NEHTA rejects claims of mismanagement

The Nation E-Health Transition Authority (NEHTA) has issued a 21-page rebuke to claims from the Medical Software Industry Association (MSIA) that the $466.7 million e-health program is being mismanaged by the government authority.

At a Senate inquiry into e-health legislation last month, MSIA made a number of claims that the specifications for the individual health identifier (IHI) — which links a person to their personally controlled e-health record — risk patient safety, because when a person changed gender or birth date information, they would be issued with a duplicate health identifier.

"Consequently, it becomes impossible to validate that identifier against the service; both the new identifier and the old identifier will fail validation," MSIA president Dr Jon Hughes said at the time. "It means that any health record based on that health identifier as the key to that record will no longer be usable and hence any information within the PCEHR [personally controlled electronic health record] will disappear. That has significant consequences in patient management."

As part of a 21-page response, NEHTA said MSIA's claims were "false".

"A correction to the patient's date of birth or gender changes does not result in the assignment of a new IHI. IHIs are assigned when a person enrols in Medicare or [the Department of Veteran Affairs] (DVA) and [for] others seeking healthcare in Australia, such as individuals living or residing in Australia, but not eligible to claim Medicare benefits or register with DVA. Where a person's Medicare details are changed (for example, their date of birth or gender reassignment) they will continue to utilise the same IHI. Even when an individual is transferred to a new Medicare card, their IHI would remain the same."

NEHTA said that there can be multiple Medicare records created for the same person, due to human error, and in this instance there would be two IHIs. NEHTA said it receives monthly reports from the system operator, Medicare, monitoring the "uniqueness of IHIs". If two IHIs are found to exist for an individual a new IHI is not created. Instead, the two IHIs are linked and categorised as primary and secondary records, with notification given that the primary record is to be used going forward.

In any case, NEHTA said that duplicate records were already an issue today.

"Duplicate IHIs do not create risks that do not already exist today. Healthcare providers today deal with duplicate records in their systems."

To date, NEHTA said there have been no replicas found in the health identifier system.

NEHTA also rejected claims by MSIA that the authority had become a "toxic workplace" with high turnover.

"This statement by the MSIA is not supported by fact. Moreover, previous claims by MSIA that NEHTA is a hotbed of bullying and harassment were discredited after WorkCover conducted an audit and had no findings against NEHTA.

NEHTA said that staff members were committed to the organisation's difficult task, and that it was monitoring employee feedback. NEHTA said that its workforce was constantly changing as the needs of the project changed.

"NEHTA utilises highly qualified staff from a small local resources pool, and is reliant on a large network of external stakeholders and partners to be successful. This environment poses challenges to retaining staff at the levels enjoyed by governments."

"For specific deliverables or parts of the work program, NEHTA requires an agile workforce made up of specialised technical experts over different periods of time. Information technology professionals are in high demand across all sectors and NEHTA competes in the employment market for this talent."

MSIA claimed that the industry had lost confidence that NEHTA could deliver personally controlled e-health records for all Australians by 1 July this year. NEHTA said this claim wasn't supported by MSIA's own members.

"Since the Senate hearing, NEHTA has been contacted by numerous members of the MSIA and broader industry to distance themselves  and their organisations from [MSIA's] testimony," NEHTA said.  

"NEHTA is committed to and actively working towards the timelines agreed with the sector, which would see consumers able to register for a PCEHR on 1 July."

The report from this inquiry was due last week; however, according to The Australian, the committee has sought an extension on the reporting period, which in turn will delay debate on the legislation in the Senate.