GP labelled a 'meat inspector' by PCEHR
This story was updated at 3pm, March 26.
A GP who created a shared health summary for a patient's PCEHR was identified on the document as a 'meat inspector' rather than a general practitioner in an embarrassing fault that the Department of Health says has since been fixed.
A DoH spokesperson confirmed that the mislabelling of the profession of more than one GP was a known issue affecting a particular medical software vendor.
The vendor, Zedmed, has been approached for comment. Three other vendors contacted by Pulse+IT said they had not heard of the fault and had not been issued a patch.
“This is a known issue with a 3rd party software vendor product that connects to the PCEHR system,” the DoH spokesperson said.
“The software vendor has advised [DoH] that this issue has been fixed within their product.
“The system operator has notified the small number of affected healthcare providers of the issue, and provided advice on rectifying the incorrect tagging on PCEHR documents that had already been created.”
It is not yet clear how the error occurred, although Pulse+IT understands that it may have originated in a faulty library of taxonomies, such as a table of Australian and New Zealand Standard Classification of Occupations (ANZSCO) codes.
In an email sent to the GP in late February, a Zedmed representative said the problem could be remedied by upgrading to the most recent version of the software.
"NEHTA provides Zedmed with libraries containing occupations that are linked to IDs, in this case the ID given was incorrectly linked as it was pointing to a 'meat inspector' instead of a "General Practitioner"," Zedmed said.
"Recently NEHTA supplied an updated library version to fix the problem, this has been fixed in Zedmed V23.4.0.1106 ..."
However, Zedmed said it was not possible to fix the shared health summaries that were posted with the incorrect provider description.
It is not possible to edit a shared health summary stored on the PCEHR, so it is understood that the authors of affected summaries must replace them with new ones.
The DoH spokesperson confirmed that the Australian Commission on Safety and Quality in Health Care (ACSQHC), which oversees the safety of the system through clinical safety audits, is aware of the issue. However, a commission spokesperson said that the issue was a technical one and has not been referred for clinical safety review.
A screenshot of a PCEHR shared health summary created by a 'meat inspector'.
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Posted in Australian eHealth
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Comments
So why not name and shame the 3rd party software vendor rather than the PCEHR. We all know that it's far from perfect, but there's simply no justification for the headline.
We are awaiting clarification from the vendor (or at least the vendor we believe it relates to) as to the origins of the problem as DOH has not supplied any technical explanation of how the issue came about, or when it started, or when it was fixed.
While ultimately harmless, I don't think this story can be dismissed as a garbage-in, garbage-out issue.
Clearly the bigger issue is the complete lack of transparency and proactive communication regarding problems (and indeed upgrades and improvements) relating to the PCEHR.
It's taken us 2 days to get official confirmation that our source's tip was accurate, despite it now being apparent that NEHTA (who liaise with the software vendors), DOH (the PCEHR system operator) and ACSQHC (the agency funded to keep an eye on the PCEHR) have known about it for some time, yet reported nothing.
Whereas it could of perhaps been deliberately placed within the program it's probably unlikely though not impossible either.
It of course may well highlight the fact that extreme diligence is required in Computerized / IT programming where had it been an article or translation that affected the way a given procedure needed to be carried out, whereby the ramifications of doing so might be dangerous to do so, more so, if the person reading the dialogue was not aware of any given serious mistake,
Am sure it will highlight the importance that IT is not perfect even though very good in many respects. It is still in its nascent stages compared to its future...
The third party provider's development must have wanted to play a joke but wasnt very funny. Someone needs to be sacked somewhere, you just dont play games on health related software.
Some years ago now, Grahame Grieve wrote a useful and probably still relevant article on these occupation codes at
http://www.healthintersections.com.au/?p=1045.
I doubt if the software vendor is to blame for this "error". e-health around the world has suffered from poorly governed code sets, often born from administrative and funding needs and more and more often now being poorly or mis-applied to more clinically oriented settings.
I don't think "naming and shaming" is the correct approach. I do, however, believe that a much more open analysis of the issue is warranted. Like any safety or quality issue, but particularly ones in healthcare, we need to learn from mistakes. We can't do that if those mistakes are hidden from the very people that need to learn from them.