news Shadow Health Minister Peter Dutton has taken a pickaxe to the Federal Government’s Personally Controlled Electronic Health Record (PCEHR) scheme, claiming the costly project was “more about spin than about outcomes for patients”.
The project was initially funded in the 2010 Federal Budget to the tune of $466.7 million after years of the 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 and Ageing in coalition with the National E-Health Transition Authority (NEHTA).
However, last month 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.”
Just last week The Australian newspaper revealed that NEHTA had lost a number of senior executives, including clinical lead Mukesh Haikerwal.
“The question is simply: If these experienced clinicians and e-Health ‘experts’ thought the PCEHR was a winner would they be bailing out at this time?” wrote prominent Australian e-health blogger David More in response to the news. “Surely they would want to be around for the kudos and rewards that would flow from a successful program?”
“The answer is really easy. Those who are leaving know vastly more than you about the program and its risks and benefits – and yet they want out. It makes it totally clear this is a lemon on which no more time should be wasted by you or your colleagues until [The Royal Australian College of General Practitioners] and the [Australian Medical Association] are convinced – and say so and it is properly redesigned and fixed, so that the PCEHR is now both useful, safe and fit for purpose.”
In a statement issued late last week, Shadow Minister for Health and Ageing Peter Dutton added to the criticism of the project. “Labor’s implementation of an e-health patient record is a $1 billion disappointment,” Dutton wrote. “With nearly $1 billion spent on the program, it has failed to deliver anywhere near what the Labor Government promised.”
Dutton claimed the e-health program has been shown to be more about politics than about policy and more about spin than about outcomes for patients.
“Australian Doctor has reported that there are only 4,000 e-health records in existence. At a cost of $1 billion that works out at $250,000 per record,” said Dutton. “This latest development proves this government is incapable of delivering on e-health. It speaks volumes about Labor’s incompetence,” he added.
Dutton claimed that apart from the very low take-up rate, the system itself was “deeply flawed”. “The Government has been throwing good money after bad, spending money getting Medicare Locals to sign people up to a program that does not yet have basic clinical protocols in place, let alone support from clinicians,” Dutton’s media release said.
“The Coalition continues to provide in-principle support for e-health, but shares the concern of many in the sector about Labor’s incompetence in managing the process,” said Dutton.
Dutton said the previous Coalition Government achieved significant improvements in the computerisation of general practice, from 17 per cent to over 94 per cent, by working with the profession and implementing effective policy.
“If elected, the Coalition will assess the true status of the PCEHR implementation and again work with health professionals and the broader sector to provide real results on this important reform for patient care,” Dutton said.
Dutton claimed the e-health debacle followed a pattern of waste and incompetence from the Labor Government, joining the ranks of “catastrophically mismanaged programs” such as pink batts and school halls. “It also follows Labor’s failure to deliver on its much promised GP Super Clinics and the 16 Early Psychosis Prevention and Intervention Centres which never materialised,” added Dutton.
Health Minister Tanya Plibersek has been invited to respond to Dutton’s comments.
The PCEHR has been having substantial problems for some time, and it’s not surprising — all the warning signs were there from the start. The truth is that the e-health records software field — in fact, the medical administration software field in general — is still quite immature and that health departments all around Australia have struggled with this issue for a decade now. I’m not surprised at all, having followed the history of NEHTA as I have and knowing this scene as I do, that the Federal Government’s flagship e-health records project has gone off the rails. Perhaps things aren’t as bad as Dutton claims — but then, when it comes to e-health medical records, nothing would surprise me.