Medpedia

Feb 06, 12 09:30PM | 0 comments
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 By Josh Taylor, ZDNet.com.au on February 6th, 2012 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...

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  • (Comment from original source - Anonymous) on Feb 06, 12 10:59PM
    This is an amazing amount of media coverage on the PCEHR. Regardless of which view is the closer to the truth it does seem to me that:

    a) unless the 'naysayers' be brought on board to openly support the existing program it does not have a snowball's hope in hell of ever going anywhere

    (b) many of those who advise caution are not against the project per se, they are just asking that it be put on hold and forensically reviewed before charging ahead willy nilly. That seems like a very reasonable position to adopt. It is too late to fix some of the problems which are claimed to exist after the horse has bolted.

    (c) those who say nothing much is wrong and there is no need to be concerned may well be right. Perhaps it will be all OK if we just keep steaming ahead.

    The conclusion I have come to is that, when one weighs up the credentials of those who want to steam ahead against those who recommend pausing and reevaluating where we are at and if we are on the right course, I cannot for the like of me see what is to be gained from steaming ahead in such difficult, turbulent, uncharted waters in the hope that all will be well. On the other hand I can see the downside of doing so from a political, commercial and public safety perspective.
  • (Comment from original source - Anonymous) on Feb 07, 12 01:20AM
    So let’s be clear, the capacity to register to access ones own PCEHR is like, what, what does that actually really mean to the punter in the street? Let’s forget the gilding of the lily from the consultants who have won the lucrative work to stand up this piece of national infrastructure ..what the f______ hell does it really mean. I will be given the privilege as an citizen of Australia to fill in an eform – and..there it is a relatively blank repository of data? But the consultants and NEHTA and DOHA can declare victory and we will have numerous press releases that use weasel words to say technically it’s all possible and no our money has not been wasted – this is not another pink batts fiasco. Go on pull the other one!!!!
  • (Comment from original source - Paul Fitzgerald) on Feb 07, 12 03:19AM
    "...there it is a relatively blank repository of data?" How can it not be blank, when there are not the systems to "feed" it? Most hospitals don't have electronic records, many specialists have no electronic records, most GPs have a record, but it is so proprietary that it will be difficult to get information from it, and finally, most aged care facilities and community care organisations have no electronic records. At the moment, it seems you will have the right to sign up (opt in, which beggars belief, although I heard the privacy spokesperson yesterday say that the system as it stands couldn't do opt out anyway!) and then add your own data as you wish - and then delete it again if you choose....what is wrong with this picture?
  • (Comment from original source - Anonymous) on Feb 07, 12 03:25AM
    Indeed - after all this recent reporting surely those that think it is all going to plan live in a different world than the rest of us. Half a billion and rising for that....... just what would anyone be registering for. Trouble is my guess.
  • (Comment from original source - Anonymous) on Feb 07, 12 03:49AM
    Can we have please the $ numbers at stake here:
    (a) what has been spent on the PCEHR so far to-date
    (b) what has been committed but yet to be spent
    (c) how much more, over and above (a) plus (b) will be required
  • (Comment from original source - Anonymous) on Feb 07, 12 05:41AM
    There will be no "blank repository", as it will be pre-filled with a patient's MBS data and PBS data, which is why the crafty bureaucrats are as comfortable, confident and bold-faced as they are, and propagating the $467M sham which is the PCEHR! That’s why the laws are being changed as a result of this process to back-fill the PCEHR with PBS and MBS data, and DOHA, Medicare and NEHTA have been very public that that’s what they’re doing yet no one seems to notice or protest its clear futility and redundancy to what’s already there and available.

    Everything of course is on track because everything is within DOHA's and Medicare's control, while NEHTA plays the patsy with Academy award winning skill, and the tax payer funded treasury is conveniently raided to the tune of $467M at the same time bureaucratic budgets and empires expand.

    It's win, win, win for the Politicians as they cut the ribbon on July 1st, Hon. Plibersek registers for her PCEHR, DOHA and Medicare wring their hands at their skill and expanded budgets and power, and NEHTA pats itself on the pack if the plan goes successfully and takes the fall should the plan go awry in a highly unlikely event.

    The senators, our voted representatives, neither have the skill nor interest to hold bureaucratic ehealth powers to account, and Sir Humphrey continues to pull the strings and call the ehealth shots at the expense of public and tax payers interest.

    The rest is just a distraction from the main event going on behind closed bureaucratic doors, and the punter knows no difference between his MBS data on Medicare online and his newly skinned and $70M PCEHR ($467M) offering.

    DOHA and Medicare reps did not look the slightest bit uncomfortable at the inquiry, and with good reason not to. NEHTA looked as clueless as ever yet the senators were not motivated or informed enough to ask and table follow-up probing or insightful questions to penetrate the lies, damned lies and deceit NEHTA regurgitate in a pathological manner with polished consistency – it’s the rail-gauge problem dummy. And when they can’t lie, they just don’t bother to answer their questions on notice.

    A PCEHR will be launched on July 1st, much tax payer money will have been pilfered over the last two budget years and it will not make the slightest bit of difference or benefit to healthcare or patients. Let’s see the metrics for the Key Success criteria of the PCEHR to justify this $467M spend and no doubt we’ll be handed a blank sheet of paper.

    And no bureaucrat, senator, representative, Quango employee or high paid consultant will lose a seconds worth of comfortable sleep in the process.
  • (Comment from original source - Andrew Shrosbree) on Feb 07, 12 03:21PM
    Peter Fleming is missing the point when he reminds us that his staff are "very skilled and dedicated", with some being the "world's leading experts in their field". On this point, I agree with him.
    This does not address the reality that all people make mistakes; the complexity of the health care environment makes it impossible for a closed group to anticipate every potential problem.
    Break down the walls of secrecy however, and you have a thousand critical eyes looking for the holes.
    Eventually, your solution approaches a state of being watertight.
  • (Comment from original source - Anonymous) on Feb 07, 12 03:58PM
    Anonymous Feb 7, 2012 05:41 AM sums it all up rather well. It's not a matter of who believes who or who is more right than wrong. The bottom line is the Senators are pretty well powerless as the bureaucrats can get round them a thousand different ways. It all comes down to politics and whether The Health Minister can be swanned by her Department and whether she "can see the downside of doing so, ie steaming ahead willy nilly, from a political, commercial and public safety perspective", as Anonymous Feb 6, 2012 10:59 PM said.
  • (Comment from original source - KH) on Feb 07, 12 04:09PM
    Anonymous Feb 7, 2012 05:41 AM writes: "There will be no "blank repository", as it will be pre-filled with a patient's MBS data and PBS data,.."
    MBS and PBS data on their own are pretty useless or downright dangerous. The PBS records will tell you that a prescription for a certain drug was filled on a particular date, but it won't tell you that the drug was subsequently stopped because the patient reacted badly. MBS records can tell you that a person had a Level B consultation with her GP but not what was discussed. MBS records may tell that she had a particular test or procedure, but not the outcome.

    Anyway the politicians have been saying for many months that anyone can "register" for a PCEHR after 1st July, not that the system will be functional in any meaningful way.
  • (Comment from original source - Anonymous) on Feb 07, 12 04:47PM
    It's all to do with mirrors - now you see it, now you don't. It doesn't matter to Medicare or the Department whether the PBS data is useful and accurate or not. It's to do with trying to convince politicians and the punters that PBS OnLine and MBS OnLine together will form the working foundations for the shared electronic health record leading to the one and only Nehtarised National Health Information Exchange(NHIE) managed and controlled by Medicare.
  • (Comment from original source - Anonymous) on Feb 07, 12 08:15PM
    That doesn't make them useless or dangerous unless you don't think a clinical user can exercise the same reasoning you just did (congratulations for being the smartest person in the room?).

    What was that medication I was prescribed last year that I was allergic to? gee, I can't remember....

    the PBS and MBS data doesn't have high value, but it's not useless, and only dangerous if the users are willfully stupid.
  • (Comment from original source - Anonymous) on Feb 07, 12 10:16PM
    yes but this is the PCEHR with the emphasis on the PC bit - personal control - so the 'user' is the person in the street. That is what the big selling point of all of this is supposed to be - that I as an individual can control more of my medical record. So the PBS data won't tell me which medication of all those I was prescribed I was allergic to if I can't remember.
  • (Comment from original source - Anonymous) on Feb 08, 12 12:04AM
    Right. But if, like my mother, you remember that it was the antibiotics, but not which ones.... like I said, limited usefulness, but not useless. And while it's personally controlled, it's (supposed to be) the doctors who leverage the data.
  • (Comment from original source - Anonymous) on Feb 08, 12 03:27AM
    This is your mother speaking.
    I don't think you need to spend 476 million to find out what my prescription was! I can ring my GP surgery - they know, or I can ring my pharmacist - he knows. Or failing that, I could even ring Medicare and ask them.
    I don't have a computer anyway, and a phone call costs me just 10 cents. Let your fingers do the walking! For that amount of money each and every australian can make about 50 phone calls a year for 5 years!
  • (Comment from original source - Anonymous) on Feb 10, 12 06:47PM
    Actually, there is a simpler solution - get your GP to print out your medications/medical record each time you visit. You have a portable, up-to-date summary that cost nothing to produce, doesn't require an internet connection and most importantly, is authoritative.

    If you really, really want an electronic version of it - take a photo or use a scanning app on your phone.
  • (Comment from original source - Anonymous) on Feb 10, 12 08:57PM
    Ok so we are all now reasonably knowledgeable that the considerable $$$ being spent is doing nothing much other than line the pockets of those with their noses in the trough. (We know who you are). So we can expect you (that’s right you kiddies from .... you suits from.. etc) to say wonderful things about the value its delivering and how swimmingly well it’s all going (for you that is). But what about the rest of us? What then of the PCEHR – it gets put back in the cupboard/left on the shelf to gather dust?
    What happens next?
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