The Saga Of Under-Testing and Glitches With the NEHRS Seems To Just Be Endless. When Are We Going To See Some Accountability and Transparency?

The following article appeared yesterday.

Secret report finds bugs in new ehealth system

Date July 30, 2012

Mark Metherell

Mark Metherell is health correspondent

Glitches in patient identity details for Australia's new ehealth system have been found in about one third of cases nationally, according to a report the federal health department refuses to publish.

The secret report shows that patient identity information held by state public hospitals frequently fails to match the data which Medicare Australia holds on the same individuals. Differences in the spelling of names or other variations can pose a significant obstacle as the system requires an exact match before individuals can gain ehealth access.

The department has refused a request by Fairfax to release the report under the Freedom of Information Act, stating that the report was subject to confidentiality undertakings, given by the IBM company which prepared the document. The confidentiality undertakings are understood to have been made to state and federal agencies; no individual patient records were involved.

Insiders with some knowledge of the project say the refusal to reveal the information has more to do with avoiding government embarrassment about more setbacks in the problem-plagued ehealth development. A department spokeswoman said the report ''does not show up problems in relation to security and safety'' of the new personally-controlled electronic health record system, the PCEHR.

More here:

http://www.canberratimes.com.au/national/secret-report-finds-bugs-in-new-ehealth-system-20120729-236si.html

This outcome is utterly predictable and clearly, to me at least, the root problem lies in the fact that, at present, the Health Identifier Service is not being used as intended by the State Jurisdictions (i.e. States and Territories) who are reported as saying they will need up to three years to have their key systems using the Health Identifier Service. See here:

States not ready for e-Health system

• by: Karen Dearne
• From: The Australian
• July 19, 2012 6:56AM

GENERAL practitioners will have to wait up to three years to receive secure discharge summaries digitally signed by hospital doctors following more delays to the Gillard government's e-health system.

State and territory health departments say they are not ready to use healthcare providers' 16-digit unique identity numbers created for the national system to verify the identity of doctors or other medical staff creating a patient's discharge summary.

Healthcare providers individual identifiers - dubbed HPI-Is - were created and assigned to all registered doctors two years ago as part of the Healthcare Identifiers service launch, which also saw unique 16-digit identifiers allocated to every Australian enrolled on the Medicare database.

Use of local hospital or state health agency identity numbers instead of a uniform national identifier will impact their use for authentication and audit purposes within the personally controlled e-health record system.

Much more here:

http://www.theaustralian.com.au/australian-it/government/states-not-ready-for-e-health-system/story-fn4htb9o-1226429582355

Of course we must not lose sight of a Victorian Health Department assessment that the use of the IHI as a single identifier was just unsafe:

Sunday, February 13, 2011

NEHTA Releases A Set of Documents Describing Integration of the Health Identifier Service With the HealthSMART Program in Victoria. Not There Yet!

The most interesting to me is this document of the release is this one:

Vic IHI Integration Clinical Risk Assessment Report v1.1

The document is one of a series of specifications and so on produced as part of a IHI Pre-Implementation Project between NEHTA and HealthSMART.

The full blog is here:

http://aushealthit.blogspot.com.au/2011/02/nehta-releases-set-of-documents.html

All in all this is shaping up as a bit of a mess. Just how all this is going to be resolved in a way that makes clinical documents developed in Hospitals (and GP surgeries) seamlessly and safely find their correct home in the NEHRS is feeling like a work in only very early progress.

It would be great to get hold of the IBM Report to be able to see just what it says and what other issues have been identified.

It really seems to be a bit of a shambles. It is interesting how there is a steady flow of these issues emerging. I wonder is this co-ordinated or whatever?

David.