The PCEHR Seems To Be Still Lacking Real Detail! There is Still No Evidence That DoHA / NEHTA Know What They Are Doing.

The following report of a briefing held last week appeared today.

Bidders seek details on $467m personally controlled e-health record project

  • Karen Dearne
  • From: Australian IT
  • January 26, 2011 1:02PM

POTENTIAL candidates for the job of keeping the $467 million nationwide electronic patient records rollout on track want greater clarity on the sprawling work program.

The Gillard government is seeking a private partner to build an analytical and evaluation framework to monitor and measure progress of the personally controlled e-health record (PCEHR) as it is introduced over the next 18 months.

But bidders have asked for a list or directory of relevant activities being undertaken by the National E-Health Transition Authority to assess the scope of job ahead.

"It seems there are a whole lot of websites all over the place, but no-one’s actually got it all together," one asked Health in a series of questions and answers released yesterday to registered bidders. "Is that part of the tender?"

Another says there appears to be "many health providers, government departments and other organisations that NEHTA has been involved with, either peripherally or centrally. Is there a list that will enable the successful tenderer to properly evaluate and monitor it?"

In response, the Health department said it does not expect tenderers to have a "line by line" understanding of NEHTA’s program at present.

Bidders also questioned whether there was any other system on the same scale as the PCEHR in existence. Health replied: "There is no single solution in place that meets all of the requirements and specifications of the PCEHR program."

"(But) every single component of the PCEHR has been implemented successfully somewhere in the world. So the system components do exist.

"Some PCEHR infrastructure components have already been implemented in Australia, while others have been implemented overseas."

Health acting deputy secretary Megan Morris told an industry briefing last week the PCEHR would provide summaries of patient health information including medications, immunisation and test results over the internet via secure access.

"The government has adopted a combined approach of ‘top down’ initiatives and ‘bottom up’ lead implementation sites," she said. "We will create a national framework to guide development and impose uniform standards, including a national privacy regime and change and adoption framework.

More here:

http://www.theaustralian.com.au/australian-it/government/bidders-seek-details-on-467m-personally-controlled-e-health-record-project/story-fn4htb9o-1225994842659

You can visit the site and see the presentations here:

PCEHR Industry Briefing

On Monday, 17 January 2011 the eHealth Systems Branch, Primary and Ambulatory Care Division of the Commonwealth Department of Health and Ageing held an industry briefing in Canberra. The purpose of the briefing was to provide further information and clarification regarding the Request for Tender (RFT) for a Benefits and Evaluation Partner for the Personally Controlled Electronic Health Record (PCEHR) Program.

Informative presentations were given and attendees’ questions were answered by representatives of the Department of Health and Ageing and the National eHealth Transition Authority (NEHTA) regarding the requirements of the RFT, and the wider PCEHR Program. These are available below for download.

PCEHR System Overview - Speech Notes (PDF 39 KB)

PCEHR System Overview - Slides (PDF 870 KB)

PCEHR Work Program - Slides (PDF 3443 KB)

BEP Scope of Services and Tender Submission Requirements - Speech Notes (PDF 49 KB)

BEP Scope of Services and Tender Submission Requirements - Slides (PDF 231 KB)

Questions and Answers (PDF 18 KB)

Here is the URL:

http://www.health.gov.au/internet/main/publishing.nsf/Content/pcehr-industry-briefing

The Q & A Session was very revealing:

Question: Does a list or directory of NEHTA’s PCEHR Program activities exist? From looking at the website, it seems as though there are a whole lot of websites all over the place, but no one’s actually got it all together, and is that part of the tender?

Answer:

The Department does not expect that tenderers will have a line-by-line understanding of the program of work that’s being undertaken within NEHTA at present. The core documentation associated with the PCEHR Program has been made available to tenderers, and will be sufficient to enable the Department to undertake an appropriate capability assessment of tenders. Other documents that may be relevant have been identified by the Department and will be made available to the successful tenderer.

Question: There appear to be many health providers, government departments, and other organisations that NEHTA has been involved with either peripherally or centrally. Is there a list or directory of all of this activity that will enable the successful tenderer to properly evaluate and monitor it?

Answer:

The evaluation only refers to the eHealth sites and the build and rollout of the PCEHR Program. Wider health reform is a broader program, which is being managed by the Department of Health and Ageing on behalf of the Australian government. The PCEHR Program is only one stream of work within broader health reform. I provided details regarding NEHTA’s broader range of health activities and business blueprint in my earlier presentation and slides. The Draft Concept of Operations for the PCEHR Program is available to tenderers.

Question: You mentioned that the evaluation of tenders for the second wave of eHealth sites is underway. When do you expect that the evaluation process will be completed, and when will we receive information about the size and location of those sites?

Answer:

The applications for second wave eHealth sites closed shortly before Christmas, and the evaluation of applications is still underway. The Department is endeavouring to have a short list finalised within the next few weeks.

Question: As part of the services of the Benefits and Evaluation Partner, will the Department be requiring any capability transfer back to NEHTA or the Department, and by June 2012 from the tenderer back to the Department? Also, are there any conflict of interest restrictions on subcontractors, or any other organisation that may wish to tender for other PCEHR Program work?

Answer:

Yes, the Department expects that the Benefits and Evaluation Partner’s capability will be easily transferable to the Department, NEHTA, and other PCEHR Program partners. There is nothing that would prevent an organisation from tendering for other PCEHR Program work. However, please note that the RFT for the Benefits and Evaluation Partner states that “the Department may, at its sole discretion, exclude a Tender from further consideration, where it considers that a material conflict of interest or potential material conflict of interest would exist if the Tenderer was successful in being awarded a contract” (see Part B, page B24, clause 8.12.2 of the RFT).

Question: Is there any other system or solution that is of the same scale as the PCEHR system?

Answer:

There is no single solution in place that meets all of the requirements and specifications of the PCEHR Program.

Answer:

Every single component of the PCEHR system has been implemented successfully somewhere in the world. So the system components do exist. Some PCEHR system infrastructure components have already been implemented in Australia, while others have been implemented overseas.

Question: In the RFT, it is stated that the successful tenderer will “where possible, consider state and territory eHealth activity which is of relevance to the PCEHR Program” (Part B, page B10, clause 5.2.2(d)). What does the Department mean by “where possible”? Does this mean that the jurisdictions may not provide the PCEHR system with full access to necessary medical information and eHealth summaries?

Answer:

The jurisdictions have been heavily involved with the Department throughout the PCEHR Program, and are a key party to the governance arrangements. It is expected that this level of engagement will continue throughout the build and rollout of the PCEHR Program.

Answer:

State jurisdictions need to make significant investments to enable the PCEHR Program to work. State jurisdictions are developing similar business cases and are allocating funding to their acute sector programs. These acute sector programs will establish links to the PCEHR system.

---- End Q & A.

My view is that all this leaves way more unanswered that actually addressed and I still have the sense the no-one at DoHA or NEHTA actually knows what they are doing. These slides and briefing go no way to assure me anything I wrote here is at all wrong:

http://aushealthit.blogspot.com/2011/01/clinician-controlled-electronic.html

If they were confident they had substantial and credible answers then we would have the PCEHR Concept of Operations available for review and discussion. Until that is released we know that DoHA and NEHTA are as much in the dark as they are keeping the rest of us.

At present all I can see that is going to be delivered by 2012 are a range of incoherent pilots which will take the rest of the decade to be properly delivered so as to provide any value to either providers or consumers.

David.

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