Don't Forget Mr David Gonski Is The Current Chairman of NEHTA.

A day or so ago the AFR published a review of Mr Gonski's board roles and previous links and boards.
You can review the article and graphic here:
http://afr.com/p/national/gonski_to_chair_future_fund_XOeSzNI2y1IbvNuynFCFwN
Here are the first few paragraphs of the associated article.

Gonski to chair Future Fund

Laura Tingle Political editor

March 14, 2012 

Federal cabinet last night confirmed prominent businessman David Gonski as the new chairman of the $73 billion Future Fund in a controversial appointment which bypasses the fund’s founder, Peter Costello, and other existing board members.
The government has also appointed Morgan Stanley managing director and chief executive Steve Harker to fill another position on the fund’s board.
Treasurer Wayne Swan and Finance Minister Penny Wong last night confirmed reports in The Australian Financial Review that the ­government had opted for an outsider, Mr Gonski, to replace the founding chairman, David Murray, rather than one of the fund’s ­“guardians”. They include Mr Costello and Goldman Sachs Australia and New Zealand chairman Stephen Fitz­gerald.
Senator Wong said the appointments brought “a unique combination of experience and strategic insight across business, corporate governance and investment markets and will position the board well for the opportunities and challenges ahead”.

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The number of roles - which actually does not even mention NEHTA - is just amazing. And now the chair of the $73 Billion Future Fund as well.
I wonder how much time, effort and insight was put in with NEHTA given all the other roles? Will he now leave? My view is that he should - given the large extra role he now has.
I wonder will having been the NEHTA Chair for the last few years come back to bite? We will see!
David.

The PCEHR Proponents Will Get a Big Fright When They Discover How Poor The Understanding of The Elderly Is Of Computer Security and Use.

The following appeared today:

Calls for better e-health safeguards

• by: Karen Dearne
• From: Australian IT
• March 15, 2012 12:15AM

THE Consumers Health Forum has called for a better complaints mechanism, greater investigative resources and additional safeguards against misuse of patient information for the personally controlled e-health record system due to launch on July 1.

The peak consumer body has turned to the Joint Select committee inquiry into Cyber-Safety for Senior Australians to raise additional concerns, including clarification around notification of data breaches on PCEHR records.

A Senate inquiry into the PECHR Bills and related matters is due to report its findings today.

"The complaints mechanism for the PCEHR will be crucial to ensuring the safety and security of consumer health information, and will be of particular interest to older Australians who are likely to be high end-users of the health system," the CHF said in its submission.

"Consumers have emphasised the importance of ensuring there is a single, clear avenue for making complaints.

"We recommend that the committee explore the management of the PCEHR complaints mechanism, and the possibility of a review of Medicare's role as the complaints body.

"We also recommend the allocation of additional resources to the Office of the Australian Information Commissioner to ensure it has the capacity to conduct investigations on behalf of consumers."

The CHF said older Australians, particularly those who lack computer and online health literacy skills, may be particularly vulnerable to misuse of information by third parties.

"We recommend the committee (considers) safeguards to prevent the misuse of PCEHR information by third parties, such as employers or insurers," it said.

The CHF notes that under the proposed enabling legislation, the system will provide an audit trail showing the organisations that have accessed their records, but not the healthcare professionals responsible for a breach.

"Consumers considered this would make it extremely difficult to identify any unauthorised viewings of their PCEHR, and will significantly undermine the safety of their record," it said.

Lots more here:

http://www.theaustralian.com.au/australian-it/government/calls-for-better-e-health-safeguards/story-fn4htb9o-1226299859094

The story sent me off to have a look at the submissions.

They can be found on this page:

http://www.aph.gov.au/Parliamentary_Business/Committees/House_of_Representatives_Committees?url=jscc/senior_australians/subs.htm

It is not often you find a collection of submissions from the likes of the Australian Crime Commission along with those of NEHTA and DoHA.

First it is clear the Consumer Health Forum - in the politest possible way says the PCEHR is open to all sorts of potential abuse with low levels of authentication etc.

Secondly it is clear NEHTA and DoHA are really lacking any way to properly authenticate consumer PCEHR users that would be considered robust. (They hope to authenticate providers at some stage but consumers, well, there are just too many of them.)

Third many of the submissions point out just how ill-equipped many of the older consumers are to handle the complexities of PC security, system updates, the cost of it all and so on.

Fourth reading the comments from both NEHTA and DoHA it is clear the real world of elder computer use has passed them by.

In that regard the first submission says it all:

Tandara Lodge Community Care Inc. (PDF 1281KB)

Talk about the real world and fantasy colliding.

Given the older Australians are a target for the PCEHR, NEHTA and DoHA seem woefully behind the curve - offering as a solution simple brochures and a help line!

Oh dear.

David.

Another Deferral of Senate PCEHR Inquiry Report

Reliable sources are now indicating the report will be released some time after Tuesday next week.

It seems there is even more documentation that is having to be considered.

To fill in the time you can read the responses to Questions on Notice from the public hearings:

Go here:

http://www.aph.gov.au/Parliamentary_Business/Committees/Senate_Committees?url=clac_ctte/pers_cont_elect_health_rec_11/submissions.htm

At the bottom of the page.

Further updates as they come to hand.

UPDATE: 1.00pm 15/3/2012

Apparently Monday 19th March is planned to be the day.

David.

A Wild Guess About The Outcome of the Senate PCEHR Inquiry

My guess:

2 reports.

The Government will say it is all 'tickety-boo' and has to rush ahead unchanged.

The Opposition will say ' this looks pricey, risky and complicated' so maybe we should have a pause to work out what are the good and bad bits.

The Greens will be concerned about a range of 'soft' issues but want to play nice with their partners in Government so will support the majority report.

We will all see tomorrow apparently!

David.

The Sad End Of Lorenzo - A Brave and Quite Advanced Idea That Just Didn’t Work. A Book Of the Why Would Be Fascinating.

The following appeared a few days ago.

DH secures £1 billion savings from CSC

5 March 2012   Exclusive by Jon Hoeksma

CSC has announced a revised deal with the Department of Health that will secure savings of £1 billion from its disputed £3.1 billion deal for the North, Midlands and East of England.

EHealth Insider understands that the new deal draws a line under DH contractual liabilities as well as securing the savings.

The savings are twice those announced in 2011 when the government first announced that it would be 'scrapping' the National Programme for IT in the NHS.

The deal will also ensure that CSC is paid for past work done and for maintaining existing systems. But the extent to which it commits the NHS to further implementations from CSC is unclear.  

In a US market announcement, CSC said today that it has “signed a non-binding letter of intent with the UK Department of Health (NHS) that defines a way forward for CSC to deliver healthcare solutions and services, primarily across the North, the Midlands and East of England."

The statement adds: "The principles contained in the letter of intent are intended to establish a framework for a broad agreement to be entered into by the parties by 31 March 2012."

The market announcement adds: "As a part of this agreement, it is intended that CSC will contract to deliver additional Lorenzo implementations, adding to the 10 deployed successfully to date, with options for more where demand materialises."

Lorenzo is the system originally developed by iSoft that CSC has been trying to deploy to trusts in the NME.

The company's local service provider deal for the regions was thrown into turmoil last spring, when Pennine Care NHS Foundation Trust, the last of four, key, early adopters, pulled out of the programme.  

Since then, the company has been locked in negotiations with the DH about a new deal, but the talks have been complicated by enquiries by watchdogs, Parliament and ministers into the national programme and the CSC deal in particular.

Last month, CSC warned that it might not get the deal it wanted, took a £1 billion write-down on the programme, and announced that it was looking to make 500 people redundant from its NHS account.

The DH appears to have decided not to completely terminate CSC’s contract, even though it said it considered the company was in breach of contract when Pennine Care left the programme. CSC has always rejected the suggestion it was in breach of contract.

.....

In return for the new deal, CSC is expected to be required to deliver a simplified version of Lorenzo to an unspecified number of NHS trusts in the NME. One source described this software as essentially a patient administration system.

EHI further understands that development of the more advanced Lorenzo 1.9 electronic patient record system has been shelved.

Lots more here:                                                                              

http://www.ehi.co.uk/news/acute-care/7587/dh-secures-£1-billion-savings-from-csc

As far as I can tell I first chatted about Lorenzo about 6 years ago.

Tuesday, August 29, 2006

iSoft – A Problem for More than the NHS!

In November 2005, I had the opportunity to review, in some considerable detail, the Hospital Information System which was being offered to an international client as a solution to provide advanced computer services for a three hundred bed tertiary private hospital.

It was clear at that time that the iSoft Lorenzo software suite was little more than ‘foilware’. The system was a concocted blend of old and new components, was obviously un-integrated and lacked any common utility in its user interface.

Needless to say I recommended that no further engagement be had with iSoft and that alternative providers of the necessary HIS software be considered.

See here for the full blog:

http://aushealthit.blogspot.com.au/2006/08/isoft-problem-for-more-than-nhs.html

Well it certainly seems that my instincts were right as now we see the system being both de-installed and essentially scaled back to a Patient Administration System.

We can only wonder why this all went so badly - having started with such promise. As I noted in the title a frank book would be fascinating!

If you want more of the history it is here:

http://aushealthit.blogspot.com.au/2006/10/how-did-isoft-get-into-so-much-trouble.html

The Lorenzo vision essentially destroyed a good portion of the NHS Program for Health IT and indirectly our largest Health IT company of the time here in Australia. Really quite a saga!
En-passant I wonder what happened to the much hyped super specialty hospital at Macquarie University and its implementation that was said at the time to be Lorenzo?
Anyone know?

David.

Report Release Alert - Senate PCEHR Inquiry Report.

The Australian is reporting the Report will be released tomorrow (Thursday)

Here is the link:

http://www.theaustralian.com.au/australian-it/government/senate-e-health-findings-loom/story-fn4htb9o-1226298801493

The Senate Page on the Inquiry has not been updated to reflect this when checked.

We wait and see!

David.

What Is Provoking All This Do You Imagine?

I was alerted to this posting late today. Not a blog I actively follow these days.

I am not sure what has provoked all this since the blog objectives were updated months ago.

Have a look here.

http://www.ehealthcentral.com.au/2012/03/ehealth-objectives-vs-objectivity/

The old rule that states 'If you can't say something nice, just remain silent' seems to have gone by the wayside.

Read and judge for yourself.

David.

We Have A Way To Go on PCEHR Privacy Plans It Would Seem. In Fact It Seems To Be Going Backwards in Some Ways.

The following document appeared in the FOI Section of the DoHA website a few days ago.

23 February 2012

Preliminary Privacy Impact Assessment (PIA) into the personally controlled electronic health record (PCEHR) system undertaken by Convergence e-Business Solutions.

You can download the document cited from here:

FOI 237-1112 Large File document 1 (PDF 1921 KB)

1 document full release.

What is interesting is that the document was written by a former very senior NEHTA Staff Member Dr Bridget Bainbridge.

The document was finalised in June 2011 and for some reason is labelled

CONFIDENTIAL - DoHA LIMITED CIRCULATION ONLY.

The key findings are presented on pages 5 and 6 of the report.

The points from the summary and the overall document I noted were:

1. It is clear having NEHTA doing technical design and DoHA doing policy setting was very unsatisfactory resulting in a Concept of Operations document which was not really fit for purpose.

2. Actually doing a proper Privacy Assessment requires much more stable technical and policy environment than presently exists.

3. The lack of a clear governance framework - which still persists - is mentioned often

4. There is a clear sense that the present legal patchwork covering privacy is just useless - with some areas not being covered and other areas having multiple different laws around the same area at State and Federal level.

5. There is a pretty clear sense that the author of the report does not believe DoHA or NEHTA really have their ’heads around’ the complexity of what is being proposed.

6. The ConOps was not sufficiently complete to permit assessment of end-to-end and longitudinal privacy impact as there was not enough detail on who would hold and mange just what information.

Sadly later versions still of ConOps and the PIA still really don’t get to grips with these issues as far as I can see.

The November 2011 attempt at a PIA is to be found here:

http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/pcehr-legals-pia#.T1Vst_XkZ8E

I have to say I agree with Dr Bainbridge in as much as she is suggesting that the true complexity and risk of the present plan is underestimated. The update from other authors does not seem to have improved things, in fact some key issues seem not to be followed up at all.

The document is clearly worth a download and careful read. That a later document has been released while the earlier one has needed FOI to be seen suggests this might be one that is quite close to the truth.

Time will tell if this whole PIA program is working or not I guess.

David.