NEHTA anticipates e-health record clarity

Looming release of draft concept of operations will begin wider discussion over e-health record

The Federal Government’s lead e-health agency is anxiously anticipating clarity around the $467 million personally-controlled electronic health record (PCEHR) program, with hopes the imminent public release of a draft concept of operations will catalyse greater cooperation from the wider industry.

Despite promises from health minister Nicola Roxon to publicly release the document, which has so far only been handed to potential bidders on key tenders, a spokesperson failed to respond to questions of exact dates at time of writing.

The National E-Health Transition Authority (NEHTA), unlike National Broadband Network wholesaler NBN Co, is currently exempt from Freedom of Information legislation, preventing parties from accessing the documentation without participating in the tender process.

The draft paper is yet to be finalised, according to members of the Department of Health and Ageing who appeared before a Senate estimates hearing earlier in the week, but will ultimately provide greater information on how the electronic health record will work and which elements will be included.

However, exactly which elements will be initially included in the record is still up for debate, according to NEHTA’s head of clinical leadership and engagement, Mukesh Haikerwal.

Haikerwal said the release of the document publicly would likely signal the beginning of a clarification process over initial elements to be included in the PCEHR, a matter that remains debatable among both health providers and the wider health industry.

“Everyone has a view of what should be in it; that view grows depending on who you talk to and so when you coalesce that you’ve got a massive elephant,” he told Computerworld Australia following his return from the United States.

“Because technology and standards and things change, that elephant moves, so to make it successful we’ve got to deliver something that is small; an elephant that is small and tied down.”

The PCEHR’s scope has been determined primarily by an unreleased business case first provided to the Coalition of Australian Governments in 2008.

Haikerwal said the GP health summary record would provide a base, but recent consultation with health authorities in Britain may ultimately result in the inclusion of major elements from the United Kingdom’s equivalent initiative, including a focus on medication, allergies and adverse reactions.

“In my view, I don’t think it’s reasonable to use the business case that went to COAG for the population of Australia to use as a basis, because nobody knows what’s in there,” he said. “If you look at the minister’s original press release, which is basically what it’s all about, then we will try to be true to that.”

Haikerwal, who labelled the July 2012 deadline for the initiative’s delivery as “hairy”, said the release of the concept of operations to the wider health industry would aid in further refining and developing the scope of the project to a manageable, initial state.

“We don’t want every size and a complete fix immediately because we can’t do it and there will also be so many questions raised at each point that we’ll be tying ourselves in knots.”

Despite a lack of clarity around the PCEHR, three first wave sites in Brisbane, Melbourne and New South Wales’ Hunter region have already received contracts from the Department of Health and Ageing, and are due to begin implementing the unique health identifier and other elements of the wider e-health record initiative in the next month based on $12.5 million in funding.

According to Haikerwal, the sites were not expected to immediately implement a stack of technologies recommended by NEHTA, but that this would implemented over time.

“My view of the [concept of operations] - and I don’t think we’re too far away to be honest - I see that as being the line from where you can start then building or taking away from [the PCEHR]; what you can start talking about, because it’s now written.

“The whole point of the next stage is to boil it down to something that is useful, deliverable, brings with it confidence so that people will be happy to use it.”

A second wave of approximately ten e-health sites will also be announced soon and will use the as-yet-unfinished draft concept of operations to implement technologies relevant to the e-health record project. They will share in a new round of $55 million in funding with 97 applicants so far responding to a request for tender, according to NEHTA head of implementation, Lisa Smith.

Follow James Hutchinson on Twitter: @j_hutch

Follow Computerworld Australia on Twitter: @ComputerworldAU

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Tags NEHTAPersonally Controlled Electronic Health Record (PCEHR)Mukesh Haikerwal

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