Tuesday, April 21, 2015

This Really Is A Travesty and Needs To Be Addressed Quickly For The Sake Of The Health Sector In General.

We had this appear last week.

Still no decision on Royle report

Fran Foo

The Abbott government has yet to decide on the future of its troubled $1 billion Personally Controlled Electronic Health Records system almost 500 days since a review into the PCEHR was conducted.
Doctors were fiercely against adopting the PCEHR for various reasons, including security and privacy concerns, and a poorly structured incentive scheme for clinicians.
On December 20, 2013, then health minister Peter Dutton confirmed receiving the report from the review team, led by UnitingCare Health Group executive director Richard Royle. The review had delved into significant concerns about the progress and implementation of the PCEHR.
The Royle report was said to have provided a “comprehensive plan for the future of electronic health records in Australia”.
Mr Dutton said the government would consider the review recommendations, including changing the system to an opt-out model, and would respond in “due course”.
The Department of Health then began consulting with stakeholders on the implementation of the review’s recommendations, aided by Deloitte. The purpose was to “influence the system design, implementation schedule, and the planning for communication, education, and risk management,” Deloitte told stakeholders last year.
However, the government has nothing to publicly show for its work to date and Health Minister Sussan Ley is making no apologies.
More than two million consumers have an e-health record, including 171,117 first registered as newborns. Clarifying media reports over PCEHR figures, a spokeswoman for Health said as of late March more than 5000 general practices registered, with 10,811 individual clinicians have been linked to the PCEHR by their registered organisation.
She said on average 500 unique healthcare providers viewed documents on the system each month.
The full article is found here:
Leaving out the political blame game which we so often seem to see these days (read the full article for all that!) it is clear that given there are about 91,000 medical practitioners in Australia ( with 35% GP and 35% Specialists so 60,000 + active clinicians) the usage of  500 of 60,000 possible users per month is hard to describe as active (less than 1%).
Here is the source of the stats:
Just where is the proper audit and evaluation that provides some really useful facts about the value and clinical impact of the PCEHR. The best - which is totally anecdotal is found there - and for such an expensive project is hardly adequate.
Someone needs to quickly admit that having been operational for almost three years the time to cut the PCEHR loose has well and truly arrived! That might just be Ms Ley! The time has really come!


Anonymous said...

Be careful David, its not wise to ask them to do anything, its much safer that they do nothing I think. The PCEHR, rest its soul is pushing up daisies. RIP

Anonymous said...

The logical time to do something is when the managed services contract that Accenture currently has with Health expires. Shouldn't be too long now.

Anonymous said...

How can they cut the PCEHR system loose? What will they do with the records and documents stored in there?
Perhaps they could back it up on a couple of thumb drives and put it in a filing cabinet somewhere?

Anonymous said...

The PCEHR only has pointers to documents stored somewhere else or copies of data stored elsewhere. Turn it off and nobody would care much or even notice.

Grahame Grieve said...

Anonymous @ April 23, 2015 6:33 AM:

Your statement is untrue - the PCHER stores documents, not pointers - and many/most are not stored elsewhere. Most of the data in them is stored elsewhere, yes, but not available to the users. And there are a few specific uses for which there is no other store of the data.

Anonymous said...

500 unique document views a month, so about 16 views a day for a nation-wide system.

Anonymous said...

sounds a bit of a mess. sometimes the data is here, sometimes there, sometime here and there. no wonder GPs and others are confused and don't trust the thing.

Anonymous said...

To be perfectly honest - there is not much in it to trust.

I access my PCEHR yesterday for two specific reasons:

1) I wanted to see all the prescriptions I had had dispensed over over the last 2 years, what drug molecules were dispensed, strength, repeats, and cost to the PBS.

2) I also wanted to see what medical services I had received over that time including Date, Service Provider, Service Provided, Cost of Service to Medicare.

In regards to 1) Pharmaceutical Benefits Report. Basic Info available but who prescribed, who dispensed, what did it cost - No Information was available and from a practicing clinicians perspective - virtually useless.

In regards to 2) Some limited info available but basically totally useless for me as a patient or for me as a clinician.

Conclusion: Not of any value to anyone. Hopeless.

Karen Dearne said...

Re: "contract that Accenture currently has with Health expires. Shouldn't be too long now..."

It has already been extended, to 30 June 2016.

There are three current contracts for NIO services

1. 6/02/14 to 30/06/16 = $18,827 million

2. 23/12/14 to 30/06/16 = $2,37 million

3. 6/2/15 to 30/06/15 = $18,827 million

Obviously it's a big job what with 500 unique document views a month and all

Anonymous said...

Karen, 1 and 3 are the same figure, however 3 is for a six month period, donyou know what the contract is for? Surely release 5 did not cost that much to turn on

Karen Dearne said...

So, for the current 18 month period to June 2016, it's costing say $40.2 million.

But what has it cost since the PCEHR started "operating" in June 2012?

Accenture got an initial $47m contract for two years to June 2014. And in 2013 it received another $8m, so presumably the $47m wasnt enough...

Even then, we taxpayers were tapped for a further $11.25m, comprising three contracts for "support services" between 2012 and 2014.

For a four-year period, we have committed almost $106.5 million to a barely functioning system.

And that's ON TOP of the $61 million spent on the build - or "providing the PCEHR infrastructure solution", as they like to put it.

Let's see, close to $170m and that's JUST what was spent on Accenture's role.

Karen Dearne said...

Sorry, lost a comment - this is response to query on contracts, and was intended to go first...

All three contracts are for "provision of National Infrastructure Operation services relating to the introduction of a PCEHR".

Contract 1, from Feb 2014 to June 2016, was only published on Feb 25, this year.

Contract 2, from Dec 2014 to June 2016, was published on Jan 22, this year.

Contract 3, from Feb 2015 to June 2015, was published on March 4, this year.

That's a lot of new money going in