Sunday, December 08, 2013

There Was Some Real Excitement Regarding E-Health In Question Time In The House Of Representatives Last Week!

Last Wednesday in Question Time we had the following exchange.

Personally Controlled Electronic Health Records

Mr SUKKAR (Deakin) (14:41): My question is to the Minister for Health. Will the minister tell the House how many of my constituents who have registered their details on the personally controlled electronic health records system would be able to have their records accessed if they presented at Maroondah Hospital in my electorate of Deakin?
Mr DUTTON (DicksonMinister for Health and Minister for Sport) (14:41): Thank you to the member for Deakin. It is great to have a great member back in Deakin. He is a good man. He is working hard for his electorate already. He is very, very concerned about the health needs of the constituents in his electorate. I knew that he had an interest in this electronic health record, or the PCEHR, as it is known.
I knew that we should try and answer this question in a meaningful way, so I said to my department, 'Let's work out on a percentage basis how many of his constituents can turn up to an emergency department and have their electronic health record accessed on the computer system there.' The first thing, of course, was to establish how many people are in his electorate: 126,672, according to the latest census. But there was a problem. There was a big problem. The department said, 'Minister, we cannot provide you with a percentage figure.' I said: 'Surely it's easy. We now know the population. We want to know how many people can access the computer system in the public hospital when they turn up'—not a big ask, I thought. So I said to the department, 'Please, we have to work harder on this.' They said, 'Minister, it can't be done.' I said, 'Let's apply more resources to it.' In any case, they came back to me and said, 'Minister, the reason that it can't be done is that the former government forgot to talk to the hospitals or the doctors about how these systems should work in the public hospitals,' so the answer of course is that zero, not one, of those 126,000 people who might turn up to the local public hospital in the member for Deakin's electorate can get their record accessed on the computer system within that hospital.
The level of incompetence knows no bounds when it comes to the Health portfolio during the time of the previous Labor government. The previous minister looks bewildered. She looks bewildered and befuddled. But it is true, Tanya. It is true. You forgot to talk to the doctors and hospitals.
Mr Burke: Madam Speaker—
The SPEAKER: The Manager of Opposition Business will resume his seat, and the minister will refer to people by their correct titles.
Mr DUTTON: Of course, Madam Speaker.
Mr Snowdon interjecting
The SPEAKER: And the member for Lingiari will desist!
Mr DUTTON: I say to the member for Sydney, who looks befuddled and bewildered: it is true. You did not talk to the doctors.
The SPEAKER: I did ask the minister to refer to—
An honourable member: He did.
The SPEAKER: Okay, fine.
Mr Burke: Madam Speaker, I raise a point of order. This minister has gone further away from direct relevance than anyone else on that front bench—anyone else. The point of order I wanted to take earlier was not only about referring to people by their titles but that what he is talking about is completely irrelevant to the question that he was asked, and he should be brought back into line.
The SPEAKER: I call the honourable Minister for Health and remind him to address the question before the chair.
Mr DUTTON: To try to provide some enlightenment to the former minister, I will leave her with these facts. They announced the personally-controlled electronic health record three and a half years ago. Eighteen months ago the former minister jumped up and said that the system—
Ms King interjecting
The SPEAKER: The member for Ballarat will desist.
Mr DUTTON: The system was going live and this was a great time for our country. A billion dollars was spent by the previous government, and 10,000 Australians out of 23 million have a record for which a doctor has uploaded a summary of their health information. Do the maths for a second, and it works out to $100,000 per patient.
Government members interjecting
Mr DUTTON: There is shock on this side, but by that side's standard it is not a bad outcome, I suspect.
Here is the link to the discussion.
What are we to make of this?
Why is a Liberal Member asking questions about the PCEHR?
Is the Government trying to move attention away from some of the present problems with China, Indonesia, Debt Ceiling, Spying etc. etc.
Does Mr Dutton think if someone talks for the doctors and hospitals all will be magically fixed?
Has Mr Dutton had a briefing saying the PCEHR Program is a disaster and needs to be closed and so is softening the public up for the news?
You would have to think that this level of criticism would be pretty game if you planned to keep the PCEHR as having seen it as broken as this as you would then really own both halves!
What do others think?
David.

8 comments:

  1. As mentioned in previous posts to this blog, the PCEHR is gone, gone, Gonski...

    Based on all the other cost cutting measures, the PCEHR will join the ranks of failed projects in health.

    Why does this occur only in the Public Sector??

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  2. It's all a bit rich this isn't it!

    DOHA, NEHTA and the C'th Govt forgetting to speak to the hospitals and doctors to connect to the PCEHR??

    So what exactly is being discussed at NEHTA Board meetings where DOHA and the Jurisdiction DG's are sitting around the Boardroom stewarding the expenditure of over $1B of Taxpayers money on the PCEHR?

    Are they really drinking their warm milk and catching up on their naps on the Taxpayers' dime??

    It would explain the obvious eHealth debacle and why it looks like the Governance machine was asleep at the wheel...

    Seems more a sin of commission rather than omission as insinuated by Dutton, but either way, the incompetent inmates have been running the asylum, and time will soon tell whether they are continually allowed to do so!

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  3. Dutton wins maximum brownie points by closing it down. If he doesn't the alternative, post review, is that he inherits full responsibility for a project which can only continue to deliver major political pain.

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  4. Minister Dutton said to Tania Plibersek "You forgot to talk to the doctors and hospitals."

    He really should have said - Departmental Secretary Jane Halton and her people forgot to talk to the doctors and hospitals. She should bear the full responsibility for this fiasco together with NEHTA.

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  5. Am I dreaming or didn't the topic of costings just get brought up recently in regards to the number of hospital discharge summaries being uploaded? From memory there were a couple of hundred a day going up, I'm not sure I understand how they are getting there since the former government "forgot to talk to the hospitals".

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  6. It is very clear Minister Dutton SIMPLY DOES NOT GET IT.

    So I {Peter Dutton] said to the department, 'Please, we have to work harder on this.'

    They said, 'Minister, it can't be done.'

    I said, 'Let's apply more resources to it.'

    CONCLUSION - The Minister does not get it. Let's apply more resources he says. Oh Minister, how stupid is that? They have had battalions of resources for many years and have delivered nothing of any use. What is it that you do not understand?

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  7. “I'm not sure I understand how (discharge summaries) they are getting there since the former government "forgot to talk to the hospitals".
    Well in some places discharge summaries are getting up there (into the PCEHR), despite the former government talking to hospitals (and not having listened to their issues and challenges – bravo to the hospitals!). The issue here though is not about putting things up there, but about being able to access a patient’s record when they come into ED or are admitted, i.e. being able to view it through the hospital clinical system, or via the web-based clinical portal to the PCEHR. To enable this, hospitals need to have set up their clinician access rights against their organizational access hierarchy, have put in new versions of clinical software that can view the records (if such software is yet available), trained their clinicians, and have made some major changes to work practices to ensure that correct user access is maintained, and that patients have correct IHIs etc.

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  8. Let us dearly hope that the PCEHR Review Committee have secured access to and are reviewing with careful scrutiny the proposed and actual costs and benefits of:

    1) PCEHR Business Case
    2) Wave#1 site tender submissions
    3) Wave#2 x9 site tender submissions
    4) NIP tender submission
    5) Benefits Realisation partner tender submission
    6) Change & Adoption partner tender submission
    7) All other PCEHR Grant funding recipients, their justification for funds and reported performance

    Acknowledging the review committee are severely constrained for time, if they are unable to conduct this level of detailed review, their #1 Recommendation needs to be a detailed Audit and Review forthcoming to have a full accounting for the over $1B of taxpayers funds exhausted on this misadventure.

    #2 Recommendation - Accenture, Deloitte, BCG and PwC are ineligible and disqualified from conducting the Audit due to their monstrous conflict of interest in having profited so greatly from this eHealth largesse!

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