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Learn from the Trouble Down Under

November 5, 2013
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If you think the United States is the only country where healthcare technology trouble is front and center, I would suggest that you pick up a newspaper and think again. Better yet, why not just grab a few thousand dollars, take some vacation days, get on a plane, and fly 20 or so hours to Australia, “The Land Down Under,” where, lately, the kangaroo burger isn’t the only thing that’s being cooked.

(I’ll be here all night…)

 Don’t have a few thousand bucks to spare? It’s OK (although having been to the country once before, I can say that you’re definitely missing out if you don’t check out Australia at least once in your life), here’s a story in The Australian that should help clear things up. Here’s another one from the same publication.

To summarize, Australian Health Minister, Peter Dutton, a Liberal member of the Australian House of Representatives (the Liberal party won the office of Prime Minister in September), is taking members of the rival Labor Party to task for that administration’s work in implementing the country’s Personally Controlled eHealth Record System (PCEHR). According to, Dutton has charged the previous administration’s government officials with implementing a system that cost $1 billion but has only gotten a few hundred doctors to upload records into it. With that rate of participation, the system cost about $200,000 a patient, the Health Minister said to reporters.

The problems are technological in nature, according to the second Australian article. The country’s National E-Health Transition Authority, its version of the Office for National Coordinator of Health IT (ONC), was reportedly warned back in June, one month before the government had targeted a benchmark of 500,000 patient users, that the system wasn’t ready for primetime.  “The strong view of members was that significant improvement was needed in the way PCEHR information is presented in healthcare provider software,” The Australian article said, quoting a government document brief that outlined the problems.

The registrations have gone up and according to The Australian are at 1,053,633, as of the end of last month. However, the number of doctors that actually are uploading health summaries with patient information is miniscule. As stated, the reason seems to be the system’s usability. This was confirmed, according to ZDNET, by Australian Medical Association president Steve Hambleton, MBBS.

Sadly, and surprisingly, that’s not all the trouble you’ll find in Australia. I also stumbled upon a story in The Age, another Australia publication, which reported on the various troubles encountered by the Victoria (a state in Australia) Department of Health’s HealthSMART program. The $471 million program aimed to use health IT systems to link statewide hospitals and provide a foundation of clinical and financial information sharing. Not only has it not done that (a few hospitals dropped out completely), but according to The Age, it was responsible for more than 100 medication mix-ups at two Melbourne hospitals.


Usability, workflow, and integration are words we hear a lot in the U.S. when it comes to potential issues surrounding EHRs and health IT.  Those words are at the center of Australia’s health IT woes. While I don’t wish to condemn the effort, it’s clear the Australian government has a lot on its plate in fixing the PCEHR program, perhaps using private sector integration as a starting point. If you’re involved with health IT systems in the U.S., this “case study” ought to be enlightening.

Australia is a future mirror in which American health officials from both parties, as well as pertinent stakeholders across the industry, should look at intently. What are the possible problems and how can we avoid them? Have we addressed usability and integration? Of course, there are differences in the two countries’ efforts to get doctors on EHRs.  But no matter how you spell it, success and failure is universal.  

Feel free to write something in the comments below or tweet me at @HCI_GPerna.