in bold.

I was prompted by the following to have a bit of a look round and see by this.

Timing ‘unrealistic’ for rollout of e-health patient ID scheme

16th Oct 2009

Elizabeth McIntosh

GPs face a long wait to see the promised rollout of an electronic patient identification system, an e-health expert claims, despite the National E-Health Transition Authority (NEHTA) saying that it will be in place by mid-2010.

Unique healthcare identification (UHI) numbers are a key plank of the e-health program, and are expected to improve patient safety by reliably identifying patients, providers and care facilities.

According to the recently released NEHTA strategic plan, UHI numbers will be rolled out to all stakeholders by July 2010.

However, health IT consultant Dr David More was sceptical of the 10-month time frame listed in the 46-page document, arguing it was unclear and unrealistic.

“Look at all the other [e-health initiatives] that they’ve attempted to introduce to help – even the ones that have been successful have taken years to be adopted,” Dr More said.

“2012 – that is reasonable – but pretending that 2009/10 is the year of delivery is not going to happen. They’re not going to have the majority of GPs signed up.”

More here

http://www.medicalobserver.com.au/index.php/news/timing-unrealistic-for-rollout-of-ehealth-patient-id-scheme

In retrospect I suspect I was being overly optimistic.

The following is a good one:

Tuesday, March 21, 2006

The Slow Demise of Health-E-Link

It’s been another bad day for e-Health In Australia.

Today we learned that the NSW HealthConnect Trial for NSW - the Health-E-Link project is coming apart for the most basic of reasons - the lack of proper involvement and consultation of healthcare providers and consumers.

More here:

http://aushealthit.blogspot.com/2006/03/slow-demise-of-health-e-link.html

We are now 4 years into this trial and what has been the outcome.

The evaluation report (a summary) appeared in December, 2008 and the whole thing has been such a success it has not been expanded some 15 months later and the web site has stopped reporting additions to the data base. If ever there was a project the NSW Department of Health hopes would just go away this has to be it!

Indeed it may just have:

See here:

http://ehealthinfo.gov.au/what-is-e-health/case-studies/

We find the statement:

“At the time of its conclusion in June 2009, Healthelink electronic health records had been produced for some 45,000 people.”

Did we all miss the announcement of it being canned?

More evidence here:

https://records.healthelink.nsw.gov.au/concerto/Login.htm

Seems the certificate for the secure log in died a week ago!

While on the HealthConnect topic, it seems the Tasmanian money wasting clone has finally vanished.

The domain www.healthconnecttasmiania.net.au has just died.

This was the link:

http://www.healthconnecttasmania.net.au/index.php

As far as South Australia – also pretty dead and empty!

http://www.healthconnectsa.org.au/Home/tabid/36/Default.aspx

Other than the excellent Primary Care Software developed by Pen Computing.

See here:

http://www.healthconnectsa.org.au/Default.aspx?tabid=85

I said it was mostly a waste of money and that is how this all turned out!

This was also a good one!

Sunday, February 25, 2007

Its Really Nice to Know You Were Right!

Well the chickens have come home to roost! Even allowing for a fifty percent margin of error E-Health in Australia is only moving forward very slowly and is certainly not progressing with the urgency hoped for by Minister Abbott!

The goal was set in June 2005. A report, from that time, of the Minister’s remarks is as follows:

See http://www.computerworld.com.au/index.php?id=1737192765&eid=-6787 for the full article.

Here as an extract:

“Health Minister Tony Abbott has put federal health IT bureaucrats on notice saying he expects tangible results within a year, specifically functioning electronic health records and accompanying smartcard system - or heads would start to roll.

"I am sick of trials and studies and working groups," Abbott said.

"I want patients to see a difference in 12 months. If patients do not see a difference, we will have failed," Abbot said, adding he was not prepared to be "held hostage" by a never-ending chase for the latest and greatest IT solutions.”

As we know it never happened as even worse it was the now Opposition Leader Mr Abbot who defunded the effort! I pointed this out in an article in 2005 that can be found here:

http://www.computerworld.com.au/article/135541/academic_says_healthconnect_will_meet_abbott_timeframe/

Of course we also have this saga outlined here which more than justified scepticism of the so called “year of delivery”

http://aushealthit.blogspot.com/2009/11/this-is-really-sad-take-careful-read-of.html

Lastly:

Thursday, February 11, 2010

NEHTA Fantasises About What it Will Deliver with the HI Service.

The following lobbed today. Comments in italics in the text.

Healthcare Identifiers Bill 2010 marks e-health progress

10 February 2010.

A major step towards the implementation of a national e-health system occurred today with the introduction of the Healthcare Identifiers Bill 2010 into the House of Representatives.

The Governments Bill represents the culmination of more than a decades work in developing a framework for the introduction of e-health in Australia across different jurisdictions and with the assistance of professional bodies.

Comment: What do we think NEHTA means by the introduction of e-Health? NEHTA has been around for 5 years and what are the changes they have delivered? And what exactly is the “e-Health System” they are talking about? Would be good to see the end state that is planned so we can all decide what we think about it. Is an IEHR involved and how is this to work?

The legislation provides for the introduction of a unique identifier which will allow all Australians to have their confidential medical information transferred electronically between health providers.

End Extract of NEHTA Press Release.

Other comments in the rest of the text in the blog.

Then my comment was:

Even now there is no clear discussion as to why any single provider or software provider would adopt all this, given the cost in time and inconvenience.

I believe this project will be DOA without careful piloting and evaluation – and then modification on the basis of the findings. This assumes NEHTA will not review a range of alternatives we know exist to solve the problem without a ‘great big’ centralised ID database.

Fantastic thinking is alive and well at NEHTA if they think this can all roll out and work nationally over the next 6 months! If this is not the plan, maybe they could tell us what the plan actually is?

---- End Extract

And now we all know, if it happens at all, it will be over years, and may have an initial evaluation in 2013 when even NEHTA now admits implementation will probably not be complete by then! This detail just did not seem to quite make it into the Press Release.

Bah, humbug and spin. It seems it takes a Senate inquiry to blast away the spin and get at the truth.

Enough, I think most of us have these bureaucrats pretty much sussed. I would love to hear examples of where NEHTA’s efforts have yet been properly evaluated and found to make any real difference clinically?

Isn’t that what they are meant to exist for?

Just so I am not accused of being excessively negative I have to say that I see all this as reflecting a ‘bunker mentality’ on the part of NEHTA’s leadership group. If they would only be more open about what is going on and actually listen to those in the Health IT Community, who have a clue or two, they could be doing a vastly better job and I could stop typing.

A really good example of this is the HI Service. Who has seen the contract with Medicare Australia and actually knows what they were asked to deliver so we can know if they have done it, or not? It’s not the dollars I am interested in but rather what was to be delivered, how it was to work, how deployed and how used by the e-Health community. I don’t think we know pretty much any of that, and there is a sense out there NEHTA has been making it up as they go along.

I really feel very sad seeing so much that is just not actually delivering what is possible. How long should we persist with trying to build these national foundations before we have a really hardnosed review and make sure there is not a better way? I believe we need to work out how to get the value out of what has been done, where possible, and that really requires a strategic review of the sort undertaken by the Boston Consulting Group three years ago. This time we also need the recommendations to be actioned and not shelved.

David.

2 comments:

Anonymous said...

Oh that it were no true. Sadly, as you have reported, it is all true.

Jim Cocks said...

"Who has seen the contract with Medicare Australia and actually knows what they were asked to deliver so we can know if they have done it, or not?"
No one - it was let by regulation (I keep harping on this I know) - no tender process, no announcement and no legislative or other due process. In the dying days of the last Federal Government.
Ergo, there are no publicly available details of expected outcomes, indicative timeframes, resources committed, effort required, or indeed anything else, but most importantly, projected costs.
I cannot conceive (I'm open to correction of course) that a project of this size and complexity would have fallen under the Commonwealth's cost guidelines for open tender.
So, if the Senate Estimates Committee are interested in the UHI proposal, perhaps they might care to ask some questions of the relevant (then) Minister for Health and his (then) officials as to the process that led up to this situation unfolding.
We live in hope.