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."

Thursday, September 12, 2013

Oh Dear, Here We Go Again With These Serial Patent Trolls. Will They Chase NEHTA Again?

This appeared a little while ago.

MMRGlobal Says It Will Refile Patent Lawsuit Against WebMD

Following a February filing of a patent infringement lawsuit by MMRGlobal against WebMD (NASDAQ: WBMD) , the two sides agreed in June to try and resolve the matter outside of the courtroom. However, MMR said today that after investing a total of "nearly eight months in good faith negotiations with WebMD," it has decided to refile the suit.
The original suit alleged that WebMD infringed on MMR patents involving its personal health record (PHR) and related technologies. MMR said it has since received another patent it claims WebMD may be infringing upon, and intends to include it in the soon-to-be refiled lawsuit.
MMRGlobal said in its press release that "the door will always be open to a fair negotiated resolution."
More here:
There is also coverage here:

MMRGlobal To Refile Patent Infringement Lawsuit Against WebMD

Wednesday, September 4, 2013
On Tuesday, MMRGlobal announced that it will refile a lawsuit alleging that WebMD infringed on MMRGlobal patents for personal health records and other technology products, the Motley Fool reports.

Background

MMRGlobal originally filed suit against WebMD in February.
In June, both sides agreed to resolve the issue outside of the court system.
…..

WebMD's Response

In response to MMRGlobal's announcement about its plans to refile the lawsuit, WebMD said it "believe[s] the plaintiff's claims are without merit."
The company said it will "vigorously defend" against the claims of infringement (Motley Fool, 9/3).
Full article here:
All I can say is that I hope NEHTA has told these pests to simply go away. They are just a blight on the landscape that I note the US Government is now working to tighten things up to make this sort of behaviour much harder.
For an Australian perspective there is a useful podcast from a week or so ago.

Patents are only inventive sometimes

Sunday 25 August 2013 7:45AM
According to Dr Hazel Moir from the Research School of Social Sciences at the Australian National University, most of the time innovations covered by patents are not really very inventive at all. In her book Patent Policy and Innovation Dr Moir attacks the patent system. She recommends that policy makers have a look at the quantum of new knowledge that ought to be required to make an invention worthy of protection.
See here for the audio
This is a problem that really needs to be sorted.
David.

Wednesday, September 11, 2013

I Think This Is A Really Good Idea. They Should Get On With It!

This appeared a few days ago:

Coalition pitches 'IT dashboard'

  • by: Stuart Kennedy, IT Editor
  • From: The Australian
  • September 03, 2013 12:00AM
THE Coalition, if elected, will open up an online window viewable by the public that tracks how major federal IT projects are performing and shake up oversight of government technology spending.
The proposed online dashboard window was one of a list of digital economy and e-government initiatives released yesterday in a joint statement by the Coalition's finance and communications spokesmen Andrew Robb and Malcolm Turnbull.
As well as the dashboard, the Coalition promised to trial an opt-in, secure digital inbox for communications from all levels of government to citizens, from next year and to require three government agencies from next year to trial cheap, new-wave telepresence systems such as browser-based Web Real-Time Communications.
The dashboard idea has been copied from the Obama administration in the US, which has had its www.itdashboard.gov service online since 2009.
To push government IT services online, the Coalition said it would ensure every government interaction that happened more than 50,000 times a year would be able to be carried out online by 2017. It would make the internet the default for interactions and create a digital service standard and digital design guide modelled on existing British systems.
From 2015, agencies would be forced to report on what proportion of their digital services aren't enabled for mobile devices.
The Coalition would keep Labor's National Digital Economy Strategy, launched in 2011, saying it would further develop the strategy in conjunction with states and territories.
Lots more here:
A plan like this should be adopted both at the State and Federal level. Think how we might have avoided the problems with the PCEHR, HealthSMART and the Qld Health Payroll Program.
Slightly at a tangent - but also in the Government IT Policy area I was pointed to this last week. A really visionary report from a UK think tank on long term Government digital futures.
Sadly with this bit of good news there is also a bad bit.

NICTA to lose $42m in Coalition cuts

FUNDING for research body National ICT Australia has been slashed as part of Coalition cuts before the federal election.
The Fiscal Budget Impact of Federal Coalition Policies released by opposition treasury spokesman Joe Hockey includes $42 million cuts by 2015-16 for discontinuing direct federal government funding to the ICT Centre of Excellence.
Given that NICTA bagged $185.50 from the Federal Government for 2011-15 at an average of $46.4 million per year, the cut is equivalent to an entire year's federal funding of the ICT research icon.

NICTA had obtained the funds just last month, which means it would have been funded for the 2015-16 financial year; the cut raises the question of whether the Coalition will offer NICTA financial support beyond June 2015, and if not, whether NICTA's days are numbered.
Lots more here:
Seems very odd to me.
David.

Tuesday, September 10, 2013

NEHTA Reports On e-Health Progress. Shows Oz E-Health Is In Disarray And That DoHA Is Just Being Obstructive and Childish!

This appeared a few days ago.

NEHTA eHealth Scorecard

Created on Thursday, 05 September 2013
This scorecard shows progress in adoption of national eHealth programs across sectors. Uptake is shown for the PCEHR system, secure messaging, electronic prescriptions and dispense ratios, healthcare identifiers and the national authentication service for health. This scorecard does not present a complete picture of uptake of eHealth, as it is limited by the data available to NEHTA.
This scorecard shows progress in adoption of national eHealth programs across sectors. Uptake is shown for the PCEHR system, secure messaging, electronic prescriptions and dispense ratios, healthcare identifiers and the national authentication service for health. This scorecard does not present a complete picture of uptake of eHealth, as it is limited by the data available to NEHTA.
Most notably, the widespread implementation of electronic medical records in hospitals is not shown, nor is the volume of messages sent between hospitals and general practice, which have been some of the most substantial eHealth programs within States and Territories.
The release is found here:
Before discussing a few points that are made in the report I have to say there is one astonishing sentence found in the release. This is:
“This scorecard does not present a complete picture of uptake of eHealth, as it is limited by the data available to NEHTA.”
What on earth is this telling us. As I read it, it is saying we don’t actually know what is actually going on in the e-Health space. Surely if anyone is meant to know and to be reporting what is going on it should be NEHTA. Just what are they being paid for if it is not this as at least part of their role. This all goes back to the increasingly clear fact that NEHTA really is not being governed and led appropriately to meet Australia’s e-Health future.
As far as the contents we have the following.
Page 2.
“Meaningful use data is not yet available to NEHTA in relation to the PCEHR System, though a change request has been progressed through DOHA to expand the data available to NEHTA to allow this reporting to occur. It is expected that the next scorecard will contain more detailed information on use of the PCEHR System. In the meantime, we can report that 4,585 shared health summaries have been uploaded to the PCEHR System as at 31st July, an increase of 230% since 23rd May 2013. More detail about documents uploaded to the PCEHR System by providers can be found in figure 5 on page 5. In addition, figure 8 on page 5 illustrates that ePrescription volumes continue to rise significantly.
There has been no change in the rating of benefit realised. Data that would permit evaluation of the extent to which benefits have been realised is not currently available to NEHTA, though qualitative case studies are indicative of early improvements associated with use of the PCHER System and other eHealth solutions. “
So we have no real idea how much the PCEHR system is actually being used and if DoHA knows - as System Operator - it does not know!
By the way has anyone ever seen a definition of what NEHTA and DoHA think is ‘Meaningful Use’. This is well defined in the US - where the term came from - but in Australia I have seen nothing. Let us all know if you have.
Page 3 seems to be saying that Community Pharmacy has a long way to go at present.
Page 5 shows us that provider usage is still less than 5% of the possible providers.
Page 6 shows us how the paid push has ramped up the numbers of people who have registered for a PCEHR.
Page 7. On the consumer view.
“Meaningful use by consumers appears to remain at a low level, and detailed data is not yet available to NEHTA. The number of consumer portal accesses lags the total number of registrations, indicating that not all consumers are interacting with the PCEHR System after they have registered. By comparison, the frequency of accessing via the mobile gateway, which has been accessed 81,733 times since 12 May 2013, is very high relative to the number of CeHR apps that have been downloaded. This would seem to indicate that the mobile channel is capable of driving relatively high engagement. Lastly, 30,700 documents have been uploaded by consumers; see figure 14 on page 9 for more detail. “
Overall it is just a shocking report as it reveals two amazing things.
1. NEHTA and DoHA are simply not working together closely - why else would we have the comments above about not having information.
2. No one has worked out just what Health Outcomes (which is surely the purpose of the PCEHR) are to be measured.
This is just a mess!
David.

Monday, September 09, 2013

Weekly Australian Health IT Links – 9th September, 2013.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

With the election done and dusted we now need to see what happens next. We have to assume there will be a period of consolidation and probably it will be towards the end of the year before we see any changes. I guess we can just standby for a while!
For this week there is little else to say…I think things will be very quiet for a while.
-----

E-health needs urgent care after election

The Consumers e-Health Alliance says the incoming government needs to address the troubled national medical information-sharing system with some urgency if any benefits are to accrue from efforts to date.
“The primary aim of any e-health system must be to improve outcomes of individual patients who choose to participate, and to also address population health improvements,” CeHA convenor Peter Brown said.
“But the Personally Controlled e-Health Record program is not yet achieving that goal, nor is it delivering the broader community and productivity benefits needed to sustain a quality healthcare service.
-----

NEHTA eHealth Scorecard

Created on Thursday, 05 September 2013
This scorecard shows progress in adoption of national eHealth programs across sectors. Uptake is shown for the PCEHR system, secure messaging, electronic prescriptions and dispense ratios, healthcare identifiers and the national authentication service for health. This scorecard does not present a complete picture of uptake of eHealth, as it is limited by the data available to NEHTA.
…..
-----

Guild urges pharmacists not to sign up to PCEHR

6 September, 2013 Nick O'Donoghue
Pharmacists working outside “lead e-health sites” are being encouraged not to sign the National e-Health Transition Authority (NeHTA) participation agreement, which is a requirement for the PCEHR.
The latest NeHTA scorecard for organisation uptake of e-health, including the PCEHR, found that readiness for the system was moderate in the community pharmacy sector, with software that implements NeHTA specifications available to 65% of the market.
However, just 271 community pharmacies were registered with the PCEHR on 10 July 2013, up from 168 in the previous reporting period.
“This represents an increase of just over 60%, but from a low base” the report said.
“The majority of pharmacies registered in the PCEHR system are in Tasmania, Queensland and Victoria, with Tasmania having registered an estimated 48 per cent of all pharmacies in the state.
-----

MLs working, says Plibersek

3rd Sep 2013
HEALTH Minister Tanya Plibersek has warned that the Coalition’s intended review of Medicare Locals is little more than a “veiled” excuse to dismantle the primary healthcare bodies and sack thousands of frontline staff.
In an exclusive interview with MO ahead of the 7 September election, Ms Plibersek defended Labor’s controversial GP super clinics, saying it “drives me crazy” that the $600 million-plus program was branded a disaster when millions of Australians had benefited from it.
Ms Plibersek, who became health minister in December 2011, continued Labor’s strategy of attacking Coalition policies, saying that although promises like extra grants for general practice had been welcomed by doctors, they were no different to Labor policies already in place.
She said she feared that the ML review, announced by shadow health minister Peter Dutton after he complained of 3000 unneeded bureaucrats in the ML network, would be used as justification to cut spending rather than improve the network.
-----

Live tweeting surgery not a Queensland option

Date September 5, 2013 - 12:01AM

Mitchell Smith

Queensland surgeons won't be distracted by Twitter if Queensland Health has anything to do with it.
One of Queensland Health's most senior officials would be very concerned about the risk to patients if Australian doctors followed the lead of their US counterparts by live-tweeting medical procedures.
Deputy director-general Michael Cleary said he was "not aware of any instances in Australia of staff live tweeting or using social media" during surgical or other procedures.
"But I would find this type of behaviour very concerning given the potential risk to patient safety," Dr Cleary said.
This comes after a number of reports of US surgeons and patients using social media to broadcast live operations.
-----

Health policy in need of major surgery

Joanna Heath
Anyone who has been tracking health policy debate at a national level over the past three years could be forgiven for expecting a bit more of their politicians during this 2013 federal election campaign.
In March 2010, before he was axed as Prime Minister, Kevin Rudd outlined the most ambitious reform to hospitals and hospital funding Australia had seen since federation. His successor, Julia Gillard, a few months later took to the election an ambitious $277 million program for mental health with no lesser aim than stopping ­suicide across the nation.
In 2013 there are no big visions or competing plans for reform. There are worthy funding announcements of a hundred million or so here or there, but rather than conducting a policy argument, Labor and the Coalition have traded blows over who might have the most budget cuts up their sleeves.
The conclusion one might draw from this is that both sides have decided the status quo is not that bad. Both health minister Tanya Plibersek and her opposition counterpart, Peter Dutton, get close to agreeing on that point in separate interviews with The ­Australian Financial Review.
-----

Health.com.au’s Andy Sheats eyes health insurance shake-up

September 3, 2013
Mercedes Ruehl
Former REA Group executive Andy Sheats wants to shake up the $16 billion private health insurance sector, the way realestate.com.au transformed buying and selling houses.
The last new substantial health insurance company to open its doors was Medibank Private in 1997, according Mr Sheats. Even though the industry has moved online, he feels there is room for a new, more modern player.
Launched in April 2012, his online health insurance company, health.com.au, generated sales of $45 million in its first year and employs 23 people. It has already grown to have more than 40,000 members.
“Health insurance is a massive industry and there is plenty of room for everybody,” Mr Sheats said.
-----

Dutton out of the shadows

3rd Sep 2013
After six years as Opposition health spokesman, Peter Dutton tells MO why he’s ready to step out into the spotlight.
As his website boasts, Peter Dutton was a retired policeman of almost a decade’s service and a former business owner by the time he entered federal parliament in 2001 at the age of 30.
In order to do so he rolled Democrat defector Cheryl Kernot in the outer-northern Brisbane suburbs seat of Dickson and quickly rose to a ministry position during his mentor John Howard’s final term as prime minister.
His Wikipedia page suggests that as a rising star within the Liberal movement, he is seen by some as a future party leader and last week he accused Health Minister Tanya Plibersek of having a “barely veiled contempt for doctors”.
-----

Quiet achievers – SWARH covers 200,000 patients with shared eHealth record

Australia’s biggest active electronic health record system has been quietly operating for nearly a decade – and now covers 200,000 patient records in 12 different public hospitals and 14 area health services in around 114 sites across South West Victoria.
The South West Alliance of Rural Health (SWARH), http://www.swarh2.com.au  was formed in 1997 to deliver IT services  for all public acute hospitals and associated health services in the region extending from west of Melbourne to the South Australian border – some 60,000 square kilometres, and now connects all sites across a secure broadband network.
“We started setting up the groundwork for a shared health record database in 2000, and we had completed all the agreements in 2003 so 12 different organisations used a unique ID to track patients between the different sites,” says Garry Druitt, who is CIO at SWARH.
-----

NICTA to lose $42m in Coalition cuts

FUNDING for research body National ICT Australia has been slashed as part of Coalition cuts before the federal election.
The Fiscal Budget Impact of Federal Coalition Policies released by opposition treasury spokesman Joe Hockey includes $42 million cuts by 2015-16 for discontinuing direct federal government funding to the ICT Centre of Excellence.
Given that NICTA bagged $185.50 from the Federal Government for 2011-15 at an average of $46.4 million per year, the cut is equivalent to an entire year's federal funding of the ICT research icon.
NICTA had obtained the funds just last month, which means it would have been funded for the 2015-16 financial year; the cut raises the question of whether the Coalition will offer NICTA financial support beyond June 2015, and if not, whether NICTA's days are numbered.
-----

Rudd goes on dummy run to announce a Tassie health hub

Date September 4, 2013

Jacqueline Maley

Parliamentary Sketch Writer for the Sydney Morning Herald

Karl the medical simulation dummy grimaced in what appeared to be existential, if not physical, pain.
Karl was simulating acute respiratory distress for the benefit of nursing students at the University of Tasmania. The students were simulating a training exercise for the benefit of Prime Minister Kevin Rudd, who observed them through one-sided glass. A mob of cameras, journalists and curious campus onlookers observed him.
Such are the simulated scenes of the election campaign, which on Tuesday brought the prime ministerial posse to the university nursing centre in Launceston.
In a press conference in a room stuffed with fake body parts, Mr Rudd promised $28 million for a "health hub" research and training facility. It would create hundreds of jobs, he said, and jobs are sorely needed in the economically depressed southern-most state.
-----

Electronic alert keeps asthma at bay

  • by: SEAN PARNELL, Health editor
  • From: The Australian
  • September 05, 2013 12:00AM
A SIMPLE alarm on an asthma inhaler could help thousands of Australians better manage the condition -- and, more broadly, demonstrate the huge potential of such technologies.
While the future of telehealth has long been promoted, researcher Juliet Foster from the Woolcock Institute of Medical Research yesterday envisaged a "utopia" where linked-in devices and electronic medical records help keep people out of hospital and an early grave.
In a paper published in the latest Journal of Allergy and Clinical Immunology (In Practice), Dr Foster demonstrated how electronic monitoring devices for preventive inhalers could improve adherence rates when used to either alert asthmatics to a missed dose or provide trend data to a doctor.
"Devices like this are seen as quite expensive and difficult to implement in healthcare systems but I think that will change when things like electronic health records become the norm," she said.
-----

Clinical Safety: Trust between Humans and Machines

Posted on September 5, 2013 by Grahame Grieve
“My point in telling this story is not to demonstrate how I beat the EEOB’s security — I’m sure the badge was quickly deactivated and showed up in some missing-badge log next to my name — but to illustrate how security vulnerabilities can result from human/machine trust failures. Something went wrong between when I went through the gate and when the person after me did. The system knew it but couldn’t adequately explain it to the guards. The guards knew it but didn’t know the details. Because the failure occurred when the person after me tried to leave the building, they assumed she was the problem. And when they cleared her of wrongdoing, they blamed the system.”
-----

Coalition pitches 'IT dashboard'

  • by: Stuart Kennedy, IT Editor
  • From: The Australian
  • September 03, 2013 12:00AM
THE Coalition, if elected, will open up an online window viewable by the public that tracks how major federal IT projects are performing and shake up oversight of government technology spending.
The proposed online dashboard window was one of a list of digital economy and e-government initiatives released yesterday in a joint statement by the Coalition's finance and communications spokesmen Andrew Robb and Malcolm Turnbull.
As well as the dashboard, the Coalition promised to trial an opt-in, secure digital inbox for communications from all levels of government to citizens, from next year and to require three government agencies from next year to trial cheap, new-wave telepresence systems such as browser-based Web Real-Time Communications.
The dashboard idea has been copied from the Obama administration in the US, which has had its www.itdashboard.gov service online since 2009.
-----

No NBN for you under Coalition - yet

Date September 4, 2013

Lucy Battersby

Australia's largest cities may receive no broadband upgrade until 2017 under the Coalition's current NBN policy, because households already have access to cable networks installed in the 1990s.
Cabled suburbs have a "pretty good service now", according to the opposition's communications spokesman, Malcolm Turnbull, and would be a lower priority than suburbs without any cable access.
The cables were installed to carry pay TV services but have since also provided broadband connections.
-----

Thousands of faults hit rushed NBN

  • by: MITCHELL BINGEMANN
  • From: The Australian
  • September 06, 2013 12:00AM
THE company building Labor's $37.4 billion National Broadband Network could be forced to repair tens of thousands of faulty connections after cutting corners in the construction processes to boost the number of homes passed by the massive infrastructure project.
The Australian can reveal that as of last week, connections to as many as 21,000 - one in eight - of the 163,500 existing homes and businesses passed by the fibre network were considered to contain defects in the network construction. Up to 7000 have major defects, which according to NBN Co documents, are those at risk of service degradation, outages or health and safety hazards.
The defects mean that network connections to thousands of homes and businesses, which have been classified as "ready for service", may require repairs before users can access the internet on the new network.
NBN Co last night disputed the figures, admitting there were significant defects but insisting the total number was lower than the figures obtained by The Australian.
-----
Enjoy!
David.

Sunday, September 08, 2013

Well The Election Is Done - What Now For E-Health?

Well we seem to have got a clear result in the House Of Representatives and I have to say what rather looks like an unpredictable set of results in the Senate and the inevitability of some really odd legislated outcomes.
With a high probability that Mr Peter Dutton will be the next senior Health Minister and Dr Andrew Southcott (Opposition Primary Care Spokesperson) looking like a certainty  in his seat their comments are both important.
Before the period immediately prior to the election we have had the following
From 2010 - the previous election period:

Coalition e-health black hole worries AMA

Summary: Australia's peak medical body, the Australian Medical Association (AMA), has expressed concern over the Coalition's seeming lack of e-health policy.
By Josh Taylor |
update Australia's peak medical body, the Australian Medical Association (AMA), has expressed concern over the Coalition's seeming lack of e-health policy.
…..
In a statement, Shadow Health Minister Peter Dutton said that the Coalition was "absolutely" committed to e-health.
"We are committed to e-health into the future. We do strongly support a roll-out of e-health and the funding is there until 2012."
"We don't trust Labor with money; we don't trust them because they have wasted it in every other area," he said. "We will review why Labor has gone nowhere on e-health in three years and whether or not the money is being most efficiently spent."
Updated at 3:00pm, 6 August 2010: comment included from Peter Dutton.
We then had the debate on the PCEHR in 2012 when it was legislated for. Dr Southcott gave a long speech where the Opposition supported the legislation but were not sounding all that convinced.
You can read this here:
We then had a pretty clear set of comments in the heat of the recent campaign.

Labor’s $1 billion E-Health debacle

Date: Mon, 19/08/2013
Spokesperson:  Shadow Minister for Health and Ageing, Federal Member for Dickson, The Hon Peter Dutton MP
Labor’s implementation of an e-health patient record is a $1 billion disappointment.  With nearly $1 billion spent on the program, it has failed to deliver anywhere near what the Labor Government promised.
The e-health program has been shown to be more about politics than about policy and more about spin than about outcomes for patients.
“Australian Doctor has reported that there are only 4,000 e-health records in existence.  At a cost of $1 billion that works out at $250,000 per record,” said Peter Dutton.
“This latest development proves this government is incapable of delivering on e-health.  It speaks volumes about Labor’s incompetence,” he added.
Apart from the very low take up rate, the system itself is deeply flawed.  The Government has been throwing good money after bad, spending money getting Medicare Locals to sign people up to a program that does not yet have basic clinical protocols in place, let alone support from clinicians.
“The Coalition continues to provide in-principle support for e-health, but shares the concern of many in the sector about Labor’s incompetence in managing the process,” said Mr Dutton.
The previous Coalition Government achieved significant improvements in the computerisation of general practice, from 17 per cent to over 94 per cent, by working with the profession and implementing effective policy.
“If elected, the Coalition will assess the true status of the PCEHR implementation and again work with health professionals and the broader sector to provide real results on this important reform for patient care,” Mr Dutton said.
More here:
Very recently we had this:

Tony Abbott eager to overhaul e-health system

  • "DoHA are already and will by: Fran Foo
  • From: The Australian
  • August 27, 2013 12:00AM
TONY Abbott has vowed to work with health professionals to review the troubled $700 million personally controlled e-health record system should the Coalition win on September 7.
One GP called for the PCEHR to be governed by an independent council comprising medical experts. The proposed review does not come as a surprise as the opposition called for a "pause" to the system's rollout more than two years ago...
Both Queensland Liberal senator Sue Boyce and opposition e-health spokesman Andrew Southcott have repeatedly criticised the PCEHR implementation over the years.
While the future of the National E-health Transition Authority - Mr Abbott's baby while he was health minister during the Howard years - under a Coalition government is uncertain, doctors say an e-health overhaul is timely. The opposition's health policy, released last week, says "if elected, the Coalition will undertake a comprehensive assessment of the true status of the PCEHR implementation".
"In government, the Coalition implemented successful incentives to computerise general practice and will continue to provide strong in-principle support for a shared electronic health record for patients.
"The Coalition will again work with health professions and industry to prioritise implementation following a full assessment of the current situation," the policy says.
So in summary we have support for the woolly concept of e-health but considerable scepticism as to how it is being done and whether the money is being spent.
It also seems clear that the Coalition will have a review as well as possibly receive some input from the Deloittes National E-Health Strategy review.
This blog also makes a key point regarding any review.

Assessing the PCEHR implementation will not tell the Liberals what they should be doing instead

The PCEHR has received a little bit of attention in the run-up to the Australian Federal Election – not much and nothing useful.
This is a slightly expanded version of what I posted to Dr David More’s Australian Health IT blog  (There’s a 4k character limit)
…..
Tony Abbott’s statement doesn’t fill me with hope:
“If elected, the Coalition will undertake a comprehensive assessment of the true status of the PCEHR implementation. … The Coalition will again work with health professions and industry to prioritise implementation following a full assessment of the current situation”
Oh goodie. They will assess the status of the PCEHR implementation and then prioritise implementation.
What the heck does that mean?
For a moment let’s pretend the PCEHR is a car. It stops working. It won’t start reliably, when it does it lacks power and doesn’t brake well. You call the NRMA. The service man gives the car a once over and says – “my assessment is that it’s not working”. That’s a lot of help. So you get it towed to a service station for a second opinion. The report says “our assessment is that the engine has blown a gasket, the transmission is stuffed and the brakes are worn out. It will cost twice as much as the car is worth to repair.”
So what do you do? Sell it for scrap and buy a replacement?
You head off to your local car dealer and ask them for advice. You tell them you have a Mazada 1 which is beyond repair and want to price a replacement. The dealer, being a good dealer ask the question “what do you want the car for?” Your reply leaves the dealer stunned. You need the car to tow your four berth caravan when on holiday and your two-horse float every weekend.
The reason your car has worn out is because you have the wrong car. The NRMA man and the service station couldn’t tell you that because they only saw the car. You didn’t tell them what you wanted it to do.
The issue is not the car, it’s your choice of car.
Getting back to the PCEHR, it’s the same situation. They can assess the PCEHR as much as they like, but without a description of what it is supposed to do – in terms of health outcomes, not registrations and health summaries – any assessment is useless. The only question it answers is “we must do something, what can we do?” Unfortunately, doing something is not the same as doing something useful.
Full blog here:
This is a really important point Bernard raises as it is really clear and has really never been well answered - namely what is the PCEHR for and what is it actually intended to do - and of course will it actually do as intended.
It would seem ‘courageous’ for the Coalition to press on without being clear what is hoped for in terms of benefits and outcomes and also an assessment of just how likely these benefits and outcomes are.
What I expect is silence for a number of months - followed by an announcement that the PCEHR will continue - but with no expansion or extension - and that it will be quietly allowed to disappear. Any spare funds will probably diverted to support of more evidenced based and proven to be useful initiatives.
What do you think?
David.

AusHealthIT Poll Number 182 – Results – 8th September, 2013.

The question was:

Do You Think NEHTA Will Exist In Its Present Form, With The Same CEO, By The End Of The Year?

For Certain 3% (2)
Probably 12% (9)
Possibly 18% (13)
No Way 62% (45)
I Have No Idea 5% (4)
Total votes: 73
This is a pretty clear outcome. Seems a large majority anticipate some real change before the end of the year.
Again, many thanks to those that voted!
David.