The almost six hours that I spent watching the Senate Enquiry was fascinating. We really had two utterly different camps in action as I briefly mentioned yesterday. You can gauge the polarity of the views presented by the reporting we have seen.
In the camp that there are a few minor issues that need to be addressed and that all is pretty much going as expected we have reports like this.
E-health records on track: government
The Department of Health and Ageing and the National E-Health Transition Authority (NEHTA) have rejected claims that NEHTA has mismanaged the national e-health record implementation.
Responding to criticism levelled at the government-owned company by the Medical Software Industry Association (MSIA) that NEHTA staff are not qualified, NEHTA CEO Peter Flemming said that his staff are "very skilled and dedicated", with some being the "world's leading experts in their field".
The MSIA had suggested that specifications around health identifiers would not correct health records when a new identifier was issued to a patient. Flemming denied this, saying that Medicare Australia has a system in place to correct problems with multiple identifiers being used for the one person.
"There is a small possibility that something may be keyed in incorrectly. Medicare, the HI system operator, has very advanced systems to detect that, identify it and rectify it."
More here:
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PCEHR on track for 1 July rollout
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PCEHR on track for 1 July rollout
The e-health record system will be open for registration on 1 July
- 07 February, 2012 14:28
The rollout schedule for the Federal Government’s Personally Controlled Electronic Health Record (PCEHR) project is currently on track, according to the Department of Health and Ageing (DoHA).
DoHA deputy secretary, Rosemary Huxtable, told a Senate committee examining the PCEHR (Consequential Amendments) Bill 2011 that the “national infrastructure” for the e-health record is currently on track, with Australians being able to register for a PCEHR on 1 July.
“The second release provides the functionality for consumers to register for the PCEHR,” she said. “Design for this release has been substantially completed and is scheduled to be completed prior 1 July 2012.”
http://www.computerworld.com.au/article/414597/pcehr_track_1_july_rollout/-----
Putting a rather different - and to be fair - more news-worthy view we have all this.
Public hearing calls for patient safety file scrutiny
- by: Karen Dearne
- From: The Australian
- February 07, 2012
THE Senate inquiry into the Personally Controlled E-Health Records program should subpoena all patient safety documents held by the National E-Health Transition Authority for external scrutiny, a public hearing in Canberra has been told.
Medical Software Industry Association president Jon Hughes said NEHTA's consistent refusal to provide the risk assessments meant the $500 million PCEHR system was "characterised by patient safety issues" even before development had been completed.
"Patient safety, and its impact on consumer confidence, is our most important concern to date," Mr Hughes told the community affairs committee.
"The MSIA recommended several months ago that the program should be paused or significantly reduced in scope until safety and other implementation issues have been addressed.
More here:
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E-Health corporation savaged at inquiry
- From: AAP
- February 06, 2012
THE private corporation established by the federal and state governments to roll out the proposed electronic health records system has been savaged by the software industry and privacy advocates.
Both the Medical Software Industry Association (MSIA) and the Australian Privacy Foundation have told a Senate inquiry hearing in Canberra that personally controlled e-health records should not go live on July 1 as planned.
MSIA president Jon Hughes says industry has lost confidence in the ability of the National eHealth Transition Authority (NEHTA) to deliver the program.
"There is evidence of a lack of probity, ineffective governance and an inability to deliver targeted programs," he told the inquiry.
"The program risks falling into disuse from the very first day of live operation."
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E-health body lacking in medical expertise
David Ramli
The top body set up by the Labor government to ensure its $467 million electronic health record system gets off the ground is facing mounting criticism for not having any members with healthcare experience.
The concerns add to the growing public outcry faced by Health Minister Tanya Plibersek from consumer, medical and privacy bodies. They used a parliamentary inquiry on Monday to slam the National E-Health Transition Authority (NEHTA), which is tasked with rolling out the program.
A spokeswoman from the Department of Health and Ageing (DHA) said the “program control group” was an oversight body set up late last year. It was designed to control and speed up the rollout of the personally controlled electronic health record (PCEHR) system.
“It’s an administrative group made up of senior public servants run by the deputy secretary,” she said. “There is no doctor on that but all the [groups] underneath have doctors and they feed up to it.”
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E-health records risk patient safety: MSIA
The Medical Software Industry Association (MSIA) has claimed there are systemic problems with the government's e-health identifier specifications that risk patient safety and has called for an overhaul to the National E-Health Transition Authority (NEHTA).
Speaking before a Senate hearing today, MSIA president Dr Jon Hughes said that a fundamental flaw exists with the specification of the Health Identifiers used for e-health records, which surfaced when a person was issued with a new identifier by Medicare to, for example, correct a date of birth or changing the gender. In this case, there is no way for Medicare to inform all health organisations using the e-health record system to update their records accordingly.
More here:
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NEHTA admits to errors within its e-health identifiers
Concession follows concerns from the MSIA around the accuracy of the identifier service
- Chloe Herrick (Computerworld)
- 06 February, 2012 16:39
The National E-Health Transition Authority (NEHTA) has conceded there have been errors within its Individual Healthcare Identifiers (IHI) service, following claims by industry that the service is flawed.
In a senate hearing into the Personally Controlled Electronic Health Record (PCEHR) Bill 2011, NEHTA chief executive, Peter Fleming, admitted there were occasional instances which produced duplicate identifiers.
“Very occasionally, there is the instance of having two numbers,” Fleming said. “Medicare has a process for identifying that, rectifying it with the individual involved and I stress that is only caused by an occasional manual error.
More here:
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Industry wants e-health records delayed
Julian Drape
February 6, 2012 - 2:34PM
The private corporation established by the federal and state governments to roll out the federal government's proposed electronic health records has been savaged by the software industry and privacy advocates.
Both the Medical Software Industry Association (MSIA) and the Australian Privacy Foundation have told a Senate inquiry hearing in Canberra that personally-controlled e-health records should not go live on July 1 as planned.
MSIA president Jon Hughes says industry has lost confidence in the ability of the National eHealth Transition Authority (NEHTA) to deliver the program.
More here
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E-Health Records marred by project, governance failures: APF
Australian Privacy Foundation warns of dire project and governance failings in the government's personally controlled electronic health records (PCEHRs) initiative
- Tim Lohman (Computerworld)
- 06 February, 2012 14:02
The Australian Government’s approach to managing personally controlled electronic health records (PCEHRs) has resulted in poor governance and repeated project failure, a Senate committee hearing into the PCEHR Bill 2011 has heard.
Speaking at the hearing, Australian Privacy Foundation Health Sub Committee chair, Dr Juanita Fernando, pointed to issues of a accountability, particularly from the National eHealth Transition Authority (NeHTA), the “retrofitting” of governance to the PCEHR, and a lack of independence of the governance of the health records.
“We are also concerned about ongoing project failure,” she said. It seems to us that there has been project failure after project failure.”
Fernando pointed to the Individual Healthcare Identifiers (IHI) project as having failed in its goal of allowing healthcare professionals to identify the right patient at the right time in the right place as an example of this failure.
“Standards are a mish-mash; there is no single standard — national or international — which applies right across the health sector. Rather we have borrowed from standards all over the place,” she said. “There are also issues with ‘informed consent’ as nobody knows precisely what the roles and rights and responsibilities of all the players – patients, clinicians, administrators and so on are.
More here:
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MSIA recommends alternative e-health record rollout
The group outlined a plan for simplified records by 1 July in the form of of PDFs or letters, with the more complex data filled records to come by 1 July 2013.
- Chloe Herrick (Computerworld)
- 06 February, 2012 12:45
The Medical Software Industry Association (MSIA) has detailed an alternative rollout schedule for the Federal Government’s Personally Controlled Electronic Health Record (PCEHR) project, following claims the system will be not even be close to completion by 1 July.
MSIA president, John Hughes, told a Senate committee examining the PCEHR Bill 2011 a reduction in the complexity and scope of the e-health program was required for the program to go live on 1 July.
Hughes outlined a plan for simplified records by 1 July in the form of PDFs or letters, with the more complex data filled records to come by 1 July 2013.
“A much simpler release one program could still deliver an effective valuable solution to the health sector by 1 July but only if the scope of that program is reduced significantly,” Hughes said.
More here:
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Reset expectations on e-health: AMA
The Australian Medical Association (AMA) has called on the Federal Government to "reset expectations" that it will deliver e-health records to Australians by July this year.
AMA President Dr Steven Hambleton told a Senate hearing this morning that the government's proposed deadline for the launch of its personally controlled e-health record (PCEHR) system for all Australians by 1 July 2012 is "problematic".
"We have a real problem with the level of expectation that has been set ... and the actual ability for doctors to deliver on that day. Even if the legislation is passed [and] the framework is available, there are many, many practices that will simply not be able to communicate with that piece of software."
He said that many medical practices would also be concerned about their risks in terms of recording who has access to the record and when, stating that much of the software around today doesn't have the ability to do that.
He said that the AMA supports e-health records, but said it will be a few years before it is completely up and running.
"I think we need to reset expectations both in the profession and the public, so we understand that there's not going to be a comprehensive personally controlled electronic health record available, or indeed accessible, by most software on that day," he said.
More here:
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E-health stricken with privacy and software lurgies
Analysis: Senate hearings begin.
With less than five months before launch, differences between interest groups in the planning of the Federal Government’s $466.7 million personally controlled electronic health record (PCEHR) will be aired today before a Senate Committee.
Submissions from medical associations, privacy groups, rural and remote services, and the medical software industry collectively raise questions over privacy, standards and the ability to service remote regions.
A common view is that the July 1 launch date is too ambitious.
More here:
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Defer e-health record system, says consultant
- by: Karen Dearne
- From: The Australian
- February 06, 2012
A LEADING e-health consultant says the government's e-health systems is not complete and the bills establishing it should be deferred.
Ian Colclough, a medical practitioner and health informatician, warns that while privacy, security and confidentiality are important issues, "they pale into insignificance when put against the many hard-nosed questions that have repeatedly been asked by a wide cross-section of health industry experts and technology developers".
"These are questions which those in charge of the PCEHR project seem unwilling or unable to answer," he says in a submission to the inquiry.
Dr Colclough says that in considering the bills, "it seems the (Gillard) government believes that the bulk of the work required to enable the PCEHR to be deployed safely in the marketplace is close to completion".
"I am not alone in believing that the PCEHR is far from being close to completion.
More here:
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E-health system flawed, says alliance
- by: Karen Dearne
- From: The Australian
- February 06, 2012
THE Consumers e-Health Alliance rejects the "medical interventionist" view reflected in the nation's e-health records program, warning that the current approach is fundamentally flawed, with more than $2 billion wasted on failed projects over the past decade.
"The almost universal view that e-health should focus exclusively on supplying 'the right information about the right person at the right time' is a medical interventionist view," CeHA says.
"Consumers have often different perspectives about the role e-health can play, including the rapid identification of disease outbreaks, information about treatment options, an electronic record of their current health status and medical history, and telehealth services as alternatives to expensive hospitalisation or unnecessary travel.
More here:
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Comment
For me the key issues raised in order of importance were:
1. Governance and the associated leadership issues.
2. Unrealistic and over inflated expectation setting.
3. Concerns around clinical safety.
4. Transparency and the lack of real consultation with stakeholders.
5. Implementation and Technical skills and competence.
6. Excessive complexity of present plans.
7. The attempts by Government to pass legislation regarding a system that was not well defined and specified.
8. The apparent uncertainty regarding ongoing funding.
Other regulatory and definitional issues are also out there! Of course we still have never seen the Business Case that justifies what is happening!
I think it is fair to say the Senate now understands that it is not just the lunatic fringe that has some concerns. Just what they (the Senate) choose to do with that information will be fascinating to watch!
I wonder will the Senate notice that all that is planned to be on offer on July 1, 2012 is a registration screen rather than a system that will do anything useful?
I wonder will the Senate notice that all that is planned to be on offer on July 1, 2012 is a registration screen rather than a system that will do anything useful?
David.
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