Tuesday, November 18, 2014

This Really Sounds Like, While They Are Not Saying It Yet, The Opt-Out PCEHR Is Coming.

This appeared today.

PCEHR pulls off a billion-dollar comeback

David Ramli
It has taken four years and over $1 billion but one of Australia’s biggest taxpayer-funded failures has almost been cured, according to the senior doctor leading the project.
The Personally Controlled Electronic Health Record (PCEHR) initiative is designed to be the foundation on which Australia’s future healthcare system will be built.
At its most basic it is designed to provide every Australian who wants it with a centralised medical record that can be accessed by doctors and hospitals across the nation, from general practitioners to emergency rooms.
National e-health transition authority (NEHTA) chairman and former president of the Australian Medical Association, Steve Hambleton, told The Australian Financial Review the project had been treading water for several months while the government considered its response to a review of the troubled project that was commissioned in November 2013.
But he also insisted the ­much-criticised project, which has burned through more than $1 billion since it was announced in 2010, has bounced back and is ready pending the belated government go-ahead.
The spokesman for Health Minister Peter Dutton said previous implementations were rushed and chaotic and that it was determined to take its time and not make the same mistakes.
Lots more here:
The article seems, from the headline, to be saying that ‘all is fixed’ but what we read is:
1. We are waiting for the Government to agree to  ‘opt-out’ i.e. everyone having a PCEHR record created unless they specifically tell the Government to go away.
2. The system is hardly being used (10,000 accesses a week from a 2 million person user base).
3. The doctors are not at all interested (if they have even heard of it) and we will need more marketing for docs and patients needed (Aspen Medical will love that!).
4. It is going to cost ‘a lot’ to implement.
5. There will be a fair few Liberal voters not at all happy with this sort of arrangement (Note: I am pretty sure some legislation will be needed)
On the same track I was asked today, from another source,  the following:
“I've been told that, in preparation for the "opt out" version  of the PCEHR/MYHR, all public health records are being batch downloaded by the DoH to the PCEHR that will become operational in 2015, without anyone's consent or knowledge.”
As the old saying goes there is seldom any smoke without a fire somewhere!
In parallel we have seen a push to upload non-consented diagnostic test results.
Additionally we have this:

Coming Soon: Invitation to Apply – Private Hospital PCEHR Rapid Implementation Programme

Created on Tuesday, 18 November 2014
With more than 260 public hospitals and health centres now connected to the personally controlled electronic health record (PCEHR) system, NEHTA will shortly be inviting private hospital organisations to apply for a funding contribution to support their integration to the system.
The Private Hospital PCEHR Rapid Integration Programme will assist successful applicants to deploy PCEHR viewing and/or clinical document upload capability. Look out for information soon on the Tender and Offers page of the NEHTA website.
The source is here:

So it seems NEHTA has some money to splash about on something that will not come to fruition if NEHTA and / or the PCEHR are to be gone.
If this is not all a concerted push by NEHTA and its new chair to both survive and thrive I will be very surprised.
Stand by to see the Abbott government add mightily to the Debt and Deficit Disaster on the basis of precisely zero evidence or evaluation.
 What do others think or know? It is hard to believe seeing all this at once is not suggesting that a major announcement is imminent.


Anonymous said...

...... all public health records are being batch downloaded by the DoH to the PCEHR.

..... that equates to uncontrolled hilarity. How insanely stupid can they be.

Anonymous said...

I would love to see the PcEHR take its place as a document store within the broader set of eHealth systems, however if those responsable for the current architecture, solution delivery and overall quality of specifications and maintenance of those specifications remain in place and uncontrolled, then I fear we will see little meaningful progress. I strongly believe they will be reluctant to expose the mess they have created chasing calendar dates and have demonstrated they have little practical understanding of delivering value or as working as a progressive team

Anonymous said...

Anonymous 7:43 PM

I second that sentiment

Anonymous said...

"The Private Hospital PCEHR Rapid Integration Programme will assist successful applicants to deploy PCEHR viewing and/or clinical document upload capability."

Does that mean that unsuccessful private hospitals will not be able to view or upload documents?

Anonymous said...

You sure it is opt-out not cop out

I will be interested to see the answer, especially as they can't state the question.

But in all seriousness, I think done right they could dismantle the past and rebuild not just PCEHR but also the P2P world, a lot of people must know a lot more than they did 4-5 years ago and it would be hard to implement those learning in a drip feed approach

Anonymous said...

The naivety of the Chair emanates from limited experience in all things eHealth. The Board is inexperienced and a captive of their bureaucrats and NEHTA executives. The Board's inexperience prevents it from asking the hard questions which lead to crystal clear accountability. Crap governance gives crappy outcomes.

Anonymous said...

Personally I am all for it, without these initiatives, NEHTA doing the bulk of the work for us and the finacial handouts we would not compete is a real software developer market place. It is strange though the funding is not dished out by centerlink, that would be more fitting

Anonymous said...

"The Opt-Out PCEHR Is Coming..."

Well I hope that there are some nice Aspen Health people that can assist those of us who wish to opt out.

If everyone is 'in', then how will DOH measure the success of the PCEHR? The number of consumers who have not opted out?

Anonymous said...

Now this just made me laugh and I had to share ...

The prime architect of the PCEHR from government was Jane Halton. She has in recent years taken to calling herself Professor Halton, based on having adjunct appointments at two universities

Today we read these universities are asking her to stop calling herself Professor because she isn't one - the adjunct appointment is honorary and entirely different.

See http://www.theguardian.com/australia-news/2014/nov/19/universities-ask-senior-public-servant-to-stop-calling-herself-a-professor

I will not make any further observations about the deeper meaning here, That is left to the reader ....

Anonymous said...


So we have the illustrious Ms. Halton as:

The "incompetent" eHealth bureaucrat; aka

The "innumerate" Finance bureaucrat; aka

The "illegitimate" Professor...

If it wasn't so tragic and detrimental to the wealth of the Australian NET Taxpayers, of which she is not one of them, it would be seriously hilarious!!

No need to threaten legal action NEHTA, DOH or the Dept. of Finance as Ms. Halton’s public track record – on this BLOG alone – makes each of these titles apropos and easily legally defensible, so no legal disclaimer required in this instance…

Anonymous said...

Dear readership,

Let's not forget this unforgettable demonstration of the skillset and mindset of this dishonourable Ms. Halton, formerly illegitimately self-professed as Professor Halton:


Say no more really.

Anonymous said...

When she was at Health she insisted on being referred to as Professor. So it wasn't just her mis-using the title.

Delusions of grandeur, snobbery, inferiority complex? You chose.

Anonymous said...

Waste of expensive, taxpayer paid for, space!

Anonymous said...

Narcissists come in various forms but in general, in the work environment, the Occupational Psychopath manifests as a classic narcissist. In fact in regards to NEHTA for a narcissist to do their job really well they get maximum fulfillment and satisfaction if a project under their control ends up as a total disaster. Mmmm.

Anonymous said...

For those who missed it, Ms Halton has just fronted the estimates committee who asked many many questions about the professor title.

Anonymous said...

Sooner or later when someone keeps conning those around them the truth will out. When caught, the way to handle it is to keep conning people with another version of the original con...... ad infinitum until everyone gets ties up in knots and no-one can discern fact from fiction. The transcripts should be illuminating.

Anonymous said...

Apparently it wasn't her doing at all, it was the deferential public servants who wouldn't stop calling her Professor, no matter how often she chastised them to stop ...


I'm feeling chastised right now, but I'm not sure why.

Anonymous said...

If she couldn't even get her "deferential public servants" to do something simple, what hope is there for something complicated - like eHealth?

and anyway if they really are "deferential public servants" they would, by definition, defer to her wishes.

It may be just me but I don't like being taken for a fool.

Karen Dearne said...

Um, yes, I can confirm I was "reminded" by department staff to use the title "professor" when referring to Her Highness in print. But I never did

Anonymous said...

Her Highness is not, and never was, wearing any clothes!

Anonymous said...

There are four sorts of departmental secretaries:

1. Those who know the right thing to do and can make it happen

2. Those who know the right thing to do but can't make it happen

3. Those who don't know the right thing to do but make the wrong thing happen

4. Those who don't know the right thing to do and make nothing happen

1 is the best, 2 and 4 don't really matter. Type 3 is the worst. They cause damage.

Her highness is of type 2. You can always tell this type by the people they employ.

Anonymous said...

Apparently the deferential souls at the World Health Organisation also failed to defer to Professor Halton's repeated requests not to use her title incorrectly


Anonymous said...

I respectfully beg to differ.

HHMH is most definitely and unequivocally Type #3...

NEHTA and the PCEHR are two perfect examples of her Type#3 behavior to substantiate this claim!

Anonymous said...

My bad. I meant type 3.

Anonymous said...

To be fair, neither NEHTA nor the PCEHR were intrinsically bad as ideas, its just that they were distorted, traduced and ruined in design, implementation and operation.

A functional national standards body working to the common good - that would have been brilliant.

A simple way for national records to be exchanged between providers and with consumer access - that would also have been bloody brilliant too.

After - lets call it an even $2 billion now - we have nothing to show but lots of contented consultancy partners and software firms. If even 1 Australian had better care because of this fiasco I'd be surprised.

Why are we cutting the ABC, education and research funding etc when you could just cancel NEHTA and the PCEHR and actually do something for the public good?

Ah, I think 'the Professor' knows better. I'd better shut up. ASIO might be listening.

Anonymous said...

Ye gods, Ms Halton, hiding behind subordinates, what a coward. But I bet you don't feel any shame.

Anonymous said...

The silly little tin box is offline again next week 29 November 9:00pm to 30 November 5 am, how do you actually remove yourself from this record outage system?

Anonymous said...

Let's think about this. If someone needs to get at a patient's health record in a hurry during normal business hours they can probably call a GP or specialist. When are these people unavailable - probably after 9:00pm and before 5:00am.

So when do they take down the PCEHR for maintenance and upgrades? During the time when getting at other health records is hardest.

Dumb. But at least nobody is using the system for anything useful or important.

Anonymous said...

Not only is it going to be off the air when it might be most useful, but it's a Saturday night - the most crowded time in emergency medicine.

It's all about technology, not health.

Anonymous said...

To be fair, it is not like there will be thousands of school leavers travelling interstate to celebrate in a more wide mannerthe would be normal.

Imstill do not understand why service would be distrupted

Anonymous said...

Just wait until pathology labs start uploading every result. That's a very serious load and I will be surprised, in fact shocked if it doesn't fall over. Maybe opt out will be its death nell? Lets see what its really made of. I would like to know how to opt out however as there is no way I am trusting any confidential data to this mess.