news Technology media outlet Delimiter has filed a Freedom of Information request for a report reviewing the Federal Government’s troubled Personally Controlled Electronic Health Records project begun under Labor, due to the fact that new Health Minister Peter Dutton has received but not yet released the sensitive document.
The project was initially funded in the 2010 Federal Budget to the tune of $466.7 million after years of health industry and technology experts calling for development and national leadership in e-health and health identifier technology to better tie together patients’ records and achieve clinical outcomes. The project is overseen by the Department of Health in coalition with the National E-Health Transition Authority (NEHTA).
However, in July the Government revealed it had failed to meet it initial 500,000 target for adoption of the system, with only close to 400,000 Australians using the system at that point.
At the time, University of Western Australia software academic David Glance severely criticised the scheme. “… even if the government had met the target of 500,000, it would have been a meaningless gesture,” Glance wrote at the time. “The vast majority of those who have signed up, if they ever get around to logging in, will be greeted with an empty record.”
“Given the lack of active participation on the part of GPs, as well as the lack of public hospital systems to integrate with PCEHR, there’s little evidence to suggest that this is going to change any time soon … GPs still struggle to see the benefit of spending time curating shared records when the legal liabilities are still unknown but are potentially severe.”
And in August The Australian newspaper revealed that NEHTA had lost a number of senior executives, including clinical lead Mukesh Haikerwal.
Due to the problems, on 4 November new Coalition Government Health Minister Peter Dutton kicked off a promised review of the PCEHR project. The review was to be led by Richard Royle, Executive Director of the UnitingCare Health group in Queensland, with the assistance of Dr Steve Hambleton, president of the Australian Medical Association and Andrew Walduck, Chief Information Officer of Australia Post.
On 20 December, only a month and a half after the review was initiated, Dutton issued a statement noting that he had received its report.
“The review of the Personally Controlled Electronic Health Records (PCEHR) system has been completed,” the Minister’s statement at the time read. “Health Minister Peter Dutton today received the report from the review team headed by the Executive Director of the UnitingCare Health Group, Mr Richard Royle.”
Dutton claimed the report — compiled over just a month and a half — “provides a comprehensive plan for the future of electronic health records in Australia”, adding that the Government would now take time to consider the review recommendations and would respond in due course. “I sincerely thank the members of the review panel for their work on this matter,” the Minister said.
However, Dutton has not committed to publicly releasing the findings of the PCEHR Review. As a consequence, late yesterday, Delimiter filed a Freedom of Information request with the Department of Health seeking to have the full text of the document released under the Freedom of Information Act.
The FoI request noted that there were there significant public interest reasons for the review to be released, given that the PCEHR project was an item of significant debate during the 2013 Federal Election, and that the report would provide the wider health community in Australia with significant information that would inform the future debate of similar electronic health initiatives.
Something smells extremely rotten here. There is just no feasible way that the entire PCEHR project could have been reviewed in just a month and a half. In the month and a half before Christmas. Judging by the many dozen reviews of similar projects I’ve read in the past, it should have taken Royle and Co that long just to write the report — let alone do the research for it. This is the sort of report you would expect could only be generated over a period of at least three months, given the number of interviews and other research which would need to be conducted.
Even more laughable is Dutton’s statement that the report “provides a comprehensive plan for the future of electronic health records in Australia”.
I have personally watched virtually every e-health plan of any magnitude (even individual hospital plans) fail in Australia over the past decade. Universally these projects have so far proven a highly effective way to waste public money and time. If you don’t believe me, I would encourage you to examine the fate of Victoria’s HealthSMART initiative, for example, or the many others of a similar nature. Queensland’s recent effort is another great example.
I highly doubt that it is possible for anyone to come up with a “a comprehensive plan for the future of electronic health records in Australia” at all, let alone in a month and a half, and I also highly doubt that Dutton has the qualifications to even know what such a plan would look like. E-Health software is just too immature, the requirements of individual health jurisdictions are just too disparate, and the medical industry is just too bogged down in its own existing bureaucracy for any such plan to succeed right now. And to boot, consumers — supposedly, the beneficiaries — aren’t interested either. Because of these factors, we really have seen very few e-health records successes in Australia over the past decade, and the future is far from clear.
What would I personally do about e-health records, the National E-Health Transition Authority and the PCEHR project? I will repeat Michael Dell’s advice on what should have been done with Apple Computer in October 1997: “Shut it down and give the mney back to the shareholders”. Because from here, things are only to get worse until the industry as a whole drastically matures.