Tuesday, April 02, 2013

No Wonder There Is A Mad Expensive And Potentially Privacy Violating Push On PCEHR Signups.

The following appeared today.

E-health take-up 'missing its target'

  • From: The Australian
  • April 02, 2013 12:00AM
THREE Australians have been allowed to use a fake name to sign up for an electronic health record but even taking pseudonyms into account, the federal government will fall well short of its registration target.
Little-known provisions in the Personally Controlled Electronic Health Record program allow people to register using another name for privacy reasons, for example, if they are taking extra precautions to avoid an abusive spouse or are worried their reputation will suffer if their health status becomes publicly known.
But in gaining the right to withhold their identity, the first three Australians to take up the provision for pseudonyms may have also lost the right to claim government benefits.
"You can seek and receive treatment using your pseudonymous Individual Healthcare Identifier, but you can only claim Medicare Benefit Scheme or the Pharmaceutical Benefits Scheme payments using your name on your Medicare card," a spokeswoman for the Department of Health and Ageing said.
The government had hoped to see 500,000 Australians with a PCEHR by July, but as of March 4 there were only 73,648 registrations, with 108 shared health summaries and 51 discharge summaries also uploaded to the system.
In February, an average of 705 eHealth records were accessed each day through the Consumer Portal, while healthcare providers had access 6147 times a day.
Opposition health spokesman Peter Dutton has already identified e-health as an area in which the Coalition would seek to deliver value for money.
Other interesting points follow in the rest of the article found here.
To get even half way to their targets DoHA will need to flog every angle it can think of. The desperation may be reflected in this report.

E-health letter free-for-all

 Medicare Local has infuriated GPs by suggesting they tell their patients there is “no cost” for creating shared e-health summaries for the Federal Government’s national e-health system.
The summaries — listing medications, diagnoses, adverse reactions and immunisation histories — are meant to form the backbone of the billion dollar PCEHR. But there has been furious debate over the plan when it emerged the government was providing no dedicated funding to GPs to either create or update the shared summaries.
Now Tasmania Medicare Local has enraged local doctors over a letter sent to practice staff last week which tells them how to handle questions from patients about the records.
The letter includes the line “How much does it cost?” and says practice staff should say: “There is no cost for creating an eHealth record.”
It adds: “Once registered for an eHealth record, doctors at this practice will be able to upload a summary of your visit”, failing to stress doctors are free to choose whether or not they want to create the summaries.
Findings from the PCEHR pilots last year suggest that it actually takes between five and 15 minutes to create the health summaries, depending on the complexity of the patient’s medical history.
Lots more here:
It all has the feel of a little desperation to me.


Anonymous said...

Federal, state and territory governments have agreed to a new memorandum of understanding on e-health which has yet to be made public.

So, the next big con act is about to be launched - move the goal posts, lower the basketball net, change the umpires, produce a list of lessons learned and hop on board NEHTA's chatanooga choo choo for another 5 year ehealth adventure.

Keith said...

The question “How much does it cost?”is an interesting one. At one level, the official answer: “There is no cost for creating an eHealth record.” is absolutely correct. On the other hand, one could look at the amount spent and the number of records created and come to a different answer entirely: "The cost of creating an eHealth record is currently of the order of $10,000." Of course with more people registering this per unit cost will come down, but it will be long time for it to fall below $1000.

Populating one's health record with a health summary is another mattter.

Paul Fitzgerald said...

I am reminded of the Yes Minister episode where he visits the hospital with no patients. "But Minister, we won a Florence Nightingale Award!" "What's that for?"
"The most hygienic hospital!"
Or perhaps the emperors new clothes?

Anonymous said...

Obviously the boffins and brain-boxes at DOHA and the Medicare Local have no idea and cannot appreciate the economic concept of "NO FREE LUNCH"!

Of course it costs, and if not another record was added to the PCEHR it will still be "costing" taxpayers just to keep the flashing lights on and file those entertaining reports at Senate Estimates hearings for its complete lack of utility. This also does not account for the "sunk cost" of over $1B getting us all to this futile point in the ehealth scheme of things.

This additionally does not account for the patient's time and physician's time completing and uploading their questionable health summary to the PCEHR, which undoubtedly and unquestioningly "costs something".

If they can't comprehend "opportunity cost", is it no wonder NEHTA and DOHA continually waste unconscionable amounts of taxpayers money with such reckless abandon!

Anonymous said...

Perhaps a better question is not 'how much does it cost' but 'what is it worth'.
I guess the theory is that as the cost goes down (per registrant), then the worth goes up? That will depend on how it is used and if it works.
And like buying a car, even if you don't use it, you need to pay to maintain it, insure it, to rent a garage for it, and to secure it.
I sincerely hope it will work, be useful and be worth it.
If not, then we always have the PCEHR Truck.

Anonymous said...

I am still amazed at all the noise being made by all parties associated with the PCEHR. It is not personally controlled, so let's drop the PC out of EHR and just call it an EHR, with minimal information and data.

I think that has now been done to cover this gap NEHR's is the new acronym I believe. So the individual has lost control. Over to government to use my data how they wish.

Why would I sign up?

Bernard Robertson-Dunn said...

Re: "fake names"

This is not exactly new news.

The following was posted on this blog almost two years ago.

"If you seek treatment using your Pseudonym IHI, you will not be able to claim benefits from Programs administered by Medicare Australia, such as Medicare and the PBS."


And this in September 2011:
"E-health push to give stars false IDs"


And to revisit my uptake spreadsheet, given the March 4 registration # of 73648.

They are now 426,352 short of their self imposed and, according to DoHA, achievable, 500,000 target for the end of June. They now require about 100,000 per month (March-June, inclusive) to get to the magic half million.

Considering they have been running at fewer than 10,000 per month, it doesn't look to me as though they are going to get to 500,000. More like 120,000; not even a quarter of their target.

Anonymous said...

As at June 2012:
Est. Population = 22.5M
Est. Pop without PCEHR = 22.5M

Prediction for June 2013:
Est. Population = 23.0M
Ext. Pop with PCEHR = 0.15M
Est. Pop without PCEHR = 22.85M

Population without PCEHR will RISE NOT FALL from 22.5M to 22.85M by the end of June 2013.

--- Tim C

Anonymous said...

"51 discharge summaries also uploaded to the system."

So , at ~$150m and rising then that would be around 3 million dollars per Discharge Summary then?

Thank you to the companies concerned. What a disgraceful gouge and an epic fail!!

Anonymous said...

If someone paid $3M per discharge (as suggested by Anonymous), plus $10K per ehealth record (as suggested by Keith), then presumably $50,000 per clinician, and $1M per shared health summary as well, then we'd have paid for the thing 4 times over.

Bernard Robertson-Dunn said...

Talking about privacy etc:

Cyber-Criminals Target Health Care Information


Look what happens when you put lots of sensitive and valuable information all in one place and make access to it so much easier.....

Paul Fitzgerald said...

@Bernard, that's why practices need cyber insurance, and an active security plan to ensure they minimise the risk and manage it if it happens.

Anonymous said...

Well if they want more people to register, then maybe they should offer in exchange, a discount on the Medicare tax levy. After all, if it makes us all healthier, then they will need to spend less?

Anonymous said...

"then we'd have paid for the thing 4 times over."

Now you are getting the idea. If the 'top end of town' consulting firms have their way the taxpayer will, and then some! At $23m a year for maintenance, let alone enhancements we are already well down that road.

Why does it cost $46m over 2 years to maintain this low value, low use system? Anyone asked that question? No, why not, over 10 years it will be ~$230m, let alone the justification money they will spend trying to get use from this thing!. Nice gig if you can get it for very little more than an overpriced content management system with 50 Discharge Summaries and less than 0.2% usage after half a year of operation!

Or maybe it will be a quick win 'saving of millions' over the forward estimates for any incoming government. Beats hacking into taxpayer's super! What a waste of money in an area that is crying out for real solutions and real help.