Saturday, October 13, 2012

Has The NEHRS / PCEHR Initiative Reached A Tipping Point And Is It Now Heading Towards Oblivion? I Wonder.

I have been wondering just what is happening to the NEHRS / PCEHR Initiative as time from launch reaches well over 4 months and still use and adoption is seemingly rather stuck at very low levels.
A few things that have caught my eye:
1. A Google News Search for PCEHR finds a lot of coverage from Pulse + IT magazine, a few tech magazine mentions, and just one article in the mainstream media in the last month or so.
2. No press releases from DoHA on the e-Health project for a good while (months) other than peripheral initiatives.
3. NEHTA having not really updated their sectoral implementation plans for as long as anyone can remember.
See here:
The IHI Service plans have not been update in years and the last Vendor Webinar seems to have been at the end of July.
4. As of my check today there is not a single provider that is compliant with all the new ePIP requirements. (MD and ZedMed are going well however). Interestingly there have been no additional registrations in the last week or so after an initial rush.
5. NEHTA having a major reduction in funding,  skills and capability with the loss of many contractors who were working on a range on NEHRS related matters (If Government was serious in pushing ahead this would not have happened).
6. The Health Minister focussing on “training more doctors and dental reform” See:
7. Very little material in the medical professional press on e-Health (other than concerns about ePIP) - save a recent video I spotted in Medical Observer:


With e-health records set to become a significant part of general practice, Byron Kaye speaks with National E-Health Transition Authority clinical lead Dr Mukesh Haikerwal to clarify some GP concerns.
Specific link: (seems to be fully accessible)
It is interesting that Dr Haikerwal’s main point was that the PCEHR was another tool for Healthcare Providers rather than for patients and did not replace what was presently happening with records and procedures.
8. The AMA saying (10 October release) on e-health the following.


One of the biggest reforms currently in train that has the potential to improve patient health outcomes and experiences is in the area of technology and e-health.  As you would be aware, the AMA has been a vocal critic of many of the components of the Personally Controlled Electronic Health Record (PCEHR) in its current form.  While the AMA considers that the PCEHR has the potential over the long term to assist with pathways and improve coordination of care, the PCEHR itself also has significant limitations built into its design (e.g. opt-in and the patient’s ability to control what information is on the record).  This will limit its effectiveness and the potential benefits to patients and the downstream benefits for the health care system.  When clinicians do not trust the content of the e-health records, they will not use them and all the potential that could have been gained from a well-developed system will be lost.  
E-health is one of the key areas where linkages between the primary and acute care sectors can be made.  The AMA considers that any National Primary Health Care Strategic Framework must address in detail what needs to happen to ensure that the PCEHR and any other e-health initiatives are supported by GPs and general practices and well integrated into primary care.  The simple fact is that if GPs and their practices do not support the government-funded e-health initiatives, they will not work and all of that potential gain of linking primary health care with other parts of the health system will be deficient and a waste of health resources.”
The full release is here:
They are still by no means happy campers.
9. The quite impractical deadlines and for Vendors and GPs to reach ePIP compliance. (sure to shift I reckon.)
10. The reduction in coverage of the NEHRS / PCEHR from the NEHTA sponsored or paid entities.
11. The complete lack of any apparent public awareness campaigns etc.
Overall it seems to me this has been placed on the distant backburner at the very least and has had the plug pulled in all but name more than likely. (I await the announcement of the new “e-Health Change Management Strategy).
What do insiders really think is presently going on. A pause that refreshes, a major longer pause or a major wind-down?