O Ye, of Little Faith
- Details
- Category: PCEHR
- Published on Saturday, 27 October 2012 22:30
- Written by David Guest
- Hits: 972
After ten years and a billion dollars, the PECHR is here and many of us are relieved to know that it has not just been all vapourware.
But it ain't perfect. The registration process is long and complicated and is still failing due to technical issues. The personal health interface is OK but as it stands it is of only slightly more use than other failed personal health websites like Google Health and Microsoft Healthvault. The software for downloading identifiers still is not widely available and the interface for medical data upload has not been opened. Even when the upload facility is actuated, data quality and presentation will be suboptimal in a variety of ways for several years.
The cost is enormous. Progress is plodding, but the PCEHR is here, it's universal and it will change the way health is delivered. If it were not government run it would be a tenth the price. Speaking as an open source software enthusiast, I would say that as an open sourced undertaking it would be one hundredth the price. Government is lousy at delivering services but it is uniquely positioned to make its solutions universal. Fragmentation of the ehealth software market has been the norm for the last 15 years and the reason why progress has stalled for over a decade.
Never buy version 1.0 of anything is a well known IT aphorism. I would describe the PCEHR currently as version 0.6. The issues are being slowly addressed and I expect over the next two years it will be mostly functional. It does however need us now to check out its features and complain bitterly about its failings. It needs increasing load on the servers to stress test them. (I am sure they would fall over with any significant load as they are currently configured.)
There are a number of choke points in the system and each of them has to be cleared in turn before the next choke point can be addressed. I would note that there are probably ten developers of eHealth medical and pharmacy software nation wide whose non co-operation could stymie the system for years. It could well be that co-operating with the PCEHR is not in their best financial interest.
It is facile to mock the PCEHR. You can decry the difficulty in authenticating, saying it is too complicated. You could bemoan that is too insecure and that data leakage is inevitable. Security and user friendliness are opposite ends of the spectrum and it is possible that you could end up with neither. However, it may still be in an individual's best interest to have a PCEHR.
For the last eight months the national eCollaborative Program has been addressing the issues for making the PCEHR a reality for general practitioners. Those of us involved in this work are the pioneers. Pioneers often headed up the wrong valley and froze to death. Some of them died on the badlands. A few were shot by Indians. But we need to accept the losses and the failures and keep plugging away for the goal is so important.
This is the message that all Australians need to hear. This is the message that doctors, pharmacists, hospitals, health administrators and politicians need to fully understand. For doctors and users the next two years will be hell. Nirvana is ten years hence. Keep the faith.
