Sunday, May 03, 2015

The Death Of the PCEHR Is Now Going To Be Drawn Out Forever. What Nonsense!

This appeared earlier today.

Ley to announce multimillion-dollar 'rescue package' for Labor health scheme

Date May 2, 2015 - 11:42PM

Adam Gartrell

The costly electronic health scheme is a white elephant and should be scrapped, expert says.
The Abbott government will spend hundreds of millions of dollars trying to salvage a Labor's electronic health scheme that has been branded an irredeemable failure.
Five hundred days after receiving a review into the e-health system – a scheme that has already cost taxpayers $1 billion over the last five years – the coalition still has not publicly announced whether it intends to save it or axe it.
But Fairfax Media has learnt the government has decided to try to save the system and will make the announcement in the May 12 budget. The rescue package is set to cost hundreds of millions of dollars over the next four years.
Labor announced the Personally Controlled Electronic Health Record system in 2010, pledging to get it up and running within two years at a cost of less than $500 million. The scheme allows patients to opt in to a personal electronic record of their medical history.
However, five years later, the cost has more than doubled and less than 10 per cent of Australians have signed up – a little over 2 million people. And only a few hundred of the country's 1300 hospitals are on board.
Former health minister Peter Dutton was a critic of the scheme and ordered a review shortly after the Abbott government won power. The review delivered its report in December 2013, recommending a raft of changes – including that it be made an opt-out scheme, rather than opt-in.
Mr Dutton has never responded to the report, effectively leaving the scheme in a costly limbo.
New Health Minister Sussan Ley still isn't publicly saying what the future holds.
More here:
The pathetic excuse offered is as follows:
“It decided to proceed with the program partly because even scrapping it would cost many millions of dollars. That's because the government is legally obligated to continue to provide e-health records and store them for up to 130 years.”
Given the usage is so low this is just a fig leaf to try and cover a totally naked policy! A move to 'opt-out' will be, of course,  an administrative and very expensive nightmare.

One has to wonder just where NEHTA will wind up fitting in all this.

I look forward to the enthusiastic reaction to this news from all around country. I am sure every doctor and patient in the country will be thrilled to see so much more investment is such a totally failed initiative.
What a farce!


Dr Ian Colclough said...

To my expert eye it looks as though Sussan Ley has, not surprisingly, been listening to a cross-section of vested interests who, for one reason or another, see value in perpetuating the status quo.

The vested interests are wide ranging from Department bureaucrats, Peak professional bodies, large consulting firms, NeHTA perhaps even Telstra to name but a few.

If she could drag herself out of the quagmire of health to look dispassionately down from above with a little help to see the world of health and eHealth from a different 'perspective' she would quickly find there are some alternative and politically attractive, less high risk, more viable and affordable ways to tackle the PROBLEM which would garner wide support and dissipate the political pain which she is at present having to deal with over eHealth and the PCEHR.

Bernard Robertson-Dunn said...

I agree with Ian's comments about vested interests being behind this, although some may think they are doing the "Right Thing"

This is from the report:

"[Labor's health spokeswoman, Catherine King] stands by the e-health scheme, saying it could save the health system $7 billion a year by cutting the diagnosis, treatment and prescription errors that lead to thousands of unnecessary hospital admissions."

Where does this $7 billion figure come from?

Dr David More MB PhD FACHI said...

The so-called benefits of the PCEHR (7 B over many years) were based on some systems dynamic modelling of aspects of clinical functionality that the PCEHR does not have. (Clinical Decision Support, Medication Management, Admin Efficiencies etc.)

It is recognised by anyone who has looked closely as total fantasy with respect to what the PCEHR presently is or could be made into.


Anonymous said...

Sadly one of the vested interests to which Ian Colclough refers is Steve Hambleton, NEHTA's Chair and one of the authors of the PCEHR Review.

He says "The foundations are in the ground. We're ready to go, we just need to raise the building and then tell people it's there and how it can benefit them,".

When someone in that position promulgates that kind of naive rubbish and people in authority believe it the Minister quickly gets sucked in to supporting the vested interests' party line.

I doubt she has the energy, time or insight to explore with others further afield alternative approaches. Too big, too hard, too costly, too much invested to date and too politically inconvenient to do anything about it other than to let those in charge keep doing what they have been doing.

Anonymous said...

...... too politically inconvenient to do anything about it other than to let those in charge keep doing what they have been doing.

Oh so true, so true. If you keep doing things the way you always have you keep getting the same result.

Anonymous said...

Let's hope the minister is going to accommodate the patient, rather than the; 'vested interests', many of which know little about patient care.

Anonymous said...

I note that on 9 April 2015 the Crown lodged an application for a trade mark - MY HEALTH RECORD - No 1686524 relating to an earlier application lodged on 29 May 2014.

One could reasonably deduce the Department is hoping to rebrand the PCEHR as MY HEALTH RECORD. The name may change but the technology base will remain the same.

Tom Bowden said...

In my view, the sad thing is that there is no sound research going on- that any of us are aware of. It sounds to me as if yet another health Minister is saying "Right-oh chaps and chappesses; who around the table votes to keep this going? - all in favour say "aye" " Somewhat reminiscent of what was probably being said in the British officers' tent at the rear of the field in the Gallipoli campaign.

Evidence and science are nowhere to be seen.

Karen Dearne said...

Good to know the health budget is so flush with cash that they can spend further hundreds of millions on something that will never deliver the needed capability.

Didn't know the vested interests had the clout of the mining industry

Dr David More MB PhD FACHI said...

Indeed - this article praises Ms Ley for common sense:

No more shortcuts to budget surplus

Date May 4, 2015 - 6:27AM

And then she goes and does this!

Walks away, scratching head!


Anonymous said...

Makes me think back to Kerry Packer who said that you would be mad not to minimize tax as the government doesn't spend it that wisely.

What we need is a path to ignore NEHTA and DOHA and just get on with the real work. After being a shameful waste of money the next biggest problem is the attention that white elephants attract, denying real advancements any Oxygen. If we could just find a way to ignore them we could at least achieve some progress in the real world. Maybe the replacement of the Centerlink system will steal the oxygen from the PCEHR. There is a debacle waiting to happen. Given the skill set they have demonstrated with the PCEHR and the Queensland Payroll you would have to be very scared of that government IT project.

Anonymous said...

Surely it would be cheaper to compensate those who are genuinely affected by the system not holding records for 130 years than to keep it going.

Anonymous said...

I suspect that many of the vested interests are those people who work on the PCEHR. It is quite possible that having the PCEHR on your CV makes it difficult to get a new job.

So the easy thing to do is keep the old cash cow going as long as possible.

And at the political level this lot is not well known for it's logical analysis and evidence based decision making. Just look at the new submarine debacle. The decisions there seem to be directly at odds withe the advice from the Defence Department.

This lot is driven by faith and truthiness.

Anonymous said...

Truthiness: I had to look that up -

"the quality of seeming to be true according to one's intuition, opinion, or perception without regard to logic, factual evidence, or the like.."

Ah yes - very apt.

Terry Hannan said...

I have finally got to this theme after nights on call and I love the Anonymous "theme" which reminds me of the rather sick joke. "we invented the word incest and we like to keep it in the 'family'". David, I am not sure if thsi si publishable.

Anonymous said...

As a Health Information Manager I am very concerned about the privacy implications with data mining of records. Also I am curious as to why a 130 year retention policy is proposed. According to the Electronic Records Retention Policy (NSW State Records) electronic records are held for the same timeframe as paper based medical records. "1.11.3 Original data where the electronic record is the only record To be retained and disposed of in accordance with the requirements for the type of patient/client records they comprise eg hospital or community health care" i.e retain for a minimum of 7 years from the date of service and then destroyed unless a record is exempted by legislation.

The cost of maintaining a date warehouse to store 130 years of data will be prohibitively expensive for taxpayers.