The following few articles appeared in the last day or so.
First we have:
PCEHR deadline too tight, says MSIA
- Karen Dearne
- From: Australian IT
- June 08, 2011
THE Medical Software Industry Association says the "extremely tight" July 2012 deadline for the start of the $500 million personally controlled e-health record program risks patient safety as there is little time to ensure new software is free of bugs.
The MSIA highlighted glaring holes in Labor's e-health proposal in its submission to a government consultation on the PCEHR.
"The timeline to develop, test and deploy software to support the PCEHR is extraordinarily short," it warns. "Many different changes are required in many different settings, and there will be safety issues unless great care is taken to ensure software is fit for clinical use."
"Key elements that are missing include the Australian Medicines Terminology (AMT), the Healthcare Identifiers service and the National Authentication Service for Health -- described in the draft concept of operations as ‘existing’ -- yet to date not one of these enablers is being used ‘live’ in any broad clinical setting," it said in its submission to the Health department on the draft concept of operations (ConOps) for the PCEHR.
"There is no timeline that tells us when these will be ready, and their availability is dependent on the (outcome) of work by the National E-Health Transition Authority and other third parties.
"But without documented delivery dates, it is impossible for software-makers to schedule their development, testing and implementation work."
NEHTA chief executive Peter Fleming last week told a Senate estimates hearing that each of the PCEHR components was "tracking to its critical path".
At a separate session, Medicare’s deputy chief executive, health, Malisa Golightly, said the identifiers service "is operating. It is ticking along", confirming there were no particular problems.
But in February, the Health department banned the use of the $90m HI service in any live environment due to concerns over the system’s safety.
Declared live by Health Minister Nicola Roxon last July, it has been sitting idle while software interface specifications and compliance issues are thrashed out.
The Australian understands some progress has been made, with a number of vendors signing to access Medicare’s HI testing environments, but licence conditions are still to be agreed.
The MSIA refers to this in its submission, saying: "There needs to be a clear indication of responsibilities, relationships and governance for all the agencies involved. This includes liability issues for information provided by government or its managing agent for the HI or the AMT, for example."
It is also seeking recognition of the need for a commercially sustainable model for software makers.
"There is no indication there will be any satisfactory agreement with current vendors to ensure that their systems will interoperate with the PCEHR in order to receive and send patient information in a safe and secure way," it said.
Next we have:
GPs need funding for e-health data quality
By Suzanne Tindal, ZDNet.com.au on June 8th, 2011
The Royal Australian College of General Practitioners (RACGP) has recommended that GPs be allocated more funding from Medicare to balance out extra time they will need to spend managing a patient's electronic health record.
The government hopes to have personally controlled electronic health records (PCEHR) up and running by mid next year. Different medical providers will contribute to the record, which will not be stored together, but use indices to link information.
The college warned in a submission to a Concept of Operations for the scheme that as the record will draw on data from multiple sources, contradictions or incorrect information could make its way into the record.
The college suggested that all professions that were able to contribute to a patient's consolidated view should have to undergo a "formal clinical safety assessment" conducted by an approved authority, such as the Australian Commission on Safety and Quality in Health Care.
However, the college also said it was important that a healthcare organisation ensured the accuracy of the information in the patient's e-health consolidated view and shared health summary, which should be carried out by the patient's nominated provider. It said that the GP was the "best-placed health professional to assume the role of nominated provider", and indeed believed that unless the patient said otherwise, their usual GP should be the default nominated provider.
The work required to complete this task "must not be underestimated", according to the college.
"IT is the RACGP's belief that the nominated healthcare provider will be burdened with substantial risk and considerable time spent on validating and updating the information in the Shared Health Summary," it said.
RACGP hoped the government would recognise the need for funding to GPs to manage the record, and not just to implement it, with funding required for training and education and a quality assurance process. In addition, the benefits of the record will flow to other health professionals more than to GPs, the college said.
"Accordingly, the RACGP would urge that government consider appropriate amendments to the Medicare Benefits Schedule to recognise the additional work general practitioners will undertake in consultations initiating and maintaining the patient's shared health summary and PCEHR," it said.
It believed that unless this occurred, there was a risk that providers would refuse to participate in the process.
The college also expressed concern about the complexity of access controls, saying that patients will require education to understand the controls, or they won't use them.
Again lots more here:
Third we have some Departmental comment:
PCEHR draft operations out in August
- Karen Dearne
- From: Australian IT
- June 09, 2011
A REVAMPED version of the draft concept of operations for the $500 million personally controlled e-health record will be issued in August, after the federal Health department was swamped by late submissions.
A total 144 submissions have been received following an extension of the deadline by one week to June 7. Only 11 submissions had been received by the original deadline.
A Health spokeswoman told The Australian more than 40 per cent of the responses came from consumers.
"The National e-Health Transition Authority and the department will review the submissions, and all input will be considered as part of updating the ConOps, which will be released in August," she said.
"The department will also publish submissions (where consent has been provided) on the yourhealth.gov.au website, and ensure this information feeds into change management and benefits realisation work streams."
Increasingly the submissions are appearing on the web-sites of the organisations and a search for PCEHR and Submission will find a great deal of reading - limit the search to the last week or so and it works well!
Browsing through it seems most of the issues raised on the blog are raised by a few others - with all sorts of additional ideas coming forward as people assess the ConOps from their perspective and interests.
As I said a day or so ago - the test will be to see just how well this information is digested and turned into a proposal that might actually be useful and viable!