Wednesday, June 14, 2017

I Wonder Why The ADHA Has Not Intervened To Improve The Way DOH IT Projects Are Delivered.

This appeared this week.

Technical bungles preventing plans to create national bowel cancer register — crucial to fighting disease

Sheradyn Holderhead, Political reporter, The Advertiser
June 7, 2017 9:43pm
A NATIONAL register for bowel cancer essential to prevent deaths from the insidious disease will be delayed 12 months as technical bungles plague the plan.
The register was meant to be rolled out on March 20 this year, but was delayed following problems pulling data from an existing paper-based version.
Federal Health Department officials have confirmed the register would not be up and running until at least the first part of next year. Officials had previously warned senators about the risks to human health if they delayed approval of legislation needed to set up the register.
“I would like to highlight to the Senate committee members the current implications for the implementation of the register and risks associated with delays in establishing the National Cancer Screening Register legislation,” senior bureaucrat Bobbi Campbell cautioned last year.
“The register has been implemented to facilitate the delivery of two of Australia’s population-based cancer screening programs, which currently have the greatest need for improved data collection and reporting systems to enable these programs to operate safely and effectively.”
Ms Campbell said Australia had one of the highest rates of bowel cancer in the world and it was the second most common cause of cancer deaths in Australia, killing about 4000 people a year.
Labor Senator Murray Watt was surprised by the significant delay given the department had warned senators about the risks if legislation and registers were delayed. “This is going to be a lengthy delay, which is going to be putting people’s health at risk,” he said.
Department health systems special adviser Paul Madden said the main cause of the delay was “around the complexities for the migration of the data” — essentially combining nine registers into one.
Mr Madden said the Department had decided to put the focus on implementing the cervical cancer register, which had also been delayed.
More here:
One really wonders with the Health Department IT with the situation above as well as things like this:

AMA Submission to the My Aged Care Evaluation

07 Jun 2017
The AMA was invited to participate in qualitative market research to provide insights to help the Department of Health assess the ongoing implementation and effectiveness of the My Aged Care Gateway. The AMA's response highlighted the worrying fact that the Gateway is a barrier to aged care services, and that there is a lack of communication between Aged Care Assessment Teams (ACATs), doctors, staff, and service providers. The Gateway forms must be interoperable with clinical practice software to reduce to the administrative burden on practice staff. 
For the My Aged Care system to work properly, it must be simple and efficient. Reports from our members indicate this is not the case, and previously simple processes have become complex and time consuming, leaving patients in need of urgent care left at home waiting.
Related document (Public): 
Here is the link:
Time for the Auditor General to look at all the IT in Commonwealth Health Department including the myHR.
David.

21 comments:

Anonymous said...

Your heading should be 'why has Paul Madden not intervened to improve the way Paul Madden Delivers iT projects, simple they let Tim turn ADHA into a paper chasing organisation who thinks IT is boring.

Anonymous said...

I agree with your sentiments David, something is very wrong with the methods being applied.

Anonymous said...

What on earth do they do their modelling in not to understand the complexity before going to market? Telstra itself must have some blame in all this? Who will pick the bill up for another years work? Yep you and I folks.

I guess the risks don't count when you are the department of health

Anonymous said...

Telstra itself must have some blame in all this? Of course.

Why do these projects fail? Huge amounts of hubris minus any systems analysis work overseen by incompetent inexperienced leaders.

Anonymous said...

Well people I think if many are honest with themselves they wished the national standards and architecture entity away. In some cases to push there own little agenda. We now have no functioning standards bodies and no national architecture and compliance body. This is the result. Perhaps the easy way was not the right way.

Bernard Robertson-Dunn said...

For those interested in learning from other industries and how governments can negatively impact innovation, have a read of this:

We Could Have Had Cellphones Four Decades Earlier
Thanks for nothing, Federal Communications Commission.
http://reason.com/archives/2017/06/11/we-could-have-had-cellphones-f

Quote:
"When AT&T wanted to start developing cellular (mobile phone technology) in 1947, the FCC rejected the idea, believing that spectrum could be best used by other services that were not "in the nature of convenience or luxury." This view—that this would be a niche service for a tiny user base—persisted well into the 1980s. "Land mobile," the generic category that covered cellular, was far down on the FCC's list of priorities. In 1949, it was assigned just 4.7 percent of the spectrum in the relevant range. Broadcast TV was allotted 59.2 percent, and government uses got one-quarter.

Television broadcasting had become the FCC's mission, and land mobile was a lark. Yet Americans could have enjoyed all the broadcasts they would watch in, say, 1960 and had cellular phone service too. Instead, TV was allocated far more bandwidth than it ever used, with enormous deserts of vacant television assignments—a vast wasteland, if you will—blocking mobile wireless for more than a generation."

If you don't see parallels with healthcare, then I suggest you aren't looking closely enough.

And an observation. Telecommunications has a vast number of standards and the engineers who work in the area have worked out mechanisms for developing them, getting agreement among many vendors, telecomms providers, regulators etc and implementing them.

And if that's not a good example of interoperability at work, I don't know what is.

Anonymous said...

Telstra's still trying to work out who is Managing Director of Telstra Health. Linked In for Shane Solomon and Mary Foley says they're both the MD!

Anonymous said...

With Telstra cutting staff and more cuts to follow it's difficult to see funds being invested to replace its antiquated health legacy software acquisitions. Will Telstra Health be quarantined from these cuts?

Anonymous said...

Somehow I cannot imagine a plaque in the Telstra Board with the words 'people before profits' inscribed on it. Perhaps by heavility reducing australian workers in there health division they can use it as a political leverage to acquire government contracts.

This is purely hypothetical and it would be odd for the Government to award large contracts without transparent due process! Would it?

Anonymous said...

7:47 AM, you mean like the National Cancer Screening Register that was done behind closed doors and senators forced to approve because lives were at risk? And how did that pan out Mr Bowels?

Anonymous said...

The Telstra Health deal is corporate welfare from the big bureaucracy who think that big organizations are beautiful. Never mind that they have no record of doing anything useful or having any ability to actually do the job. They ignored the existing people with a history of being able to do the job. Telstra Health, after the vote of confidence from their mates in DOHA then tried to poach the people who actually knew something. DOHA have also pushed small GP surgeries who actually managed to have continuity of care, to close, and now we have big corporate GP clinics milking the Care plan system. You have trouble seeing the same GP there and bandaid medicine is the new normal. Generic management is a fad that will eventually fail, but at what cost?

Bernard Robertson-Dunn said...

re: "You have trouble seeing the same GP there (i.e. GP clinics) ..."

Could someone please explain to me how "nominated healthcare provider" works in a Medical Centre or GP Clinic?

On this page
https://myhealthrecord.gov.au/internet/mhr/publishing.nsf/Content/find-out-more?OpenDocument&cat=Managing%20your%20My%20Health%20Record
it says:

"Your nominated healthcare provider is decided by mutual agreement and has the role of developing and managing your Shared Health Summary. To be a nominated provider, the person must be a medical practitioner, registered nurse, or an Aboriginal and/or Torres Strait Islander health practitioner with a certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care (Practice)."

In other words, a person, not an organisation. AFAIK, if you don't have a regular GP you won't get, and can't update if you've had one uploaded somehow, a Shared Health Summary.

The SHS seems to be the key document in MyHR but it would appear to have some serious shortcomings in its operation.

Maybe the ADHA strategy will explain how they intend to fix this. Or maybe not.

Anonymous said...

Bernard be a good little citizen, if the health department or ADHA want your opinion they will give it to you. The HI service would be needed to be fully implemented for this work I believe, wonder his Tim is doing unrelaxing that Jurisdictions on that one.

Anonymous said...

Pulse IT 16 June 2017 article describes "how test reports will be added to My Health Record". So it's all done and dusted then David? Tim Kelsey's on a winner is he not?

Anonymous said...

Yes he is but not because of him solely. Now let's see what can be done with it and who will use it. Can we now ditch our best practice software and just license an app from the government for free?

Anonymous said...

The test results is a positive step forward. However it is only a proof on concept, there is some way to go yet. Sonic may prove to be the incentive as it create a competitive stimulus. How artificial this is only time will tell. I would also point out that the last few years has resulted in a lot of change, strangely while the government was asleep and not interfering.

Anonymous said...

Can we now ditch our best practice software and just license an app from the government for free?

Not yet, but I am sure that will not be far off, I am sure overtime the MyHR will look to replace GP desktop software, probably use security as a leverage. Certainly makes you wonder just what Pandora's box will unleash.

Anonymous said...

Pulse IT 16 June 2017 article describes "how test reports will be added to My Health Record". So it's all done and dusted then David? Tim Kelsey's on a winner is he not?

Interesting you cherry pick this, PulseIt also report a majority of there readers polled think ADHA scores a fail. Friends in the U.K. Confirmed that the current CEO is skilled at sales and marketing but the failure of care.data andNHS choices was widely seen as the weakness and inability to operate a programme of what was in the U.K. a rather small undertaking.

David it would seem that it is not only this blogs readers who are seeing patterns around performance that does not bode well for the future.

Bernard Robertson-Dunn said...

re: "I am sure overtime the MyHR will look to replace GP desktop software, probably use security as a leverage"

Really?

So how will they (the people who operate the MyHR) protect against widespread power disruption, communication failure and/or system overload because of medical/natural disasters? And of course the system would need to be high-availability, 24/7 and would cost two to three times as much as has already been spent and even then wouldn't be reliable enough.

Compared with a local system with local back-up power a centralised system is a non-starter. A national, centralised system can never be relied upon to support clinicians working at point of care, therefore such a system can only ever be a secondary system.

Anonymous said...

Bernard, you are correct if one applies logic, there are not many smart people in Government. It did get me wondering, once opt out takes place, how much additional accountability has the Government taken on board?

Anonymous said...

I don't believe there would be any case where the government could be held to account in relation to negative outcome resulting from use of their EHR system. If a case should arise I am sure legislation would be passed faster the a case could be brought to court. There is also clear evidence the government would apply great pressure on any individual who made such an attempt.