MSIA attack: When vitriol backfires

The Medical Software Industry Association’s attack on NEHTA and DoHA during Senate committee hearings last week appears to have backfired on the organisation, with several MSIA members involved in building the PCEHR describing the allegations as “vitriol” and disowning them as “particularly foul”, “unsubstantiated” and “unbalanced”.

With the issue about to come before Senate Estimates tomorrow, one long-standing MSIA member said the association executive appeared to be largely out of touch with the development of interfaces between the PCEHR and GP desktop software. He said accusations made by the organisation in a Senate committee hearing last week that patient safety was being endangered by “parasitic software” feeding health identifier numbers into practice sofware were misleading  and did not reflect the experience of MSIA members actually working on the project.

A number of association members rejected claims by the organisation’s recently elected president, Mr Jon Hughes, that the industry had “lost confidence in the ability of the National eHealth Transition Authority (NEHTA) to deliver the program”. One senior developer said the recent pause in PCEHR development that resulted from the discovery of differences in some releases of specifications was “not out of the ordinary for such a large and complex project involving so many different bodies working to such accelerated time lines”.

Representatives of GP desktop software vendors said they had had extensive contact with NEHTA officials over a lengthy period and had seen no evidence to support the contention of MSIA treasurer, Dr Vincent McCauley, that there had been an alarming staff turnover within the organisation. They rejected his claim that “the people in charge of the rollout of the IT implementations have no experience in either IT or health.”

“The credibility of some of the people making the negative comments is not that high,” one long-term member of the MSIA said, “and the more they carp, the lower their credibility becomes.”

Several members also criticised “one-sided reporting” of ehealth issues by The Australian’s IT reporter Karen Dearne, and ehealth blogger, Dr David More, who is currently describing the PCEHR as “a train wreck” and “a humongous mess”.

One executive of the Australasian College of Health Informatics described Dr More – a fellow of the college – as “a loose cannon” and said his media comments as an “ehealth expert” were becoming a frequent embarrassment. “He does not represent the views of the college,” a spokesman[in fact not a spokesman, because the college doesn't have one, according to its president in a comment below] said.

One long-term medical software industry figure questioned why he had never come across Dr More during his work in the field. “I never understand David More. I have been in this industry since the early 1990s and I have never met him. Who is he? What gives him credibility? To my knowledge he has never had any active role in major ehealth development. He just seems to stand on the sidelines and criticise things.”

There is an increasing belief in the industry that some segments of the MSIA are campaigning to have NEHTA disbanded and to stall the ehealth agenda. There are suggestions that the intention is to have the industry direct developments and that “some vendors want to reduce the scope of the PCEHR until it basically just does what the MSIA board’s existing products currently do”. One claimed that “There is a very real feeling among some MSIA members that they were bypassed for DOHA funding and outsiders and comparatively new developers were given large amounts of government money for doing relatively little. I think there’s a certain amount of petty jealousy.”

One MSIA member working on GP desktop software said that Dr McCauley’s assertion before the Senate committee that “most of the [lead] sites were using a NEHTA-sponsored initiative to inject Individual Healthcare Identifiers (IHIs) into GP desktop software … largely without the consent or cooperation of the software vendors” had been overtaken by the fact that all the desktop software vendors, including the market-leading Medical Director, which has recently begun working with NEHTA, could now directly import the identifiers without the need for “bolt-on” or “parasitic” software.

“This stuff about so-called ‘parasitic software’ is kind of true, but nobody from the MSIA asks us whether we have any concerns about it, or what it could do. In fact it may end up never being used,” he said.

“And  to be honest, in practice it’s very hard to get a wrong health identifier back from Medicare. How many people have the same first name, surname, date of birth and Medicare number? There’s a theoretical risk, but in practice it’s not been an issue.”

Another vendor representative said that medical practices were also using the company’s desktop software to import IHIs without any problems, and she was bewildered by the accusation of potential dangers.

“The only thing I can imagine they were talking about – and let me be clear I am not endorsing the view that this is potentially dangerous software because I am not 100 per cent sure that it is – the only other thing I can think of is that there are some practices that have used it to date, and maybe that’s the issue. I don’t know.”

She said that members of the MSIA were working very happily with NEHTA, and the fact that the association which supposedly representing them was presenting “such an unbalanced view” made it difficult.

“It would be interesting to know what the trigger was for such vitriol. If it was just a statement of a view that was substantiated reasonably that I happened to disagree with, that’s fine. I think that is a good thing. But it is certainly not helpful when such an unbalanced view is expressed so forcefully.”