This collection of files appeared the day before yesterday on the NEHTA web site.
Go here to see for yourself.
What is even more typical is - guess what? - it turns up on a Friday!
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This is simply amazing! All of 12 days before all this is meant to be in use we have a mega data dump.
This material should all have been finalised and distributed to everyone involved at least six months ago.
This is not the way to run a ‘chook raffle’ - let alone a billion dollar e-Health program that has to have many thousands of busy professionals get involved and be supportive.
The old saying ‘I am from the Government and I am here to help’ has now become ‘I am from the Government and I am going to do my best to screw you over’!
I think we will look back at the execution of this program in this messy way and realise that this sort of failure is a major contributor to what I believe will turn out to be a pretty bad waste of public funds and clinical time.
I think we will look back at the execution of this program in this messy way and realise that this sort of failure is a major contributor to what I believe will turn out to be a pretty bad waste of public funds and clinical time.
Astonishing.
David.
13 comments:
"...this sort of failure is a major contributor to what I believe (delete) 'will turn out to be' a pretty bad waste of public funds and clinical time."
Strongly recommend an editorial correction.
It is not a case of will turn out to be, it unequivocally (insert) 'already is and has been for over 7 years now,' a pretty bad waste of public funds and clinical time.
All anyone needs to do is objectively compare the vast amount of taxpayer funds spent and the substantial expense of misguided and misdirected labour in the public and private sectors against the paucity of any meaningful and measurable outcomes within the healthcare sector to see this is undoubtedly the case.
Unless of course you are a NEHTA or DOHA "insider" or handsomely funded "consultant" that is measuring "success" by the amount of funds personally extracted from this process against the absence of any meaningful beneficial contribution in return, then this is boom times with an ehealth taxpayer funded gravy train that just keeps on lavishly giving.
I agree with your view - lets see how others feel..
David.
It would certainly be illuminating to hear what the AMA has got to say given their recent calls for a deferral of the 1 Feb ePIPs.
Too "pretty", too much, too late and close to too/two billion...
How long, and how much has it cost to prettify these documents?
Firstly, there is something seriously wrong with a system that needs a library of 37 documents (plus the many already published) to explain it. GP's and their staff are about delivering healthcare, not unravelling complex and arcane IT systems.
Second, the timing, as David points out, is totally inadequate. Ill-conceived last-minute flurries of activity seem to be a recurring theme in the Government's eHealth activities.
Third, there are several pieces of insfrastructure still not finished. The NASH failure seems to have been papered over, in part I think by watering down the security requirements. (I can't see how a $24M contract can fail without having an impact.) I haven't heard what happened about the rush to make the two prescription exchanges talk to each other, but I suspect that is still a work in progress. We are still waiting for the vendor of Australia's most commonly used clinical software to release their ePIP-compliant version. Their website has had a notice for a few weeks saying the software will be released "Real Soon Now" but 10 days out it hasn't happened. To be fair, the previous version will probably meet the immediate requirements, but installing that requires patches and hot fixes to correct the performance and reliability issues that have dogged this software since its release several months ago so not everyone has updated. Even if the new version is released today it is now too late for many of us to install before February.
I expect that many GP practices will simply walk away from this ePIP. Some of those will increase fees by a modest amount to compensate for lost income.
There is nothing I can see among the barrage of documents that will have any impact on the 1 Feb implementation of ePIPs.
If I were a skeptic I'd say NEHTA has done this document dump all at once because someone in Treasury has has been asking hard questions.
We need to claw back billions of dollars for the Federal Budget. The Budget cycle is coming to a close ready for May. Why should you at NEHTA be excempted when every other man and his dog are being asked to make a contribution? More so when it is difficult to see what you at NEHTA have delivered?
NEHTA's answer - send out a truck load of documents to impress Treasury.
We are still waiting for the vendor of Australia's most commonly used clinical software to release their ePIP-compliant version.
Looking at NEHTA's ePIP register most clinical software vendors seem to be compliant already. Could you indicate please which of the major players are missing from the list.
I believe all HCN's software is now ePIP compliant according to an article last week. Most others also seem to be done or mostly done.
David.
What about Practix?
Soem random feedback. This list is like a very bad menu. it makes one want to vomit.
I would not look to the AMA (even though they play hard in this game) I personally do not believe they are any clearer in what is required. As I have stated before the Libs have no celar e-policy because they don't get "e-health" so imagine how many billions $AUS they are going to spend.
I'm still interested in the access controls on the PCEHR. So I had a look at the glossary in the document
I noticed that there is a term "Document Code" defined as "A document code is a code which may be used to restrict access to individual documents within an individual’s eHealth record."
There is also a term "Record Code" defined as "A record code is a code which may be used to restrict access to an individual’s eHealth record. The code is provided to a healthcare professional to grant access to the individual’s eHealth Record.
Neither term exists in the latest ConOp. But I did find reference to them in the PCEHR rules 2012 available from http://www.comlaw.gov.au/Details/F2012L01703/Download
They are also referred to in various other documents, but the legislation seems to be the base source, from which the others are derived.
In the legislation document there is a complex set of rules which appear to be designed to address many of the failures in the ConOp document, such as rule 27. User account management within healthcare provider organisations.
This says:
Healthcare provider organisations must ensure that their information technology systems, which are used by people to access the PCEHR system via or on behalf of the healthcare provider organisation, employ reasonable user account management practices including:
(a) restricting access to those persons who require access as part of their duties;
(b) uniquely identifying individuals using the healthcare provider organisation’s information technology systems, and having that unique identity protected by a password or equivalent protection mechanism;
.... etc
There are lots of other rules about access control which do not seem to relate to the ConOp, but which appear to have been created as the result of many comments made on this blog. To be fair, comments and feedback may have come from other sources.
Comments:
* This legislation was dated 16th August 2012. Six weeks after the system went live.
* The rules document says "The PCEHR Rules commence on the day after they are registered on the Federal Register of Legislative Instruments.", which appears to be 17 August.
* Rule 5 "Advanced access controls" is highly complex and seems to be predicated, at least in part on consumers "adjusting the advanced access controls for their PCEHR"
* No updated ConOp has been released which details how the current system actually works.
Questions:
* what does "reasonable user account management practices" mean? Who decides what is reasonable? If it needs a court of law to decide, then don't hold your breath.
* Does the current system comply with the legislation?
* Does the legislation allow for non-compliance of some rules, either temporarily or permanently?
* Were these rules part of the RFT requirements? If not, when are they expected to be incorporated, and at what cost?
* What does "restricting access to those persons who require access as part of their duties;" actually mean?
* When is there going to be some sort of education program telling people what they can or cannot do with the advanced access controls, how they do it, when they can do it
* Was any any broad consultation undertaken to validate these rules with the general and health communities?
* Why were the rules not finalised before the final ConOp and the RFT released?
* given the changing nature of the system (i.e. the rules were only settled mid August and the system released 1 July) does the funding model reflect the development and testing and education that seems to be necessary to make the system legal.
* If I have misunderstood or not seen relevant documents, would someone please let me know?
@Terry Hannan
"As I have stated before the Libs have no celar (sic) e-policy because they don't get "e-health" so imagine how many billions $AUS they are going to spend."
This implies both Terry Hannan and the present Labor government actually do "get 'e-health'"?
Based on the track-record to-date, not a lot of evidence available the Labor government gets ehealth at all!
Can't speak for "Terry Hannan" as I don't know your track-record in ehealth?
Insinuating the "Libs" will waste even more billions $AUD is not based on fact as they spent, and arguable wasted, far less while they were pulling and funding the ehealth policy strings, even when they had the misguided notion of setting up NEHTA in the first place based on the 2004 BCG Report, which was strategically and conceptually flawed because BCG didn't understand Australia's healthcare system.
So if anything, based on the past track-record and last election ehealth policy promises, the "Libs" stand to "waste" substantially less taxpayers money than the present Labor government could ever dream of.
Note to DOHA, NEHTA and BCG:
"The tragic error of many change agents is that they fail to understand the status quo well enough to overcome it, and their failure to understand the status quo undermines their change effort. The reason for this phenomenon is that individuals take up the mantle of change agent precisely because they despise the status quo. Because they hate the status quo, they don't respect it enough to understand it."
(Breaking the Code of Change, Beer M., Nohria N., 2000)
Dr David More MB PhD FACHI said...
I believe all HCN's software is now ePIP compliant according to an article last week.
Yes and no. Here is a quote straight from the HCN website homepage: "HCN has been listed on the PIP eHealth Product Register for its upcoming product release MD/PS3.14d - coming soon." As of today (23 Jan) MD/PS3.14d is still "upcoming".
Similarly Argus is listed in the Secure Messaging register on the basis of Version 6 accredited in Feb 2012 but still not released to subscribers (except in NT).
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