After The Hype Now the Reality. Shared Records are Years Away, if Ever! We Have Been Here Before in 2004!

NEHTA released its second Clinical e-Newsletter a day or so ago – dated 19 May, 2010.

The full document can be obtained from here.

http://www.nehta.gov.au/component/docman/doc_download/1005-nehta-clinical-enewsletter-may-2010

Main Headline is this.

Federal Budget - $467m for personally controlled electronic health records for all Australians

The Government’s investment of $467m into the development of electronic health records announced in the 2010/11 budget on 11 May represents a key building block of the National Health and Hospitals Network.

A secure system of personally controlled electronic health records will provide: summaries of patient health information including medications, immunisations and medical test results; secure access for patients and healthcare providers to their e-health records via the internet; rigorous governance and oversight to maintain privacy; and national standards, planning and core national infrastructure to enable healthcare providers to use the system.

In 2010-11, the Dept of Health and Ageing (DoHA) will consult with stakeholders on the planning, design and development of a personally controlled electronic health record system and will also develop related national governance and legislative requirements.

The second year will focus on building on existing foundation development to increase linkages to other health information elements, such as pathology and specialist reports, for incorporation into the electronic health summary.

The Budget paper also noted that in 2010-11 the Government will continue to provide incentives to general practices to promote the use of e-health tools and systems through the Practice Incentives Program (PIP). It also noted that DoHA will continue to support the development of secure messaging specifications to assist the use of electronic referrals, prescribing and discharge summaries ahead of the personally controlled electronic health record system rollout commencing in 2012-13

The secondary headline is here:

Federal Budget – Pharmacy e-prescription incentives

The Fifth Pharmacy Agreement with the Pharmacy Guild includes $82.6m in e-prescription incentives. From 1 July 2010 the Commonwealth will pay a fee of 15 cents per transaction to approved suppliers dispensing electronic prescriptions. Software vendors will have 24 months to comply with the requirements that include compliance with the Australian Standard specified relevant version of NEHTA’s specifications for ETP.

The Pharmacy Agreement defines an electronic prescription as one electronically generated by a prescriber, authenticated (electronically signed), securely transmitted (either directly or indirectly) for dispensing and supply, seamlessly integrated into dispensing software and, for PBS prescriptions, able to be electronically sent to Medicare Australia for claiming purposes.

----- End Extract.

For a silly bit of trivia it is worth noting that the document dated 19 May asks for consultation responses on e-Referrals and says this consultation closes on the May 21. What?

But to the substantive issues:

On the Personally Controlled Electronic Health Records (PCEHR) we note:

It is DoHA and not NEHTA who is going to consult on the planning, design and development of the PCEHR. This work is to happen 2010-11.

In 2011-12 we will work on messages to fill up the apparently central repository.

And implementation starts after all that.

I will leave it as an exercise for the reader to try and figure out where the skills for this project will come from, how whatever is planned will be procured (surely DoHA would not try to develop something like this?), what the governance will look like, and why clinicians would send information of this sort to a Government repository among a host of other questions about data quality, data priority, legal liability for contents transmitted and so the list goes on.

Remember we went down a similar path with such shared records ages ago. The program was called HealthConnect and was killed when Mr Abbott and Mr Hockey discovered just how much it was going to cost – and turned it into the legendary ‘change management strategy’.

All the details can be found here from December 2004!

This is a presentation of the concepts and how it would work

http://moreassoc.com.au/downloads/bap_dec2004.ppt (400k)

And here are all the details:

http://moreassoc.com.au/downloads/BA%20V1.9i%20final.zip (800k)

On the basis of this we have hardly moved forward in half a decade. Read and weep. Only the names have essentially changed!

If people are interested I have a large archive of this stuff – I can post the key ones. Let me know.

Remember as some wise soul said ‘those who forget the lessons of history are condemned to repeat them!’ (George Satayana or Arnold Toynbee - Google not clear!)

The e-Prescribing announcement is just amazing! Basically it seems to say for 2 years you can use any old un-standardised system to transmit prescriptions for 2 years – and get paid - and then you will have to conform to NEHTA’s specification! How about getting standardised first and then get paid. This is absolute policy rubbish in my view.

Sadly we seem to live in some very stupid and forgetful times!

David.

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