[LINK] Unable to Register for a e-Health Record

[Roger Clarke]

At 22:24 +1100 9/2/13, Jim Birch wrote:
>The registration process has been caned all round.  I gave up too.
>Apparently they are working on a new simplified process.
>Personally, I can't see that the PCEHR is heading for a failure as an
>endpoint, more a case of passing through a number of failures.  They will
>keep working on it until it works.  The case for a common health record
>both for cost savings and for improved health care seems pretty solid.
>  There's just the non-trivial matter of making it work...

Unfortunately the PCEHR design fails on a much larger number of tests 
than just information technology competencies.

It's based on the false premise that more data is better.  In fact, 
health care professionals are drowning in data as it is.  Their 
problems are:
-   getting access to a limited amount of very specific data that they
     judge that they need in relation to each of the many very specific
     contexts that present to them in each day's work
-   being able to trust the quality of that data

The PCEHR does precisely nothing to address those needs.

Rather than being targeted at chronic conditions that might benefit 
from consolidation of data, the PCEHR is about basic data about the 
healthy - which is of very limited value to healthcare professionals.

The PCEHR has not been designed, or even intended, to improve health 
care for individuals.

Its role is to support administration and research, and maybe 
insurance.  It was always intended as an obligatory national 
register.  At some stage the Dept will tell yet another of the green 
Ministers that pass through the portfolio that the way to fix the 
problem is to abandon the silly ideas of voluntariness and consent 
and make it mandatory.

The designers have been kept well away from healthcare consumer 
advocates.  That was achieved by creating a flotilla of 'engagement 
analysts', who ensured that advocates got to listen to briefings, and 
could submit anything they liked in writing, but that it all 
disappeared into a hole.

The result is that the design pleases no-one except the bureaucrats 
who wanted the scheme in the first place.

There's no healthcare case for any 'common health record'.  A 'common 
health record' would benefit only the bureaucrats.

There *is* a healthcare case for multiple, targeted forms of 
consolidated health care record, each designed specifically to 
support the treatment of a chronic and/or complex condition by 
dispersed teams of healthcare professionals.

But no such project exists, and a billion dollars has been wasted by 
first the HealthConnect fiasco and now the NEHTA/DoHA PCEHR.


-- 
Roger Clarke                                 http://www.rogerclarke.com/

Xamax Consultancy Pty Ltd      78 Sidaway St, Chapman ACT 2611 AUSTRALIA
                    Tel: +61 2 6288 1472, and 6288 6916
mailto:Roger.Clarke at xamax.com.au                http://www.xamax.com.au/

Visiting Professor in the Faculty of Law               University of NSW
Visiting Professor in Computer Science    Australian National University