briefing paper - electronic health records final 10feb2012

7/27/2019 Briefing Paper - Electronic Health Records FINAL 10FEB2012

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QLD Health Refuses$500 Million GiftsELECTRONIC HEALTH RECORD

OPTIONS IGNORED

A BRIEFING PAPER

Graham Bates AMS


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Graham Bates

2

Contents

Executive Summary .................................. 3QLD HealthImpregnable Fortress ....... 4

The EHR Imperative ................................ 6Wildcard Events ........................................ 7Cyclone Yasi - QLD .................................. 8Hurricane Katrina2005 .......................... 9

A SolutionToday .................................. 11Vista EHRUS Dept of Veterans Affairs13Is Australia There Yet? ............................ 18

What is NEHTA Up to? .......................... 19The Time To ActNow ......................... 23


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EXECUTIVE SUMMARY

Queenslanders live in the Information Age too, yet opportunities to transit from anarchaic paper-based medical/health records system to an Electronic Health Record [EHR]have been wasted.

During this time, $100s of millions1 have been spent in research, analysis, system designs,reports and submissions without any product development.

Senior QLD Health bureaucrats have expressed interest in a system that enables them toalter or remove EHR entries, no doubt with hindsight from the Patel Case;

Another email addressed to chief information officer Ray Brown,released to the State Opposition under Right to Information laws,warned of the increasing need to document potential risks "even ifwe can't find the resources to remove them" in case of disaster

and patient death.

"The no-surprises rule may be applicable and would help in aCoroner's Court," the clinical adviser wrote.

Other Australian States, Territories and hospitals already have functional ElectronicHealth Record [EHR] solutions, examples including;

Northern Territory & Royal Darwin Hospital2

Logan Hospital QLDsee page 4.

Meanwhile, private medical practices, including pathology laboratories and radiologypractices have taken up EHR or Digital Information Systems with minimal resistance.

There are available solutions and this paper proposes an answer that is;

Cost effective, Already scaled for upwards of 22 million people, FREE and available NOW.!

1 Article entitled Queensland Health eyes software system despite red flags , by Koren Helbig, Courier Mail- dated21st SEP, 2011: website: http://www.couriermail.com.au/news/queensland/health-software-on-the-sick-list/story-e6freoof-1226142181877

2 eHealth NT website: http://www.ehealthnt.nt.gov.au/Shared_Electronic_Health_Record/index.aspx
http://www.couriermail.com.au/news/queensland/health-software-on-the-sick-list/story-e6freoof-1226142181877http://www.couriermail.com.au/news/queensland/health-software-on-the-sick-list/story-e6freoof-1226142181877http://www.couriermail.com.au/news/queensland/health-software-on-the-sick-list/story-e6freoof-1226142181877http://www.ehealthnt.nt.gov.au/Shared_Electronic_Health_Record/index.aspxhttp://www.ehealthnt.nt.gov.au/Shared_Electronic_Health_Record/index.aspxhttp://www.ehealthnt.nt.gov.au/Shared_Electronic_Health_Record/index.aspxhttp://www.couriermail.com.au/news/queensland/health-software-on-the-sick-list/story-e6freoof-1226142181877http://www.couriermail.com.au/news/queensland/health-software-on-the-sick-list/story-e6freoof-1226142181877


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Graham Bates

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QLD HEALTH IMPREGNABLE FORTRESS

Logan Hospital has been successfully operating an EHR system for over 10 years.

Known as ERIC3, the software designers claimed in 2006, that 12 tennis courts worthof paperwork has been reduced to 14 disks.

After this success, QLD Health bureaucrats refused an option to upscale this systemenabling a roll-out across the state as a clinician4 from Redland Hospital states;

I will add my two bobs as a concerned clinician at Redlands Hospital.

Logan Hospital has had an Electronic Medical Record for almost 10 years

now which, despite bumps along the road, I am told works really well and

supports clinical care tremendously at Logan.

The previous Southside Health Service District CEO had a vision and

pushed for the roll out of the electronic medical record to Redlands

Hospital. This was very much supported by the clinicians and there was

IT support for it.

Then Queensland Health restructured, got rid of the old CEO and put in

a new CEO who has said that the system roll out cannot progress. This is

despite the fact that actually putting the system in will improve patient

care, save money into the long term, and was supported by the hospital.

He literally shut the project down less than 4 months from the date it was

supposed to start and I am of the belief that more than 90% of the moneyhad already been spent!

Now we are told we won't be getting the system because there is no

money!! What I don't understand is how 'no money' is allowed to be an

excuse when the money had already been spent? All the IT was in, the

project team was working towards a plan and everyone was expecting the

change?

I want to ask Queensland Health to explain why such a system, which is

proven to benefit patients, is now going to be stopped and shut down andhow their e-health project allows it!

3 Brochure by Filenet on Logan-Beaudesert Health Service Districtwebsite:ftp://service.boulder.ibm.com/software/au/pdf/Logal_Hospital_Oct06.pdf

4 CommentsConcerned clinician on ZDnet website: http://m.zdnet.com.au/qld-health-buries-trakhealth-suit-339295927.htm
ftp://service.boulder.ibm.com/software/au/pdf/Logal_Hospital_Oct06.pdfftp://service.boulder.ibm.com/software/au/pdf/Logal_Hospital_Oct06.pdfhttp://m.zdnet.com.au/qld-health-buries-trakhealth-suit-339295927.htmhttp://m.zdnet.com.au/qld-health-buries-trakhealth-suit-339295927.htmhttp://m.zdnet.com.au/qld-health-buries-trakhealth-suit-339295927.htmhttp://m.zdnet.com.au/qld-health-buries-trakhealth-suit-339295927.htmhttp://m.zdnet.com.au/qld-health-buries-trakhealth-suit-339295927.htmftp://service.boulder.ibm.com/software/au/pdf/Logal_Hospital_Oct06.pdf


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I think it is a deliberate attempt to sabotage so they can state that they

still need to spend tax-payers money on employing people to look at e-

health. I want to know why the system at Logan cannot be rolled out

further as it meets the clinicians needs?

Why doesn't the government ask the new CEO to explain? Instead they

leave him to make decisions on his own when he clearly cannot make

financially wise ones.

QLD Health will refute such dissent from people wishing to maintain their privacy.Their culture clearly supports an entrenched Policy of Discrimination against any employeedissent or whistleblowing.

TheJayant Patel Case is an excellent example. Senior Registered Nurse Toni HoffmanAO, exposed the Bundaberg Hospital Disaster5, where a 2005 Inquiry found;

The head of a royal commission-style inquiry, former SupremeCourt judge Geoff Davies QC, lauded Ms Hoffman as a hero inlate 2005. He found her care, passion and courage were key inbringing to light a disaster, that led to at least 13 deaths andinjuries to dozens of patients.

Rather than support such an employee, later awarded an Order of Australia for hercourageous stand, Ms. Hoffman claims that QLD Health still treat her like a leper;

Ms Hoffman, whose serious complaints about Dr Patel werelargely ignored for two years by management at Bundaberg

Hospital, issued a plea to Premier Anna Bligh to personallyexamine "the way I've been treated the past six years for trying todo the right thing for the patients". Queensland Health wants meto feel guilty -- they ostracise me, treat me like a leper and wantme out," Ms Hoffman said yesterday. ..people need to knowthat the bureaucracy is just out of control.

Its culture is sick."

This sick culture of QLD Health bureaucracy continues an impregnable fortressagainst good ideas, good governance and by ignoring existing EHR solutions, good

healthcare outcomes.

5Article entitled,Jayant Patel whistleblower treated like a leper by Queensland Health, by Hedley Thomas:TheAustralian16th DEC, 2011: website: http://www.theaustralian.com.au/news/investigations/patel-whistleblower-treated-like-a-leper-by-queensland-health/story-fn6tcs23-1226223423898
http://www.theaustralian.com.au/news/investigations/patel-whistleblower-treated-like-a-leper-by-queensland-health/story-fn6tcs23-1226223423898http://www.theaustralian.com.au/news/investigations/patel-whistleblower-treated-like-a-leper-by-queensland-health/story-fn6tcs23-1226223423898http://www.theaustralian.com.au/news/investigations/patel-whistleblower-treated-like-a-leper-by-queensland-health/story-fn6tcs23-1226223423898http://www.theaustralian.com.au/news/investigations/patel-whistleblower-treated-like-a-leper-by-queensland-health/story-fn6tcs23-1226223423898http://www.theaustralian.com.au/news/investigations/patel-whistleblower-treated-like-a-leper-by-queensland-health/story-fn6tcs23-1226223423898


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Graham Bates

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THE EHR IMPERATIVE

The exponential growth of science and medicine over the past 100 years has created perhaps the

most complex papermountains in human historyhospital and healthcare records and theycontinue to grow.

Everyone agrees that creating, managing, storing, retrieving and securing each persons healthrecord is a priority. This exponential growth of paper-based health records is overwhelming alreadystressed health services.

To achieve best healthcare practice we must have an integrated Electronic Health Record system.

Excerpt from Managing Hospital Recordsby the International Records ManagementTrust, 1999: website edition

http://www.irmt.org/documents/educ_training/public_sector_rec/IRMT_hospital_recs.pdf
http://www.irmt.org/documents/educ_training/public_sector_rec/IRMT_hospital_recs.pdfhttp://www.irmt.org/documents/educ_training/public_sector_rec/IRMT_hospital_recs.pdfhttp://www.irmt.org/documents/educ_training/public_sector_rec/IRMT_hospital_recs.pdf


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WILDCARD EVENTS

There are many studies that detail and justify immediate solutions to the paperworkavalanche, however, especially with wildcard eventse.g. war, natural disasters. We need anEHR system now.

Excerpt from Evolution ResearchEnquiry into claims regarding leprosy testing onAboriginal children in the Northern Territory between 1920 and 1960website:

http://www.health.gov.au/internet/main/publishing.nsf/Content/D19F17E110F01074CA2576BF0013E6DE/$File/leprosy_testing.pdf

Image of Darwin suburbs after Cyclone Tracy 1974unknown source
http://www.health.gov.au/internet/main/publishing.nsf/Content/D19F17E110F01074CA2576BF0013E6DE/$File/leprosy_testing.pdfhttp://www.health.gov.au/internet/main/publishing.nsf/Content/D19F17E110F01074CA2576BF0013E6DE/$File/leprosy_testing.pdfhttp://www.health.gov.au/internet/main/publishing.nsf/Content/D19F17E110F01074CA2576BF0013E6DE/$File/leprosy_testing.pdfhttp://www.health.gov.au/internet/main/publishing.nsf/Content/D19F17E110F01074CA2576BF0013E6DE/$File/leprosy_testing.pdfhttp://www.health.gov.au/internet/main/publishing.nsf/Content/D19F17E110F01074CA2576BF0013E6DE/$File/leprosy_testing.pdf


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Graham Bates

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CYCLONE YASI - QLD

Excerpt from an article, entitled Renal Dialysis service and Patient Evacuation during the

Queensland Cyclone Yasi Disasterby Bronwyn Hayes in the Renal Society of AustralasiaJournal // July 2011 Vol 7 No 2.

Website: http://www.renalsociety.org/RSAJ/journal/jul11/Hayes.pdf
http://www.renalsociety.org/RSAJ/journal/jul11/Hayes.pdfhttp://www.renalsociety.org/RSAJ/journal/jul11/Hayes.pdfhttp://www.renalsociety.org/RSAJ/journal/jul11/Hayes.pdf


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HURRICANE KATRINA 2005

Australia is not the only country exposed to these types of risks.

Hurricane Katrina disaster in New Orleans, USA in 2005 provides a sentinel example.


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Graham Bates

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Excerpts from an article entitled, Hurricane highlights need for digital Records, byAssociated Press, 13SEP2005

website: http://www.msnbc.msn.com/id/9316246/ns/health-health_care/t/hurricane-highlights-need-digital-records/#.Tyk7kch15to
http://www.msnbc.msn.com/id/9316246/ns/health-health_care/t/hurricane-highlights-need-digital-records/#.Tyk7kch15tohttp://www.msnbc.msn.com/id/9316246/ns/health-health_care/t/hurricane-highlights-need-digital-records/#.Tyk7kch15tohttp://www.msnbc.msn.com/id/9316246/ns/health-health_care/t/hurricane-highlights-need-digital-records/#.Tyk7kch15tohttp://www.msnbc.msn.com/id/9316246/ns/health-health_care/t/hurricane-highlights-need-digital-records/#.Tyk7kch15tohttp://www.msnbc.msn.com/id/9316246/ns/health-health_care/t/hurricane-highlights-need-digital-records/#.Tyk7kch15to


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A SOLUTION TODAY

Following the Hurricane Katrina disaster, there was a significant effort by US Health

authorities at every level to fast-track widespread development & evolution of the EHR.

Aboveexcerpt from an article entitled Personal Health Records: Definitions, Benefits, andStrategies for Overcoming Barriers to Adoptionby Paul C. Tang, MD et al; Journal of the

American Health Informatics Association: website:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447551/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447551/http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447551/http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447551/


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Graham Bates

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The US Department of Veterans Affairs6 has consistently improved their softwarepackage over the past 10 years. Today it is a mature product that has been thoroughly stress-tested by events like Hurricane Katrina and other natural disasters.

6 Report entitled,The US Dept. of Veterans Affairs National-Scale Electronic Health Record Systemby StevenBrown OCT2011 website: http://e-sundhedsobservatoriet.dk/sites/2011.e-sundhedsobservatoriet.dk/files/slides/slides/BrownSteve.pdf
http://e-sundhedsobservatoriet.dk/sites/2011.e-sundhedsobservatoriet.dk/files/slides/slides/BrownSteve.pdfhttp://e-sundhedsobservatoriet.dk/sites/2011.e-sundhedsobservatoriet.dk/files/slides/slides/BrownSteve.pdfhttp://e-sundhedsobservatoriet.dk/sites/2011.e-sundhedsobservatoriet.dk/files/slides/slides/BrownSteve.pdfhttp://e-sundhedsobservatoriet.dk/sites/2011.e-sundhedsobservatoriet.dk/files/slides/slides/BrownSteve.pdfhttp://e-sundhedsobservatoriet.dk/sites/2011.e-sundhedsobservatoriet.dk/files/slides/slides/BrownSteve.pdf


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VISTA EHR US DEPT OF VETERANS AF FAIRS

Slides from Steven Browns presentation in October, 2011 indicate that this powerfulsoftware is a National-Scale7 enterprise and is gaining widespread acceptance across theglobe.

The developers of this software, known as VistA have put all of the source code into thePublic Domain and placed a Free Public License on the software.

This means that QLD and Australia can take up this software todayand it is free toroll-out and use across our entire healthcare networks.

7 Presentation to the Annual 2011 e-Health Observatory Conference, entitledThe US Department of Veterans AffairsNational-Scale Electronic Health Record System, by Steven Brown; website: http://e-sundhedsobservatoriet.dk/sites/2011.e-sundhedsobservatoriet.dk/files/slides/slides/BrownSteve.pdf
http://e-sundhedsobservatoriet.dk/sites/2011.e-sundhedsobservatoriet.dk/files/slides/slides/BrownSteve.pdfhttp://e-sundhedsobservatoriet.dk/sites/2011.e-sundhedsobservatoriet.dk/files/slides/slides/BrownSteve.pdfhttp://e-sundhedsobservatoriet.dk/sites/2011.e-sundhedsobservatoriet.dk/files/slides/slides/BrownSteve.pdfhttp://e-sundhedsobservatoriet.dk/sites/2011.e-sundhedsobservatoriet.dk/files/slides/slides/BrownSteve.pdfhttp://e-sundhedsobservatoriet.dk/sites/2011.e-sundhedsobservatoriet.dk/files/slides/slides/BrownSteve.pdf


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Graham Bates

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As stated above, this software is Public Domain and freely available through the USFreedom of Information Act.


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Graham Bates

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IS AUSTRALIA THERE YET?

Within our national context, Australias efforts to introduce a National-Scale EHR arealso floundering, with NEHTA, the primary responsible, spending increasingly hugeamounts of moneyalso without any product roll-out.

This anonymous8 assessment succinctly sums it up this;

Sadly, you don't know the half of it! We've been told to put our work onhold because NEHTA is building another more detailed architecture onthe PCEHR that we'll have to fit into somehow, but that won't beavailable until the middle of next year.

Don't hold out much hope for the Politically Correct Electronic Health

Record (PCEHR) from the Never Ever Have To deliverAnything(NEHTA) organisation

8 Comments on the website, Australian Health Information Technology; http://aushealthit.blogspot.com.au/2010/12/it-isnt-only-wikileaks-that-can-cause.html
http://aushealthit.blogspot.com.au/2010/12/it-isnt-only-wikileaks-that-can-cause.htmlhttp://aushealthit.blogspot.com.au/2010/12/it-isnt-only-wikileaks-that-can-cause.htmlhttp://aushealthit.blogspot.com.au/2010/12/it-isnt-only-wikileaks-that-can-cause.htmlhttp://aushealthit.blogspot.com.au/2010/12/it-isnt-only-wikileaks-that-can-cause.htmlhttp://aushealthit.blogspot.com.au/2010/12/it-isnt-only-wikileaks-that-can-cause.html


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WHAT IS NEHTA UP TO ?

Rather than invite discussion and input from the hundreds of thousands of Australianhealthworkers, there is a culture of secrecy surrounding the design, planning and format ofthe NEHTA efforts.

For example, only a selected few consenting to secrecy could view this document;


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Graham Bates

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NEHTA Concept of Ops Diagram


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Graham Bates

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NEHTA secrecy exposed

Full details of this and other comments may be found on this comprehensive website;

http://aushealthit.blogspot.com.au/2010/12/it-isnt-only-wikileaks-that-can-cause.html
http://aushealthit.blogspot.com.au/2010/12/it-isnt-only-wikileaks-that-can-cause.htmlhttp://aushealthit.blogspot.com.au/2010/12/it-isnt-only-wikileaks-that-can-cause.htmlhttp://aushealthit.blogspot.com.au/2010/12/it-isnt-only-wikileaks-that-can-cause.html


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THE TIME TO ACT NOW

Whilst Australia has spent hundreds of millions of taxpayers money in redesigning andrebuilding the wheel, it is time to take decisive action, now.

Rather than acquiesce to an EHR effort that is just an updated version ofThe Emperors NewClothesperhaps it is time to end the waste.

ReportE-Health: Enabler for Australias Health Reform Version 22008by Booz&Co;

website:

http://www.racgp.org.au/Content/NavigationMenu/ClinicalResources/ehealth/Resources/Booz_eHealth_Report.pdf

In an era of rising global tensions, financial shocks, budget deficits,failing economies and increasing Natural Disasters,

can we allow the potential benefits of28 thousand million dollars

get wasted.?
http://www.racgp.org.au/Content/NavigationMenu/ClinicalResources/ehealth/Resources/Booz_eHealth_Report.pdfhttp://www.racgp.org.au/Content/NavigationMenu/ClinicalResources/ehealth/Resources/Booz_eHealth_Report.pdfhttp://www.racgp.org.au/Content/NavigationMenu/ClinicalResources/ehealth/Resources/Booz_eHealth_Report.pdf

briefing paper - electronic health records final 10feb2012

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