Quote Of The Year

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

Thursday, July 08, 2010

We Have Utter Madness Afoot at DoHA. This Is An Election Pending e-Health Fraud I Believe.

The following is from page 48 of a document that was released yesterday by the Federal Health Minister (07 July, 2010)
The document in full can be downloaded from here:
The document title is

A National Health and Hospitals Network for Australia’s Future – Delivering the Reforms

Stream 8 — eHealth

The Commonwealth will make a landmark $467 million investment over two years in the key components of an electronic health record system, so that all Australians have access to a personally controlled electronic health record (PCEHR) if they choose to. In order to fully realise the significant benefits of this Commonwealth investment, states and territories will also need to continue their planned or expected investments in core health information systems. States and territories will also need to provide the complementary investments to build their capacity in readiness for connection to this national system.
This will enable Australians to access their own health care information and permit authorised health care providers to access and use this information, when and where it is needed, to provide better coordinated and effective care for the individual. Implementation is expected to focus initially on people who have the most contact with the health and hospital system. These include people with chronic and complex conditions, older Australians, Aboriginal and Torres Strait Islander peoples, and mothers and their new-born children.
A PCEHR system will enable Australians who choose to have an electronic health record to have more confidence in the information available to them and their health care providers. It will help patients experience smoother transitions between health care providers, reducing waste and inefficiency, and enable better and safer care that is more responsive to patients’ needs.
Additional privacy safeguards will be established through supporting legislation, regulation, and robust governance arrangements. The national eHealth records system will also be designed to incorporate audit trails, technology, and data management controls and an appropriate security access framework. These features will ensure availability of high-quality information and assist patients to have greater control of their health information.
In addition to the national activities above, it is intended that a number of lead PCEHR implementation sites that align with the national work program, will be concurrently funded across different geographic and functional parts of the Australian health sector. The purpose of these lead implementation sites will be to:
Deploy and test national eHealth infrastructure and standards in real world health care settings;
Demonstrate tangible outcomes and benefits from funded eHealth projects;
Build stakeholder support and momentum behind the national PCEHR system work program; and
Provide a meaningful foundation for further enhancement and roll-out of the national PCEHR system.
Within the agreed national framework of governance, standards, workforce etc, lead implementations will focus on implementing PCEHR components that support sharing of electronic health information.
This investment builds on the work of the National eHealth Transition Authority (NEHTA), which has among its priorities the development of eHealth foundations, the coordination of solutions and processes, and the accelerated adoption of eHealth in Australia.
This investment also builds on the Healthcare Identifier (HI) Service established by legislation in June 2010 and being operated from 1 July 2010 by Medicare Australia. The HI Service will allocate unique identifiers to healthcare recipients, healthcare providers and healthcare organisations to improve safety and accuracy in electronic management and communication of health information. Healthcare identifiers are a key building block for the PCEHR system.

Outcome: Australians have access to their own personally controlled electronic health record

Stream Purpose
To provide better access to health information enabling better health outcomes through more integrated care centred around the needs of patients.
Provide every Australian with a PCEHR that is controlled by them.
Ensure individuals’ privacy.
Improve efficiency in the healthcare system through streamlining access to patient information thereby reducing duplication and improving use of scarce resources.
Provide continuity of care by enabling access to patient information at the point of care.
Improve safety and quality in healthcare.
Key Milestones
  • PCEHR interim governance framework agreed and in place
  • PCEHR long term governance framework agreed and in place
  • stakeholder consultation – state and territory governments
  • stakeholder consultation - health care providers and software vendors are informed and engaged in development activities
  • public consultation – public website established
  • public consultation – collect and analyse public views
  • change management – work practice analysis
  • change management – implement training and awareness activities
  • change management – monitor and evaluate training and awareness activities
  • change management – revise and implement ongoing awareness and take up strategies based on lessons learned
  • lead implementation sites – selected (minimum of three)
  • lead implementation sites – contracted
  • lead implementation sites – operational
  • lead implementation sites – initial evaluation
  • lead implementation sites – final evaluation
  • PCEHR analysis, IT architecture and requirements developed
  • PCEHR IT standards developed
  • national infrastructure established
  • legislative amendment as required
  • PCEHR available for registration on-line
----- End Extract
A little analysis reveals this for the utter bunkum it is.
Some examples (there are heaps).
1. The lead implementation sites (at least 3) are to be selected, contracted, operational and implemented and evaluated  by Apr/Jun 2011 and by the same time relevant standards are to be developed.
2. Analysis and development of the IT architecture is to be done Jan/March 2012 after the lead implementations and at the same time as the National Infrastructure is being established.
3. There is funding until June 2012 and the system is not available until then or a bit later. How ongoing operation is to be funded is left hanging.
4. Consultation with providers does not happen until after the lead implementations are completed. So what on earth is going to be in these records and why would any professional access them?
5. It is utterly unclear what happens after the lead implementations are evaluated. Do they all just roll on, turn into mushrooms or what?
All this ignores the points I have made about where the information in the PCEHR is to come from etc etc.
See here:
and here:
This is a fiasco waiting to happen and we can be sure it will be a mess that won’t deliver the claimed benefits on the basis of these plans.
Download and read for yourself!


Anonymous said...

Pure election madness - the aim is to capture the hearts and minds of the average punter. It might win a few votes, but that's not really the point. We are heading into very turbulent waters with health reforms and stakeholders jostling for position increasingly more day by day. This will lead to new IT opportunities opening up everywhere. How chaotic will that be?

Anonymous said...

The only logical assumption you should make is that some software developers are beavering away on the design and structure of a PCEHR in the expectation that if they can produce a better spec than what NEHTA has, is or might come up with (and that will not be too difficult) then they will be given a guernsey as one of the lead pilot implementations.

They also hope they will be paid and that they will have a shoe-in for receiving government support to roll-out their PCEHR beyond the lead pilot geography.

It's a gamble, a big gamble which a few will be deluded enough to take. Go for broke will be their modus operandi and if history is any guide it will end in tears.

Anonymous said...

You might be right but I think the big boys will get preference so the little ones had better align with them, like Microsoft, iSoft, Intersystems.

Anonymous said...

and don't forget Telstra.

Anonymous said...

what a botch-up!

Anonymous said...

Well the botch-up as you so aptly describe it should not be surprising. It's pretty much the same sort of thinking they have used on a number of past occasions going all the way back to HealthConnect. It reflects public sector culture and the mind numbing creativeness (or lack thereof)of bureaucrats with little experience but lots of misguided enthusiasm to be seen to be doing something regardless. Yep, I like your term botch-up.