QLD Health Refuses $500 Million Gifts

ELECTRONIC HEALTH RECORD OPTIONS IGNORED

A BRIEFING PAPER

Graham Bates AMS

Contents

Executive Summary .................................. 3 QLD Health Impregnable Fortress ....... 4 The EHR Imperative ................................ 6 Wildcard Events ........................................ 7 Cyclone Yasi - QLD .................................. 8 Hurricane Katrina 2005 .......................... 9 A Solution Today .................................. 11 Vista EHR US Dept of Veterans Affairs13 Is Australia There Yet? ............................ 18 What is NEHTA Up to?.......................... 19 The Time To Act Now ......................... 23

Graham Bates

EXECUTIVE SUMMARY Queenslanders live in the Information Age too, yet opportunities to transit from an archaic 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 to alter 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 if we 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 a Coroner's Court," the clinical adviser wrote.

Other Australian States, Territories and hospitals already have functional Electronic Health Record [EHR] solutions, examples including; Northern Territory & Royal Darwin Hospital2 Logan Hospital QLD see page 4. Meanwhile, private medical practices, including pathology laboratories and radiology practices 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.!

Article entitled Queensland Health eyes software system despite red flags, by Koren Helbig, Courier Mail - dated 21st SEP, 2011: website: http://www.couriermail.com.au/news/queensland/health-software-on-the-sick-list/storye6freoof-1226142181877
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eHealth NT website: http://www.ehealthnt.nt.gov.au/Shared_Electronic_Health_Record/index.aspx

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QLD HEALTH IMPREGNABLE FORTRESS Logan Hospital has been successfully operating an EHR system for over 10 years.

of paperwork has been reduced to 14 disks.

Known as ERIC3, the software designers claimed in 2006, that 12 tennis courts worth

After this success, QLD Health bureaucrats refused an option to upscale this system enabling 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 money had 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 and how their e-health project allows it!
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Brochure by Filenet on Logan-Beaudesert Health Service District website: ftp://service.boulder.ibm.com/software/au/pdf/Logal_Hospital_Oct06.pdf Comments Concerned clinician on ZDnet website: http://m.zdnet.com.au/qld-health-buries-trakhealth-suit339295927.htm
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Graham Bates

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 ehealth. 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 employee dissent or whistleblowing. The Jayant Patel Case is an excellent example. Senior Registered Nurse Toni Hoffman AO, exposed the Bundaberg Hospital Disaster5, where a 2005 Inquiry found;

The head of a royal commission-style inquiry, former Supreme Court judge Geoff Davies QC, lauded Ms Hoffman as a hero in late 2005. He found her care, passion and courage were key in bringing to light a disaster, that led to at least 13 deaths and injuries to dozens of patients.
Rather than support such an employee, later awarded an Order of Australia for her courageous stand, Ms. Hoffman claims that QLD Health still treat her like a leper;

Ms Hoffman, whose serious complaints about Dr Patel were largely ignored for two years by management at Bundaberg Hospital, issued a plea to Premier Anna Bligh to personally examine "the way I've been treated the past six years for trying to do the right thing for the patients". Queensland Health wants me to feel guilty -- they ostracise me, treat me like a leper and want me out," Ms Hoffman said yesterday. ..people need to know that the bureaucracy is just out of control. Its culture is sick."
This sick culture of QLD Health bureaucracy continues an impregnable fortress against good ideas, good governance and by ignoring existing EHR solutions, good healthcare outcomes.

Article entitled, Jayant Patel whistleblower treated like a leper by Queensland Health, by Hedley Thomas: The Australian 16th DEC, 2011: website: http://www.theaustralian.com.au/news/investigations/patel-whistleblowertreated-like-a-leper-by-queensland-health/story-fn6tcs23-1226223423898

THE EHR IMPERATIVE

The exponential growth of science and medicine over the past 100 years has created perhaps the most complex paper mountains in human history hospital and healthcare records and they continue to grow. Everyone agrees that creating, managing, storing, retrieving and securing each persons health record is a priority. This exponential growth of paper-based health records is overwhelming already stressed health services. To achieve best healthcare practice we must have an integrated Electronic Health Record system.

Excerpt from Managing Hospital Records by the International Records Management Trust, 1999: website edition http://www.irmt.org/documents/educ_training/public_sector_rec/IRMT_hospital_recs.pdf

Graham Bates

WILDCARD EVENTS There are many studies that detail and justify immediate solutions to the paperwork avalanche, however, especially with wildcard events e.g. war, natural disasters. We need an EHR system now.

Excerpt from Evolution Research Enquiry into claims regarding leprosy testing on Aboriginal children in the Northern Territory between 1920 and 1960 website: http://www.health.gov.au/internet/main/publishing.nsf/Content/D19F17E110F01074CA25 76BF0013E6DE/$File/leprosy_testing.pdf

Image of Darwin suburbs after Cyclone Tracy 1974 unknown source

CYCLONE YASI - QLD

Excerpt from an article, entitled Renal Dialysis service and Patient Evacuation during the Queensland Cyclone Yasi Disaster by Bronwyn Hayes in the Renal Society of Australasia Journal // July 2011 Vol 7 No 2. Website: http://www.renalsociety.org/RSAJ/journal/jul11/Hayes.pdf

Graham Bates

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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Excerpts from an article entitled, Hurricane highlights need for digital Records, by Associated Press, 13SEP2005 website: http://www.msnbc.msn.com/id/9316246/ns/health-health_care/t/hurricanehighlights-need-digital-records/#.Tyk7kch15to

Graham Bates

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.

Above excerpt from an article entitled Personal Health Records: Definitions, Benefits, and Strategies for Overcoming Barriers to Adoption by Paul C. Tang, MD et al; Journal of the American Health Informatics Association: website: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447551/

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

Report entitled, The US Dept. of Veterans Affairs National-Scale Electronic Health Record System by Steven Brown OCT2011 website: http://e-sundhedsobservatoriet.dk/sites/2011.esundhedsobservatoriet.dk/files/slides/slides/BrownSteve.pdf

Graham Bates

VISTA EHR US DEPT OF VETERANS AFFAIRS Slides from Steven Browns presentation in October, 2011 indicate that this powerful software is a National-Scale7 enterprise and is gaining widespread acceptance across the globe. The developers of this software, known as VistA have put all of the source code into the Public Domain and placed a Free Public License on the software. This means that QLD and Australia can take up this software today and it is free to roll-out and use across our entire healthcare networks.

Presentation to the Annual 2011 e-Health Observatory Conference, entitled The US Department of Veterans Affairs National-Scale Electronic Health Record System, by Steven Brown; website: http://esundhedsobservatoriet.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 US Freedom of Information Act.

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IS AUSTRALIA THERE YET?

Within our national context, Australias efforts to introduce a National-Scale EHR are also floundering, with NEHTA, the primary responsible, spending increasingly huge amounts of money also 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 on hold because NEHTA is building another more detailed architecture on the PCEHR that we'll have to fit into somehow, but that won't be available 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 deliver Anything(NEHTA) organisation

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

Graham Bates

WHAT IS NEHTA UP TO? Rather than invite discussion and input from the hundreds of thousands of Australian healthworkers, there is a culture of secrecy surrounding the design, planning and format of the NEHTA efforts. For example, only a selected few consenting to secrecy could view this document;

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NEHTA Concept of Ops Diagram

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

Graham Bates

THE TIME TO ACT NOW

Whilst Australia has spent hundreds of millions of taxpayers money in redesigning and

rebuilding the wheel, it is time to take decisive action, now.

Rather than acquiesce to an EHR effort that is just an updated version of The Emperors New Clothes perhaps it is time to end the waste.

Report E-Health: Enabler for Australias Health Reform Version 2 2008 by 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 of 28 thousand million dollars get wasted.?