Tuesday, June 17, 2014

I Wonder How I Missed This Little Gem. It Was Hardly Well Publicised I Guess!

I noticed this a day or so ago, when reviewing the PCEHR Review site on the DoH site.

Personally Controlled Electronic Health Record System Operator: Annual Report 2012-2013

The Personally Controlled Electronic Health Record (PCEHR) System Operator (Secretary of the Department of Health) has prepared an annual report for 2012-13 period in accordance with section 107 of the Personally Controlled Electronic Health Records Act 2012. The report includes information on the operation and security of the PCEHR system, the volume of registration and use of the system, activities undertaken by the System Operator and the operation of the advisory committees - the Jurisdictional Advisory Committee and the Independent Advisory Council.

Table of contents

Here is the link:
The Executive Summary makes interesting if old reading:

1. Executive summary

The personally controlled electronic health (eHealth) record system commenced operation on 1 July 2012 and provides secure, national infrastructure to support a shared electronic health record which can be viewed by patients and their authorised healthcare providers.
The PCEHR can include information on medications, allergies, Medicare Benefit and Pharmaceutical Benefit claims data, organ donation status, location of advance care directives, emergency contacts, and for children – immunisations and early development. Patients can keep a private health diary through the PCEHR if they wish. A child development mobile app is also available.
Clinicians in healthcare organisations involved in a person’s care can upload, view and download clinical documents including:
                        Shared Health Summary – including medications, diagnosis and treatments
                        Event summary – to record a particular visit, diagnosis or treatment
                        Discharge summary – from hospitals including medications
                        Specialist letter – recording medications, treatments
                        Referral – including details required by the specialist
                        Prescription and medication dispense record – from pharmacies.
Privacy and security features include audit trails of access to the record, ability for consumers to create access controls, requirements for digital signing of clinical documents, and a multi-layered ICT system of firewalls, gateways and portals to ensure only authorised users can access the system.
During the year, 397,742 people registered for an eHealth record. 58% of these were assisted to register by healthcare providers, with the remainder registering online, by phone, mail or face-to-face. Healthcare provider organisations have been able to register since August 2012 and 4,310 organisations were registered during the year.
Over 6,000 clinical records, 2,328 prescriptions and dispense records and around 29.5 million Medicare held records have been uploaded to patient’s records in the system.
Signed Jane Halton.
Personally Controlled Electronic Health Record System Operator.
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I will leave it to the reader to note the way some items are put rather cleverly - we all know, for example, that clinicians - as opposed to providers which might be paid recruiters - undertook only very few registrations. The sudden spike in the last 2 months of the year when the recruiters were in the field is revealing! (See page 8)
The governance comments are interesting:

Governance

The eHealth record System Operator is the Secretary of the Department of Health and Ageing (DoHA). The System Operator works with a range of agencies and organisations to deliver the eHealth record system. Many of the System Operator’s functions are delivered by Accenture, contracted by the System Operator as the eHealth record system’s National Infrastructure Operator (NIO), and the Chief Executive Medicare, Department of Human Services (DHS).
In performing functions the System Operator must have regard to the advice and recommendations given by the Jurisdictional Advisory Committee and the Independent Advisory Council. These committees ensure that the operation of the system reflects key expertise and the involvement of states, territories and key stakeholders.
The eHealth record system framework is found in legislation, contracts and agreements.
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At 30 June last year - there were over 29 million documents held in the record - of which only 31,000 were patient provided or clinician provided  (0.1%).
So the system was just not really being used!
The financial statement is also interesting:
The total cost was claimed to be $81 million and the operational contractors seem to have scooped up over $45 million. Seems like a lot to just operate a system! (200 staff at $200,000 p.a.!)
That is a lot of money for not much use and even less benefit.
At the very end of the document there is this:
All information in this publication is correct as at November 2013
I wonder why it has taken so long for it to be released.
Glad we now have this is the public domain!
David.

3 comments:

Anonymous said...

Timing is interesting!

"All information in this publication is correct as at November 2013

I wonder why it has taken so long for it to be released."


Can only speculate it was buried in some bureaucrat's backyard, hiding from the prying eyes and review from the Commission of Audit panel, or maybe even the PCEHR Review team...

How on earth can you explain how this obscene waste of Taxpayers' money failed to be justifiably cut as part of the present budget cuts??

Tee this question up for the next waste of time at the scheduled Senate Estimates committee meeting whenever that may unfortunately be...

Anonymous said...

I love the very optimistic, flowery language in the Exec Summary "The PCEHR ....CAN be viewed by patients.. CAN include information on medications, allergies.....advanced cared directives etc..". "Clinicians ...CAN upload, view and download clinical documents...."

Where is the actual value for money stuff in this annual report that states that for all the millions and millions spent on this, patients and clinicians ARE actually using the system in earnest and getting some value from it!! Some of the stats mentioned really are the same airy fairy stuff we've been hearing for years - no substance.

Anonymous said...

"JULIE BISHOP: When projects don't deliver the results we expect, they'll be put on a rigorous path to improvement or be terminated."

Maybe the Hon Dutton should consult the Hon Bishop on what to do with the PCEHR and NEHTA!