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H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Wednesday, November 04, 2015

DoH Provides An Annual Report from The PCEHR System Operator. What Is Missing Is What Matters.

This appeared a little while ago.

Personally Controlled Electronic Health Record System Operator

Annual Report

1 July 2014 to 30 June 2015

Here is the link to the .pdf
The executive Summary makes for a useful summary:

1.                     Executive summary

The personally controlled electronic health (eHealth) record system commenced operation on 1 July 2012 and provides secure, national infrastructure to support a shared electronic health record which can be viewed by patients and their authorised healthcare providers.  Clinicians in registered healthcare organisations involved in a person’s care can upload, view and download clinical documents. Patients with access to the internet can access their Personally Controlled Electronic Health Record (PCEHR) no matter where they are in the country or the world.
In the PCEHR system’s third year of operation, work has focussed on increasing participation and improving services.  In 2014-15 two major PCEHR system releases were undertaken which provided additional functionality and improved usability including the ability to upload pathology reports and diagnostic imaging reports.
In 2014-15 the System Operator registered 547,164 people for a PCEHR bringing the total number of people with a PCEHR to 2,277,010 by 30 June 2015.
By 30 June 2015, 7,773 healthcare provider organisations registered to participate in the PCEHR system. These organisations represent a range of healthcare services including general practice, hospitals, aged care, dental, physiotherapy and pharmacy.
In 2014-15 the number of clinical documents uploaded to the PCEHR system increased by over 2 million.  This was largely due to the upload of nearly 1.4 million prescriptions and a significant increase in Shared Health Summaries, Discharge Summaries and Event Summaries.  Consumer documents on the PCEHR system rose by 36% and Medicare documents by approximately 50% in the same period.  Over 75 million documents were uploaded to the system in 2014-15.
The PCEHR system’s availability target is twenty-four hours a day, seven days a week with 99.5 percent system availability outside of scheduled downtime. In 2014-15, the system availability was 99.7% (excluding planned outages).
Five audits of the system were undertaken in 2014-15: three audits by the Office of the Australian Information Commissioner on access controls applied by healthcare organisations and privacy policies of 40 general practice clinics; and two clinical safety audits by the Australian Commission on Safety and Quality in Health Care relating to Shared Health Summaries and Event Summaries.
In 2014-15 the Australian Government announced its response to the recommendations of the review of the PCEHR.  The 2015-16 Budget measure, My Health Record – A New Direction for Electronic Health Records in Australia, provides $485.1 million over four years to strengthen eHealth governance arrangements and undertake trials of participation arrangements, including an opt-out system.  It also included three years funding to redevelop and continue to operate the system.
Changes to governance will include the creation of a new entity, the Australian Commission for eHealth (ACeH), which will assume responsibility for all national eHealth operations, functions and activities from July 2016, including the role of the System Operator.  The Government also announced that the PCEHR system will be renamed the My Health Record.
Martin Bowles
Personally Controlled Electronic Health Record System Operator
September 2015

----- End Extract.
The devil - as usual is in the detail.
Among some highlights are:
1. Seven audits were conducted but there are no reports linked or available. Who knows what was found?
2. Actual clinical documents created by clinicians seem to simply not be flowing:

Table 1: Documents by type in the PCEHR system

This table identifies the number of each type of document uploaded to the PCEHR system in the 2014-15 financial year and the totals as at 30 June 2015.
Type of document
2014-15 F/Y
Total as at 30 June 2015
Clinical documents
Shared health summaries
Discharge summaries
Event summaries
Prescription records
Dispense records
Specialist Letter
eReferral Note
Consumer documents
Consumer-entered health summaries
Consumer-entered notes
Advance care directive custodian reports
Personal health observations
Personal health achievements
Child parent questionnaires
Medicare documents
Australian Childhood Register documents
Australian Organ Donor Register documents
Medicare Benefits Schedule and Department of Veterans’ Affairs reports
Pharmaceutical Benefits Scheme and Repatriation Pharmaceutical Benefits Scheme reports

The core clinical record is the Shared Health Summary. About 25,000 were uploaded on behalf of 2Million + patients. i.e. 1 in 80 records actually saw activity added to the Shared summary - and 79 did not!
Consumers were even lazier with only ¼ of the activity.
The obvious question is if only this many of the interested, registered patients actually entered something - just what activity can we expect from the non-volunteers.
3. Just where are the reports and discussions of the good that has flowed from having the system. Pretty thin on the ground as far as I can see.
All in all the collection of useless documents grows as hardly anything of any use is being added.
What an ongoing fiasco.

1 comment:

Bruce Farnell said...

Vanity metrics glued together with waffle. It's a winning recipe for those on the gravy train.