The headline announcement this week that health minister Nicola Roxon had hatched a $77 million deal with global services behemoth Accenture to deliver its controversial e-health records system has failed to quell the rage of vocal detractors who say taxpayers are being taken for a ride.
The chosen consortium, also including Oracle, Orion Health and a suite of smaller IT minnows, is charged with rolling out the $467 million “personally controlled electronic healthcare record system”, or PCEHR. It will allow patients to register for an e-health record that could be accessed by GPs and specialists around the country. The winning trio triumphed in the Singapore government’s bid to deliver a similar system last year.
Roxon has unsurprisingly championed the project, due to go live next July, with a spokesperson telling Crikey this morning that it represents “good value for money and will pay dividends for Australian patients for many years to come”. But a range of critics, led by the Australian Privacy Foundation and the Australian Medical Association, continue to arc up.
Prominent e-health dissenter Dr David More, a former acting-chief information officer in NSW, questioned the raison d’etre of the entire initiative.
“You’ve got to step back and ask yourself is this a sensible thing to be doing and is this the right approach? Only then can you begin to start measuring whether it’s value for money … this is one of these utterly crap projects that is ill-considered, it’s not being managed well and it’s going to fall over big time. It’s a massive waste of $467 million.”
Dr More said that government has conceived the project simply to “tick the box” on e-health without looking at what the project’s broader aims and goals were meant to be.
“There’s one huge question you have to ask. Who is this EHR for? Is it for doctors to communicate with other doctors and share patients’ information so that the quality of care improves or is it for patients to record what they think? The two things are not the same system.”
The wisdom of contracting out government services in the style of the ABC has also attracted criticism.
Previous Accenture government projects include the ATO’s recent IT “change program”, which came in $400 million over budget with the firm earning well over half-a-billion dollars in total. Sources say that the ATO originally intended to make use 75% of existing off-the-shelf without customising it but the upshot was only 25% was used and that costly retro-fitting had to take place.
And they say the ambitious timeline — that gives Accenture just 10-and-a-half months to get it up and running, is way too tight to ensure proper quality control. The National e-Health Transition Authority, which is overseeing the project, has a storied history of spending millions of dollars on outside consultants — a questionable practice when that money is being spent to manage what is essentially public information.
Australian Privacy Foundation chairman Roger Clarke has expressed dismay that the PCEHR system would act as “smokescreen” for a national patient database. And the Australian Medical Association also has issues, claiming that grumpy GPs will refuse to use it.
Liberal Senator Sue Boyce, who has subjected public servants to extended questioning in Senate Estimates, said that Accenture deal “requires very close scrutiny”.
“It’s supposedly a copy of the Singapore system, but the Singapore system aims at providing records for providers who supply services to consumers. It’s very different from the Labor government’s aim of a ‘personally controlled’ system. As well our security and privacy protocols are very different from theirs. If that part of the system has to be rewritten, that’s expensive and complicated.”
Roxon defended the process this morning: “PCEHR will be an Australian system based on the Australian concept of operations developed after extensive consultation with clinicians, consumers and the IT industry.
“The government’s procurement for the PCEHR infrastructure partner was an extensive process over many months, complied with government tender guidelines and was very competitive. The tender process effectively tested the market on price as well as delivery.”
The reported unsuccessful bidders for the Accenture consortium’s contract — Computer Sciences Corporation, IBM and Fujitsu — all declined to comment on the record.