Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

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

Friday, March 19, 2021

I Wonder What Is Really Going on Here? It Seems Very Late To Be Asking The Question!

This appeared and closed pretty quickly!

Australian Digital Health Agency

RFQ DH3265 - Cost benefit analysis of Australian healthcare identifiers

Opportunity ID

11560

Deadline for asking questions

Thursday 11 March 2021 at 6pm (in Canberra)

Application closing date

Monday 15 March 2021 at 6pm (in Canberra)

Published

Monday 8 March 2021

Panel category

Strategy and Policy

Overview

• Document benefits and disbenefits for Australian healthcare identifiers – HPI-I, HPI-O, IHI • Develop methodology/cost model to assign to benefits • Complete cost benefit analysis for HPI-I for each state and territory governments, based on costs to be provided by the Australian Digital Health Agency

Estimated start date

29 March 2021

Location of work

Offsite

Working arrangements

Weekly update and additional meetings if required

Length of contract

3 months

Evaluation criteria

Essential criteria

Weighting

Ability to meet scope and requirements 40%

Availability and ability to meet deadline 20%

Experience working with engaging jurisdictions and Commonwealth effectively in digital health space 40%

Here is the link:

https://marketplace.service.gov.au/2/digital-marketplace/opportunities/11560

As best I can tell Legislation enabling the Health Identifier System presently used in Australia was passed in 2010.

Here is the link:

http://classic.austlii.edu.au/au/legis/cth/consol_act/hia2010199/

Here are the contemporaneous details:

“The Healthcare Identifiers Bill 2010 was introduced to Parliament on 10 February 2010. The Healthcare Identifiers Bill 2010 was passed by Federal Parliament and received Royal Assent on 28 June 2010. The then Chief Executive Officer of Medicare Australia commenced operations as the Healthcare Identifiers Service Operator (HI Service Operator) on 1 July 2010. There have subsequently been Regulations made under the Healthcare Identifiers Act2010 (HI Act) on 20 October 2010. The Act anticipates that a State or Territory may make its own Healthcare Identifiers legislation to cover public bodies of that jurisdiction. It is noted that Healthcare Identifiers are regulated under existing legislation in some jurisdictions, such as Health Privacy Principle 12 in the NSW Health Records and Information Privacy Act 2002.”

So what on earth is going on now?

I would suggest the Health Identifier Service is so embedded into the National Digital Health Infrastructure that working out what benefits it now provides would be tricky? Do you turn it off and see who bleats or what?

As far as I know the system is used throughout the country by both the private and public sector for document, report and record matching and so on as well as regulating access to the #myHR and so on.

Is the Commonwealth wanting to charge the States for it use do you think or are they wanting to justify turning it off?

I have no idea – suggestions welcome!

David.

 

27 comments:

Anonymous said...

Maybe someone is starting to ask questions about the net benefits ADHA and its predecessors have actually delivered. It would appear that ADHA is only providing costs for identifiers

Dr Ian Colclough said...

disbenefits - please. Who writes this nonsense? Is that an antonym of benefits?

Dr Ian Colclough said...

www.merriam-webster.com Dictionary definition of:

A disbenefit is the measurable decline resulting from an outcome perceived as a negative by one or more stakeholders. Disbenefits are different to project risks. ... Disbenefits are more typically managed and mitigated after the project has been delivered.

Well that's pretty clear isn't it?

Bec said...

Maybe it should have been missed-benefits, sure there are a few of those.

Anonymous said...

Here's a disbenefit

Pfizer coronavirus vaccine doses wrongly delivered to Perth instead of Adelaide, delaying SA rollout

https://www.abc.net.au/news/2021-03-19/sa-coronavirus-vaccines-wrongly-delivered-to-perth/100018366

A shipment of Pfizer vaccine doses destined for South Australia has been wrongly delivered to Western Australia, causing delays to the state's rollout.

Key points:

A shipment of Pfizer vaccines intended for Adelaide has been wrongly sent to Perth

The mistake will delay the rollout of the vaccine in SA

Aged care facilities were told scheduled immunisations would not be happening today

The ABC understands aged care facilities involved in the phase 1A rollout were told by the federal Department of Health that COVID–19 immunisations would not be happening today as scheduled.

Impacted care homes were originally told the delay was the result of a "logistics issue".

The ABC has been told the issue that caused the setback was that a shipment bound for Adelaide was incorrectly delivered to Perth.

tygrus said...

"Disbenefits" sounds strange. "Disbelief" is the word that comes to mind when investigating claimed benefits & real achievements from actual implementations of government led eHealth/DigitalHealth.

John said...

Dis-benefits (with a hyphen) is the proper term in that context (sloppy and probably a worshipper of SAFe) – simple put “the outcomes from a programme which are perceived by one or more stakeholders as negative, e.g. new operational costs, or loss of green space in an area due to the building of a new school. The same change can be seen by different stakeholders as both a benefit (net cost reduction through fewer staff) and a dis-benefit (job losses). These dis-benefits can be classified, managed and measured in the same way as benefits. - this is the general description using OGC frameworks (P3O, MSP, Prince2 ITIL etc).

As an example: Let’s say you purchase a new car for $40K cash; this is a cost, not a dis-benefit. Upon the purchase, you assume an increase in home operating costs associated with the car: car insurance payment, fuel to run the car and associated car maintenance. This change in home on-going operating costs are dis-benefits and are not included in the purchasing cost of the car. Dis-benefits are only included when considering Total Cost of Ownership of the car.

Another might be: A project manager is constructing a large water dam. The project manager incurs a budget shortage. To compensate, the project manager purchases less expensive turbines with a shorter maintenance cycle. The end result is less project cost, but higher operating cost (dis-benefits). The “magic” is done using mirrors by shifting the project cost reflection to dis-benefits (i.e., now a concern of the operations manager instead of the project manager). Hopefully, the project stakeholders are astute enough to understand the “illusion.”

So in the context of the tender dis-benefits are changes to on-going operating costs as a result of a project; they could be perceived as positive or negative. These dis-benefits are included in defining the Total Cost of Ownership rather than a component of project cost, and is more of a focus for controllers due to its on-going nature rather than one time project savings and revenue.

I applaud the desire here, but am not convinced what ADHA understands the scope of what they are asking, that or it is an attempt at illusion.

(Examples taken from old educational material)

Anonymous said...

..... the error has been described as a "change in schedule" by the Federal Health Department and the Health Minister.

POLITICAL SPEAK equals BULLSHIT.

It is virtually impossible today for many Federal politicians and bureaucrats to confront and accept reality, to speak openly and honestly, to use plain unambiguous language to describe a situation that has gone awry and is embarrassing.

WARNING.
Women of Australia do not expect much to change while this deeply-embedded self-serving artificial 'language' remains te norm in the House of Federal Politicians.

NOTHING will change.
RESISTANCE will prevail.
MAINTAIN the rage.

Anonymous said...

re benefits and disbenefits. How about someones asks if it has any value - i.e. if anyone actually wants it, whatever the claimed benefits might be.

Anonymous said...

@9:56 AM Well said. This should be widely distributed on Social Media.

Anonymous said...

The vaccines went to WA instead of SA. This was not a Change of Schedule. The vaccines went AMISS; plain and simple Minister.

Amiss is clear speak not political gobbledygook.

Anonymous said...

Ministers don't seem to realise that when they fudge and exaggerate it devalues everything else they say.

People start to wonder if what the government says about MYHR is actually true.

Long Live T.38 said...

Supply chain mistakes and MyHR are all very interesting. The post is about the HI service. As David points out the service is well amd truely embedded and in use. Not completely as intended but embedded. What John describes does sound like a large question. Not convinced it is the intention of ADHA.

My guess it is a gig for a mate running a small consultancy and is intended as shelf ware. The sort of independent report where the answer is provided.

Anonymous said...

March 20, 2021 12:54 PM - you might be right, we seem to have a core group like that, all previous employees of ADHA and associates from Nehta days. All full of it and a bit patronising. The last half a job clown ran some process dictating how standards should be selected and agreed by small groups of “experts” behind closed doors. The funny thing was most old guard had little time for him or his opinions.

Hopefully all this will soon stop amd the bush was can settle down and be a business again instead of personal experiments.

Anonymous said...

March 20, 2021 2:02 PM - second that, information modeller extraordinar, technical writer and Business analyst god was the impression I got.

G. Carter said...

The aim of individual healthcare identifiers is to help healthcare providers accurately communicate information with each other and identify and access patient records in the My Health Record system. The purpose of healthcare provider identifiers is to identify providers accessing the HI Service database and to link records with the right healthcare provider, at the right location.

Anonymous said...

The key theme G Carter would be the My Health Record. Clearly this is about the My Health Record not the HI service. The former a success story of pre-PCEHR/MyHR days. Since the HI act was passed we have witnessed 11 years spent floating about in a used kidney dish.

Anonymous said...

Reviewing the ongoing value is never a bad thing. Might be good if all identifiers were assessed, there are up to 30 per citizen in some cases. But as others point out, this is just a standard gateway review process. The previous short-term CEO deploy these and other track covering exercises.

Anonymous said...

Please leave the former CEO out of your les than polite comments. She came of a break to lead the Agency through difficult times and implemented great cultural initiatives and made us all feel safe during her tenure. A great showing of unselfish sacrifice to help others in troubled times.

Andrew McIntyre said...

"The purpose of healthcare provider identifiers is to identify providers accessing the HI Service database and to link records with the right healthcare provider, at the right location."

Yes, that is what they should be, but that is not what was delivered. They are not location specific, which makes them next to useless. Another huge waste of money, Someone in the past had their act together as provider numbers do both quite well.

Sarah Conner said...

A great showing of unselfish sacrifice to help others in troubled times. - Hmmmmmm

Well $367k pay cheque sounds like a sacrifice most could only dream of. As for the elements I understand there are many views on that.

Anonymous said...

Sara Conner - where did you get the tidy sum of $367,000?

Sara Conner said...

Data taken from the 2019-2020 Annual report - https://www.transparency.gov.au/annual-reports/australian-digital-health-agency/reporting-year/2019-20-11. - Human Resource Management Section.

I have no issue with peoples remuneration- just don’t tell me it is done solely out of the goodness of one heart.

Peter Padd said...

G Carter interested in your thoughts on how overtime HI has delivered benefits. As an insider are they also looking at NASH? Which seems to have been a series of failures from the very beginning.

Bernard Robertson-Dunn said...

NASH - as defined in the Concept of Operations and supposedly to be implemented by IBM - was never delivered. They used an existing institutional (rather than a per individual id) oriented system the Centrelink had already implemented.

Yet another failure, just like the "essential" interoperability on which the whole edifice was designed.

What was delivered was not what was designed, so the system does not do what it was originally promised.

But the rhetoric claims that it was.

G. Carter said...

Worth scanning the previous reports on the HI service. A four to five year event. https://www.ehealth.gov.au/internet/main/publishing.nsf/Content/91134273A157B7B0CA257C350014D786/$File/Healthcare%20Identifiers%20Act%20and%20Service%20Review%20Final%20Report.pdf

Amazing how you can overlay the closing of Nehta the ADHA years and the distraction that is the my health record and see the effect of inaction and poor leadership. Still at least they focused on creating corporate culture every year shaped in their own image but still managed to retain the bumbling performance and tribalism.

Sarah Conner said...

Bernard writes - What was delivered was not what was designed, so the system does not do what it was originally promised.

But the rhetoric claims that it was.


No surprise then that those behind the designing have all overtime been nailed to the portcullis wall. Those that ignored the designers and bumbled the implementations have largely gone on to bumble even more, each time seemingly rewarded. I guess they own the story hence the rhetoric.