Thursday, February 02, 2012

I Wonder Who Has The Correct Story Here? Can They Both Be True?

In the NEHTA release on the Clinical Software ‘glitch’ which was made public last week we read the following.

NEHTA pauses implementation in pilot sites

24 January 2012. National E-Health Transition Authority CEO, Mr Peter Fleming has announced that following a detailed internal review and analysis, NEHTA is temporarily pausing implementation of Primary Care desktop software development around its specifications for the eHealth pilot sites.
"Our specifications are subject to rigorous assessment processes and this has highlighted some technical incompatibilities across versions. We have identified problems with the specifications and have made the decision in order to avoid any risks," Mr Fleming said.
The pilot sites were established to test and deploy software and eHealth capability in real world healthcare settings prior to the introduction of the personally controlled electronic health record system. While the pilot site and national infrastructure projects have operated in parallel, neither is a critical dependency for the other project.
More here:
Separately NEHTA released the following to the eHealth Central blog.
“None of the software has ever gone live this is about quality control to ensure absolute confidence in the software being used in the eHealth pilot sites. One of the reasons for having these sites was to test software and ‘iron out the bugs’ prior to the national infrastructure go live.”
The full release is here:
For comparison we read in the (rather brief and oddly presented) NSW Health Submission to the Senate Enquiry.

St Vincent’s / Mater Health Sydney (Wave I)

·         Sending of Discharge Summaries from SV&MHS to participating GP practices;
·         Sending of Shared Health Summaries from participating GP practices; and
·         Sending GP electronic referrals from participating GP practices.
Progress to Date
·         SV&MHS was the first eHealth site to sign-up / register consumers to the PCEHR
·         230+ GPs have already signed up to participate (>80% of the target)
·         SV&MHS is now receiving electronic referrals to all areas of the campus from participating GP practices
·         St Vincent’s Hospital is sending electronic discharge notifications to participating GP practices
·         St Vincent’s Hospital will implement electronic discharge summaries commencing in December 2011 with completion by January 2012 – with the discharge summaries being sent electronically to participating GPs
·         St Vincent’s Private Hospital electronic discharge referrals (nurse initiated) will be implemented in December 2011 and sent electronically to participating GPs
·         Specialist letters from St Vincent’s Hospital clinics will be sent electronically to participating GPs commencing in January 2012
·         Consumer recruitment within St Vincent’s Hospital outpatient clinics will commence late January 2012
Note in items 3 and 4 of progress to date there are suggestions that sending and receiving are live.
I wonder what is actually going on? Is someone jumping the gun, over-claiming, or just a little detached from the real action. I am sure we will get an explanation soon enough!
I have to say it does look like some real progress is happening at SV&MHS- which is good to see. Pity NEHTA didn’t quite deliver their bit!
This might all seem like a trivial issue but it is actually important - for all concerned - that some clarity about what is live and what is not is provided - and of course the affected software may be not the same as is being used and SV&MHS - but with the confusing messages being sent about who is actually assessing Clinical Safety for the PCEHR program and just how good they are at addressing these issues we are entitled to explicitness which seems to be absent about just what is happening!
(Note in the Webinar of the 02/02/2012 we were told by NEHTA that the documentation on how safety was assessed is secret - you have to trust us. Sorry I don’t!)
That the clinical software community is less than happy about the shifting sands (of specification and expectation) with which they find themselves having to work will surprise nobody!
It also looks as though NSW Health Quality Control could use some work. On Page 3 we read
7. The products that NEHTA designed, made, tested, certified for use in the PCEHR;
“NSW Health will continue to work closely with all jurisdictions to ensure all national eHealth solutions are fit for purpose and will continue to integrate these solutions and standards into local initiatives.
A critical milestone was achieved in December 2012, with NSW Health achieving integration with the Healthcare Identifier (HI) Service. Medicare-generated Individual Healthcare Identifiers can now be used in our statewide Image Archive and for communication with General Practice as part of the Greater Western Sydney PCEHR lead site initiative.”
An example of forward retrospectivity it seems!

1 comment:

Anonymous said...

Looks like we are going to have even more non interoperable health information silos. much for the right information in the right place at the right time.