The Medical Software Industry Association (MSIA), whose members include Cerner, Cisco, iSoft and Microsoft, has delivered a scathing criticism of the National e-Health Transition Authority’s (NeHTA) handling of the government’s national e-health record project.
In its submission (PDF) to the Senate committee examining the Personally Controlled Electronic Health Record (PCEHR) Bill 2011, the industry body said issues of accountability, transparency and timely delivery still needed to be addressed.
MSIA referred to NeHTA’s recent “pausing” of the implementation of primary care desktop software at a number of the PCEHR’s lead implementation sites and said the actions had taken industry by surprise.
“No one in industry has been informed of what the issues are, when we may know the size of the problem or which of the many complex programs are incompatible with the build of the National Infrastructure,” the submission reads. “A failure to adequately inform stakeholders, be transparent, or to provide any timeline is consistent with NeHTA behaviour during the past few years.
“It does not make for trusting relationships, or inspire confidence in a way that allows industry to make decisions to invest in, and engage with processes in which NeHTA is involved.”
The MSIA called for a more detailed description and a specific publish date for the “rules” of the PCEHR, as the proposed rules are not yet determined and have severe penalties in place for breaches of the Act from 1 July 2012 – the date the system is scheduled to go live.
“Underlying this is the problematic policy decision not to provide incentives or recompense to system participants who are nevertheless expected to contribute extensively to the PCEHR and while doing so, assume significant risk in the event of breaches.
“Without education, consumers and organisations are unlikely to take up the challenge of participating in the PCEHR system.”
The MSIA also doubts the readiness of the system itself and has called for NeHTA to reduce the scope of the 1 July release of the program to defer elements that are not sufficiently mature or reviewed.
The current scope will leave little time for medical software developers to implement a set of e-health foundations, the submission argues, with numerous documents on the Department of Health and Ageing (DoHA) website being either out of date, having parts missing or not being final.
“This does not give confidence to the software vendors – yet the Australian Department of Health and Ageing and NeHTA believe a document with the word 'Final' on the front is 'Final' and fit for use.
“There are numerous other examples of poor planning, failure to complete to deadlines and a range of other unacceptable behaviour that contravene normal Australian business practices – these have led to a reluctance to commit to development work in such a changing and uncertain environment.”
MSIA also claims that NeHTA as an organisation “appears to be off all accountability radars”, as it is not listed as either an agency under the Financial Management and Accountability Act 1997, or as a corporation under the Commonwealth Authorities and Companies Act 1997.
“The ACCC [Australian Competition and Consumer Commission], which would look at such issues on behalf of an industry group is unwilling to review issues relating to a 'body' which is fully funded by state and federal governments,” the submission reads.
“The Productivity Commissioner is also unable to assist as NeHTA has been constituted as a private not-for-profit entity and therefore not subject to the considerable 'level playing field' provisions available to other sectors where considerable amounts of taxpayer’s money is being spent in a market place.”
NeHTA should be made accountable for all of its services and activities, the submission argued, and subject to federal Freedom of Information legislation. The Auditor General should also carry out a financial, information technology and efficiency audit of NEHTA as soon as possible
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