Friday, May 21, 2010

The Government Line on E-Health. Pity Its Over Simplistic and Being Oversold.

ABC Radio National Breakfast had a session on E-Health this morning.

E-health battleground explained

E-health is another political battleground opening up between the government and the opposition. More than $460 million was set aside in this month's budget to establish a national e-health system. Patient records would be available on-line, giving doctors ready access to their medical histories including medications, immunisations and test results. But the coalition has vowed to dump the measure, even though leader Tony Abbott voiced his strong support for electronic records when he was health minister.

Guests

Dr Nathan Pinskier
National Electronic Health Transition Authority

The web site is here

http://www.abc.net.au/rn/breakfast/stories/2010/2905500.htm

We are told the Health Identifier Service is all ready to go July 1, 2010 and that this will really make a difference – apparently overnight!

Oh dear, oh dear. Why not just be open and honest make it clear e-Health will be a long and difficult program that will take years to make a major difference?

Setting expectations too high is a very bad way to start!

David.

15 comments:

  1. What on earth do you mean by "apparently overnight"? The interviewee never said or even implied that. I think you need to listen to it again.

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  2. I heard the interview as specifically saying it would all start July 1, 2010. We all know it (the HI Service and anything that follows) will happen over years. The clear inference was that the date was important - and we all now it is irrelevant.

    If others heard it differently, so be it.

    David.

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  3. Yes, he said the Service is ready to go on July 1.

    But I've never heard anyone say that there will be any systems to interact with it on that date. They will have to be built over time. The Service needs to be working first so that systems to use it can be designed and tested against a real thing and not a pilot or sandbox (which will also allow time for reviewing of the existing interface mechanisms - because no one gets it perfect the first time).

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  4. Dr Pinskier stated that the HI Service will be ready to go on 1 July, but requires the legislation to pass. He did not give a date on the PCEHR.

    I think he gave a decent overview of what the PCEHR could be in the short time he was allowed.

    The only comment I, and many others, disagree with is that the IHI is essential. It is highly desirable, but we can do without it if necessary. We have been managing without for many many years.

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  5. What has the PCEHR got to do with this? We don't even know what the term actually means yet. I heard him talking about information exchange, not a PCEHR.

    Accurate eReferral, eDischarge and pathology results on their own would be enough to justify the HI Service.

    Yes, we've been "managing" without it, but people have come to harm because their information wasn't accurate. We *must* have it (or something else that performs the function of accurate identification). It is a moral necessity.

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  6. Hi David

    Could I use your blog to highlight a concern I have with the NEHTA-sponsored blog, ehealthcentral, censoring comments?

    Charles Wright chooses to criticise my coverage of e-health matters, and that's fine.

    However, he is apparently not prepared to publish my responses, and that's not fine.

    On Saturday, I tried to submit a comment pointing out that Dr Pinskier's scenario as described on ABC Radio - involving his son's blood test results being misplaced - was due to human error, and the same thing could happen if staff assigned the wrong patient identifying number to the sample, instead of the wrong name.

    In my view, in this situation a number is potentially far more dangerous, as people tend to assume the number is correct, and it's much easier to spot a wrong name than an incorrect string of numbers.

    Unfortunately, my comment did not pass moderation and was not posted.

    Perhaps it was because I also noted that Medicare had been so unconcerned about the dangers of misidentified patient information in doctor's own systems after the system error earlier this year that Medicare didn't warn doctors about the situation for 10 weeks - and only then because they were forced to.

    Or it might have been the reference to Pinskier and the Govt continuing to insist the HI service is ready to start on July 1, providing the legislation is passed. That cannot be correct as no interfaces with doctors' software have yet been built and Medicare has yet to do any real-world testing of the system. What happens when IT projects are switched on without testing? Think Qld Health payroll debacle.

    Since Charles Wright is using a taxpayer-funded platform to air his views, perhaps someone should remind him that political censorship is not okay in Australia, and if he chooses to attack individuals/organisations then he should give them a right of reply.

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  7. There you go again, Karen, leaping to unfortunate conclusions and making unfair and outrageous public statements. It's not the sort of thing a grown-up journalist should do.

    Your accusations are complete rubbish, but I am, as always, absolutely delighted to have them on my blog. As with your previous comments, they would have been posted immediately ... had you not made an elementary error.

    Having already made a comment on eHealthCentral, your email address has been registered through the WordPress software for automatic posting. I don't get the chance to censor it. You should have realised that from the past couple of comments that you posted. You pushed the submit button, and - whoosh! - up they went to the site.

    Unfortunately, this time you used a different email address. The Word Press system requires a new email address to be approved.

    Secondly, you assumed that I moderate the blog over the weekend. My records show you posted the comment early on Saturday morning, when I was soundly asleep.

    I needed the rest because I had a busy weekend ahead of me. On Saturday morning I had to drive to Geelong, where the South of the River Gospel Choir that I sing with was doing a workshop and later a public performance. (I'm sure you'd find my solo performance of Swing Low Sweet Chariot, backed by the choir, terribly uplifting and soothing to the paranoid personality.)

    On Sunday I had another singing commitment. It was a demanding weekend for bass baritones, apparently, and I very much enjoyed singing an old Spanish love song called Amapola.

    So what with my musical weekend, I didn't look at the blog until Monday morning, just a little while ago, when I duly pushed the approve button on your post. I didn't check out this blog either.

    You can imagine how I felt when I got a phone call informing me that you'd accused me of censoring you.

    As I'm sure you'd understand, Karen, we journalists hate censorship. And being accused of engaging in the practice is deeply offensive.

    For the record, I have not censored a single comment on eHealth Central. Not one. All the logs will prove that.

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  8. Karen may have incorrectly assumed Charles chose to censor her comments and that is unfortunate. Even so, the facts of the matters of substance behind Karen’s other comments are quite correct, disturbingly so.

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  9. Karen is obviously a journalist and the Australian community (at least those who read the Australian) would benefit greatly from Karen undertaking a course in health informatics. A professional health informatician could simply not say much of what Karen contributes.

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  10. Sorry, did I miss something? Charles Wright is a health informatician? No? Only discovered e-health when engaged by NEHTA to write his blog?
    At least I actually talk to health informaticians, I dont just make things up

    Karen Dearne

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  11. Hold on a sec. You make up a bunch of stuff about another journalist and your answer is to accuse him of making things up now????

    Sounds like an episode of days of our lives!

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  12. All,

    Given the way this discussion is becoming personal - only comments with a real name will be accepted from now on.

    David

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  13. Let's see. I submit a comment on Saturday morning, and there is a message saying it is being held for moderation. It stays that way for some hours, showing as 1 comment, held for moderation. Check back Saturday night, disappeared - no comment, no message. Same thing when I checked Sunday. The conclusion: comment didnt pass moderation. How was I supposed to know that the NEHTA sponsorship doesnt extend to checking on traffic once or twice over the weekend?

    Two things - Wright's blog only recognises "known" or pre-approved addresses, therefore no anonymous posts are possible (unlike this blog). And provided your email address is known, an automated system will allow you to post anything at all, without moderation? My goodness, what an opportunity...

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  14. Look, Karen. You really must not accuse people of doing things they haven't done, and then, when they offer you the opportunity to apologise and move on, defame them yet again.

    Accusing a journalist of fabricating stories is a very serious allegation. You might like to reconsider your position.

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