Friday, February 08, 2013

Karen Dearne - Health reveals 16 records uploaded to PCEHR.

In preparation for Senate Estimates Hearings next week we have some information releases from DoHA which came out yesterday.
Karen Dearne Reports:
Only 16 Shared Health Summaries had been uploaded to the Personally Controlled E-Health Record System by November 12, according to the federal Health Department.

"These summaries were uploaded from pilot sites ahead of the planned rollout of clinical software to connect providers to the PCEHR system," the department says, in belated answers to questions on notice from the Senate Estimates hearings last October.

"As at November 22, there were 48,335 documents downloaded from the PCEHR, with consumers accessing the system an average 306 times a day."

By the same date, 275 provider organisations had completed registration, while five software vendors had completed Medicare's "Notice of Connection and Conformance, Compliance and Accreditation for a range of PCEHR transactions through the (Human Services Department) B2B interface".

Health did not provide any information on the number of "distinct clinical discharge summaries uploaded", as requested by Queensland Senator Sue Boyce.

Given the department missed the December 7 deadline for responses and the Community Affairs committee meets for the next Estimates round next Wednesday, it is puzzling that more recent figures are not available.

In October, a Health official said 13,340 people had registered for a PCEHR, while the department had forecast 500,000 registrations in the first full year of operation.

Meanwhile, Health has confirmed there have been "a series of outages" in the e-health environment, including the Healthcare Identifiers service, vendor PCEHR test environment and the Pharmacy Benefits Schedule, saying these were planned outages "to allow for system maintenance and upgrade".

"The PCEHR system availability target is similar to targets set for other Australian government and hospital systems, and also the Singapore e-health record system (on which the PCEHR is based)," it says.

Human Services separately reported 137 ICT Reliability outages in the period October 1, 2011 to September 30, 2012, primarily in internal systems used by Centrelink and Medicare. Twenty-eight were experienced in the outsourced Vendor Managed Environment.

On occasions these unscheduled outages affected customer access to services like Centrelink Online, Medicare Online, PBS Online, the Health Professionals Online System and the PCEHR.

"As systems stability is a key priority, improvement programs undertaken over the past 12 months have realised a 27 per cent reduction in reliability outages during (the most recent quarter) July-September compared to the April-June quarter," Human Services says.

"Four major pieces of work are currently underway to improve the reliability and availability of ICT systems."

These involve the transition of seven old data centres into two modern facilities over the next few years; upgrade of the customer portal to a 64-bit environment to increase the capacity of concurrent session handling, and configuration of agentless monitoring devices for data packet monitoring to provide greater transparency and more comprehensive reporting of ICT transactions.

ICT services previously outsourced to IBM and HP are also being transitioned to in-house management, "removing dependency on external factors, thus enabling proactive service management and increasing reliability as a result", it says.
A pretty sad story.



Anonymous said...


So as of November 12 we’ve had 16x documents uploaded and by November 22, 48,335x documents downloaded?

There seems to be some severe asymmetry here!

Are we talking “documents” downloaded 48,335 separate times? If so, what “type” of documents have been downloaded, how many “unique” document downloads have occurred, and how many unique “downloaders” are accessing these documents?

Doesn’t seem to pass the reasonableness test on face value.

Do DOHA and/or NEHTA have scripted robots downloading these 16x documents over 3,000 odd times each?

Or is DOHA talking about PCEHR “page hits” where every single individual file and graphic image downloaded to a browser is being counted as a unique “document download”??

It’s hard to see how these numbers and metrics make any reasonable sense without some further follow-up questioning and interrogation.

The floor is yours and the ball is in your court Senate Estimates, don’t let the poor downtrodden Australian taxpayer down and let these obfuscatory bureaucrats and QANGO sycophants get away with their obvious incompetence and ongoing deceit!

Dr David More MB PhD FACHI said...

The 48 K or so documents are almost certainly PBS and the like documents. My NEHRS has at least 20 documents attached.

The 16 documents are probably non Medicare clinical documents (i.e. from GPs etc.)

Hope that makes sense.


Anonymous said...

Amazing statistics!
The 48000 downloads of documents by consumers are likely just their medicare and PBS claims data, organ donor and immunisation documents replicated from the Medicare database into the NEHRS.
Consumers averaging 306 accesses per day - poppycock! Most of this is probably just the access required build up from zero to 13,000 odd registrations in setting up the record. (Divide the number of registrations by the number of days that they could register).
Lies and statistics! Why not simply tell the truth, and simply provide the reasons why the figures are low.

Anonymous said...

This disgraceful failure is a gouging waste on the public purse that the participants on both sides should be truly ashamed of! No pathology, no clinical documents of any real note, where is the benefit for the 150m spent on this alone?

Such a wasted opportunity to improve things! Imagine the lives that could have impacted positively if it had been done right and hang your head in shame!

150m for 16 clinical documents? ~10 million dollars a document! What a disgraceful state of affairs on its own, but when you look at how the local e-health industry has been ignored and knocked about by this it is even more sickening.

As the mining industry cools down we see rhetoric everywhere about how the remaining industries need to take up the slack! Accenture, can you tell us what have you developed out of this that will benefit the Australian taxpayer?

When are DOHA/NEHTA going to stop this nonsense and start to engage with the MSIA ? When will you stop taxing us and giving it away to the top end of town for delivering failure at so many levels?

Things are bloody crook in Tallarook!

Anonymous said...

“By the same date, 275 provider organisations had completed registration, while five software vendors had completed Medicare's "Notice of Connection.

“In October, a Health official said 13,340 people had registered for a PCEHR

“It is puzzling that more recent figures are not available.”

They are available. Karen just hasn't bothered to ask for them.

Dr David More MB PhD FACHI said...

So what are they and why wasn't Senate Estimates told?

I am sure they are just amazing!


Karen Dearne said...

No doubt Jane Halton will be delighted to tell us next week.

In October she was quite ecstatic: "Literally, day on day -we get the numbers everyday of how many people have registered. I open it and think, 'Goodness me'. People really want this. It is amazing."

Ms Halton has forgotten that she originally forecast 500,000 registrations from the three lead sites in the year before the PCEHR launch last July 1.

However, I wasnt referring here to the registration numbers but the numbers of documents uploaded and downloaded.

The answers last week contain the only official information about these released to date.

Sixteen documents uploaded? 306 look-ups a day? At information already available through Medicare Online?

Since the department clearly had the details provided by the end of November, why didnt they bother to forward them in time to meet the December 7 committee deadline?

Because they were hoping the figures would be better come February?

No doubt we'll find out next week.

Bernard Robertson-Dunn said...

Tom Worthington is an IT consultant based in Canberra and he's far from computer illiterate.

This is on his blog

Friday, February 08, 2013
Unable to Register for a e-Health Record

A letter from the last hospital I was in invited me to register for an e-health record. After going to I was directed to where I filled in some more details, until I got: "A previous session has been started and has not completed. Please try again later."

The letter indicated that the e-health record "... will not contain any clinical data", so I could not see what use it would be, even if I could manage to register for one.

So at that point I gave up.

If an IT savvy person a) can't signup and b) doesn't see any value
in it, what hope is there for getting the citizen in the street to sign up?

Karen Dearne said...

Another FOI update:

Thank you for your response to my FOI Request No 175-1213.

However I am at a loss over your decision to impose substantial charges to access a document that should already be in the public domain.

The Commonwealth Department of Health has advised the Senate Community Affairs Committee that the Memorandum of Understanding on eHealth replaces the expired National Partnership Agreement on E-Health.

The expired E-Health Agreement is to be found among all such publications on the Federal Financial Relations website.

This is the one I am referring to:

It details the legal and financial arrangements, plus performance reporting requirements, agreed between the Commonwealth, State and Territory governments on E-Health, under the provisions of the Intergovernmental Agreement of Federal Financial Relations.

Under the Agreement, each party has specific roles and responsibilities with regard to supplying financial contributions and undertaking actions to support the aims of a nationwide e-health system, via the foundation efforts of the National E-Health Transition Authority - a not-for-profit body previously established by all the parties for that purpose.

It was originally signed on December 7, 2009, at a Council of Australian Government meeting, by the then prime minister, Kevin Rudd, and all state and territory premiers/chief ministers; it expired on June 30, 2012.

I understand that the MOU I am seeking was agreed in place of a renewed formal NPA on eHealth.

If so, the MOU should be available either on the above site, or on the DoHA site. Indeed, it appears there are some 38 MOUs available on the Federal Financial Relations site related to various initiatives.

The financial details of the eHealth MOU - effectively, the funding arrangements for NEHTA - will in any event be reported to the public via Budget statements, annual reports and other statutory financial disclosures, as has been the case in previous years.

NEHTA's most recent Annual Report discloses total "member" contributions of more than $237 million for the 2011-12 financial year; "members" being each of the commonwealth, state and territory governments.

In the most recent federal Budget, the Commonwealth allocated $233.7 million for the continuation of the National e-Health program over two years to the end of 2013-14, including $67.4 million being the Commonwealth's share of NEHTA's core funding.

Other state governments have disclosed their commitments, for example, the South Australian Health Budget 2012-13 reports an allocation of $4.9 million over two years as the state's contribution to NEHTA's work program, while the Victorian Government has allocated $16 million to NEHTA over the same period.

In short, these financial details are either already in the public domain, or will be reported in the agencies' next annual reports.

And since the parties have already agreed their commitments - presumably in a binding, legal fashion - to NEHTA and its work program over the next two years, I cannot see any reason why the information should not be made available; nor why it might require extensive consultation with individual participants before release.

Therefore I request that this request for access proceed forthwith, in line with the normal expectation of general public interest grounds for disclosure.