Sunday, February 03, 2019
The Goings On In Queensland E-Health Really Do Have It All As Far As Going Off The Rails Is Concerned.
A rather terse press release from the Director-General a day or so ago (31/1/2019)really had the staff agog.
This morning, I provided allegations to a senior eHealth Queensland executive about a potential undeclared conflict of interest regarding an alleged relationship with a staff member involved with the Patient Administration System replacement.
The allegations are not related to the rollout of the state’s digital hospital system – the Integrated Electronic Medical Record (ieMR) system.
The information has been referred to the Crime and Corruption Commission who is investigating.
The Patient Administration System records and retrieves non-clinical related information about patients, and is not part of the ieMR project.
The Department of Health will not proceed further with the current process for a replacement Patient Administration System. This will mean we will not have a replacement system in place as quickly as we’d like but the procurement must be beyond reproach.
I want to acknowledge the professionalism and work of the staff in the eHealth Queensland-based Patient Administration System replacement team.
I expect all of Queensland Health’s 90,000 staff to meet the highest possible standards.
Today, the eHealth Chief Executive resigned for personal reasons.
The Department will not comment further on the investigation into the issue while it is ongoing with the CCC.
Media contact: 3708 5376
Here is the link:
Wow! Corruption, relationships and a resignation of the CEO. Quite a day for those involved.
The story has run in the Brisbane Times for the last few days.
There is this:
29 January 2019 — 10:54pm
Patients will be seriously harmed if the rollout of Queensland Health’s multimillion-dollar integrated electronic medical record project continues, clinicians and private consultants have repeatedly warned the state government.
Blood tests labelled with the wrong patient data, personal information going to the wrong patient records, surgeons and doctors unable to see or find key patient data on the software, patients administered double doses of medication, cervical screening tests going missing, and multiple alerts telling clinicians not to use the software because data is not showing up correctly are documented examples of the integrated electronic medical record damaging patient health.
But a spokesman for acting Health Minister Mark Bailey said patient safety had “markedly improved” since the integrated electronic medical record was rolled out, and it had reduced the average length of stay, unplanned re-admissions, and the number of serious falls and pressure injuries.
The integrated electronic medical record (ieMR) is designed to allow every Queensland patient’s full medical record to be shared across all public hospitals. The aim is to improve patient care and safety but clinicians say the opposite is occurring.
Projected to cost $600 million in 2017, the ieMR project was recently revealed to be costing Queensland taxpayers at least $1.25 billion for installation and maintenance alone until 2025.
A Brisbane Times investigation has revealed software flaws are putting patients at risk, and clinicians are deeply distressed by the pressure placed on hospitals and staff by eHealth Queensland to accept the integrated electronic medical record.
Vastly more here:
30 January 2019 — 9:49pm
A Queensland Health general manager requested an independent consultant modify a 2014 report to remove damning warnings about the department’s electronic medical record project, documents reveal.
About 40 pages of the 105-page report were requested to be removed, including all "unfavourable statements" about the integrated electronic medical record project and references to a US children's hospital which recorded an "unexpected increase" in children's deaths after an electronic health record was rolled out.
The consultant refused in writing to alter the report, saying the company would “not engage in any activity that constitutes professional negligence or unconscionable conduct”.
The consultant's final unaltered report, leaked to Brisbane Times from within Queensland Health, found it appeared “no lessons have been learned” from the Queensland Health 2011 payroll debacle, and serious problems with the electronic medical record in other jurisdictions “[seem] to have been ignored”.
The consultants, Bushell & Cornish, further warned the integrated electronic medical record system could have similar consequences as the Queensland Health payroll catastrophe when released into Queensland’s hospitals.
In 2011, a failed attempt by Queensland Health to transition public hospitals to a new staff payroll system saw thousands of staff go without pay, triggering a commission of inquiry in 2013.
Queensland Health’s integrated electronic medical record (ieMR) is a multimillion-dollar project to install a statewide patient record that can be accessed by all doctors and staff at all hospitals, for all patients.
A spokesperson for acting Health Minister Mark Bailey said the consultant's report into the electronic medical record was commissioned by the Campbell Newman-led LNP government "and any questions about it should be referred to them".
“The recent Queensland Audit Office report into digital hospitals released just last month, confirmed the digital hospital program is improving healthcare and patient outcomes,” the acting Health Minister’s spokesperson said.
“Patient safety has markedly improved since the integrated electronic medical records was first rolled out.
“It has reduced the average length of stay, unplanned readmissions, and the number of serious falls and pressure injuries.”
Clinicians believe an electronic medical record is a valuable and powerful tool for doctors across the state, and one should be installed in Queensland hospitals.
However, since Queensland Health began the rollout of the Cerner software, clinicians and health bodies have repeatedly warned the state government the software is dangerously flawed.
Again vastly more here:
31 January 2019 — 4:06pm
Senior Queensland Health executive Richard Ashby, who led the eHealth Queensland division responsible for the integrated electronic medical record project, has resigned amid allegations of an undeclared personal relationship with a staff member and has been referred to the Crime and Corruption Commission.
Queensland Health staff received an email from the department's director-general Michael Walsh announcing Dr Ashby's resignation on Thursday.
In a statement, Mr Walsh said he "expect[s] all of Queensland Health’s 90,000 staff to meet the highest possible standards".
"This morning, I provided allegations to a senior eHealth Queensland executive about a potential undeclared conflict of interest regarding an alleged relationship with a staff member involved with the Patient Administration System replacement," Mr Walsh said.
Again a lot more here:
And a day or so ago this:
1 February 2019 — 12:08pm
A "very strange model" allows all Queensland Health clinicians to edit the medical data of all patients in public hospitals that have the integrated electronic medical record installed, a leading health law expert says.
Queensland University of Technology innovation law professor Matthew Rimmer said it appeared the $600 million electronic medical record project had a “whole host of issues”.
QUT law professor Matthew Rimmer: “There’s a real failure there to understand what adverse impacts could take place.”
Dr Rimmer, who specialises in intellectual property and public health, questioned why clinicians working in any of the state's digital hospitals could view any patient's record and edit all aspects, including medication prescriptions.
“That seems a terrible approach, surely one would want to engage in data minimisation,” he said.
An Australian Medical Association Queensland letter to Queensland Health director-general Michael Walsh, dated September 2018 and seen by Brisbane Times, warned that clinicians were seriously concerned about the statewide access.
"Clinicians are concerned that write access to medication charts outside their immediate hospital can result in adverse events," the letter reads.
"For example, a doctor from Princess Alexandra Hospital had prescribed heparin on a patient in Mackay ICU who was also on other blood thinning agents, resulting in the patient bleeding and coming to harm."
The letter says the AMAQ's medication safety committee had been "inundated with incidents" due to difficulties prescribing medications such as insulin and heparin, a blood thinner, through the integrated electronic medical record (ieMR), and other medications have gone missing from the system.
In one instance a clinician calling the ieMR helpline because oxytocin "went missing from the system" was told to prescribe an alternative drug, when there was none available.
"System wide 'upgrades' have also resulted in alerts to all ieMR sites about patient safety risks on the medication module and an order to revert to using paper with little notice," the AMAQ letter says.
The letter cites an alert issued on April 11, 2018, which warned of urgent patient risk.
Read the full saga here:
A huge well done to Lucy Stone, the journalist, for getting all this out in the open. There is clearly a rather sordid mess happening here which is going to need some considerable skill to resolve as Qld. Health needs a functional modern PAS and a decent clinical implementation of a feature rich EMR. The challenge will be in the way the change is handled and people are brought along to support what is done.
My guess is that, having seen the fairly useful Cerner implementation at RNSH up close, that the problem is 95% people and change management and maybe 5% technical if that. There is way too much ‘blood on the carpet’ here and I hope a prompt and sensible way through can be found.
Queensland Health needs and deserves that.
Posted by Dr David G More MB PhD at Sunday, February 03, 2019