The rough end of the pineapple
There was a bit of breaking news late yesterday afternoon and no it wasn't a final, desperate bid to halt the inevitable march of Australia's troublesome My Health Record. It was the resignation of eHealth Queensland CEO Richard Ashby for personal reasons amid intense scrutiny of the procurement of a new patient administration system to replace the very elderly and infirm HBCIS system that has been puttering away for nigh on 30 years.
Queensland has made a few attempts to replace HBCIS, which is based on the old Homer technology that still lurks about in both Australia and New Zealand, including one by InterSystems last decade that was a failure. It has been clear for some years that replacing HBCIS will be incredibly difficult as it is inextricably entwined in many of the systems, old and new, that support the Queensland healthcare system.
So it was understandable perhaps that QH would issue a restricted tender rather than an open one to the handful of large technology companies thought capable of handling it, although there were a number of vendors miffed that they were not even given a shot. It did look a bit dodgy though, especially as the shortlist of two included Cerner, which has the contract for the state's EMR which itself has been the subject of some disquiet as it did not go to open tender either.
The procurement of the EMR was cleared by the Queensland Audit Office some years ago, but it is understandable that Queensland Health Director-General Michael Walsh has now called a temporary halt to the PAS procurement following Dr Ashby's resignation. It is not clear exactly what was involved in the personal relationship between Dr Ashby and a staffer that has been referred to the Crime and Corruption Commission, but the CCC has been nosing around since last year and Pulse+IT was twice informed in 2018 by very good sources that Dr Ashby was on his way out.
Dr Ashby landed the combined eHealth Queensland CEO/Queensland Health CIO job in February 2017, leaving his previous position as CEO of Metro South Hospital and Health Service, where he had a long involvement with the implementation of Cerner technology. We explained the somewhat chequered path of Queensland Health CIOs in this article, where you might spot that the Crime and Misconduct Commission has been called in before. The CMC, now the CCC, was set up following the state's notorious Fitzgerald Inquiry.
The politics of the pineapple state are very messy indeed so it won't be a surprise to see the state opposition try to tie this saga to that other notorious disaster, the Queensland Health payroll scandal. There are also the ongoing complaints about the ieMR, with quite a few clinicians and vendors now hopeful that with Dr Ashby gone, Queensland Health might look a little more kindly at retaining current systems that work, or purchasing best of breed systems that aren't all from the Cerner suite. We hear that the single vendor mindset is seriously annoying many clinicians and alternative vendors in NSW as well.
New Zealand is also going through its own round of restructures and unexpected new faces, with Capital & Coast DHB CIO Shayne Hunter this week being named as the new deputy director-general for data and digital at the Ministry of Health, a role that is in effect the country's digital health top gig. The role had been occupied by Ann-Marie Cavanagh, who was head-hunted by former MOH director-general Chai Chuah as part of his 'dream team' of executive leaders in 2016. Mr Chuah himself had a stormy tenure, dumping the well-regarded National Health IT Board and its director Graeme Osborne and completely restructuring the ministry before standing down last year following the unexpected outcome of the 2017 election. While the ministry says Ms Cavanagh is still onboard, it is unclear in what role.
We thought that South Australia's clicky, clunky and cumbersome EPAS saga would be this week's top story, but Dr Ashby's troubles knocked that on the head and quickly became the most read story of the month. It also pushed the My Health Record off our front page, which will be a relief to most. Unlike last year when the opt-out period was extended under enormous political pressure, the end of the opt-out period on Thursday all went off with a whimper. Within the next month, there'll be about 17 million extra records added to the existing 6.5 million, and we'll see if this creaky, troublesome, unwieldy and unloved system ever gets really going.
That brings us to our poll for the week. We've asked this before but let's give it another round: With critical mass, will the My Health Record finally prove useful?
Our poll from last week asked: Do you think the RACGP's recommendations on software requirements should be adopted? 70 per cent said yes, 30 per cent said no.