3 July 2012

The Chief Minister on the health statistics scandal. Too little too late.

| johnboy
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Chief Minister Gallagher has let it be known what she plans to do following the Auditor-General’s findings of systemic and ongoing dishonesty by the Health Directorate in the compiling of statistics:

The Chief Minister has instructed the Directorate to bring in new procedures, training and governance documentation around the emergency department’s EDIS computer system. She has also instructed the Directorate to implement new computer access arrangements, including changing the reporting arrangements for the system’s administrators so that they report to a supervisor outside the hospital environment.

“The government will commission advice on best practice data security systems to be implemented as soon as practicable,” the Chief Minister said.

The Chief Minister also noted the Auditor General’s recommendations around qualitative measures of emergency department care.

“I agree with the Auditor General that there is a need to broaden out the performance measures on the ED. Our emergency departments have the highest rates of patient satisfaction in Australia and everyone who comes to our emergency departments receives high quality care,” the Chief Minister said.

The Chief Minister will write to the Auditor General to request that she review the work that has been done in 12 months.

“It is important to note that this is an issue about statistics and computer systems, not patient care. It is also about an individual who took a decision to do the wrong thing. As we all know there is never a good reason for doing the wrong thing.

What are you going to do to find the others Chief Minister? The Auditor-General’s report makes it pretty clear it can’t have been an isolated employee.

Governance documentation isn’t much use around dishonest people. Especially when you ask them to write it.

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From http://www.abc.net.au/news/2012-07-05/new-role-to-oversee-hospital-data/4112716?section=act
“New role to oversee hospital data”

Do we really need to appoint a “director of data integrity”?
Is more bureaucracy really the best solution to this problem?
1. Focus on fixing the root cause – get emergency departments staffed adequately, and with the right tools and processes to do their job efficiently so that there is no need to fudge the data.
2. Make sure that we have adequate whistleblowing protections so that people can bring these problems to light without fear of persecution.
3. Fix the executive culture that enabled this problem to occur at all.

Am I missing anything here?

devils_advocate said :

OP: “It is important to note that this is an issue about statistics and computer systems, not patient care.”

Um, since when is the amount of time that a patient has to wait to get care not a patient care issue? Health care in a hospital is not a service where consumers derive anticipation utility – timeliness is an important component of the quality of the care. I’m pretty sure I want the medical assistance when I’m having the heart attack, not when it’s time to harvest the organs.

For bonus points, the “we can’t meet the predetermined performance benchmarks, so instead we will ‘broaden’ (i.e. dilute) those benchmarks. Because heaven forfend we actually work towards the original idea of shortening the waiting times. Kthnxbai.”

I think you might be missing the point somewhat. Waiting times ARE a patient care issue. The dodgy reporting of waiting time data, however, had no impact whatsoever on the actual waiting times experienced by the patients in question. The data, accurate, altered, or otherwise, sitting in a computer and various reports to government after the fact, have nothing to do with the quality of those patients’ care in ED.

devils_advocate1:56 pm 04 Jul 12

OP: “It is important to note that this is an issue about statistics and computer systems, not patient care.”

Um, since when is the amount of time that a patient has to wait to get care not a patient care issue? Health care in a hospital is not a service where consumers derive anticipation utility – timeliness is an important component of the quality of the care. I’m pretty sure I want the medical assistance when I’m having the heart attack, not when it’s time to harvest the organs.

For bonus points, the “we can’t meet the predetermined performance benchmarks, so instead we will ‘broaden’ (i.e. dilute) those benchmarks. Because heaven forfend we actually work towards the original idea of shortening the waiting times. Kthnxbai.”

JerryJohnson said :

Ian said :

banco said :

If the canberra times either can’t establish who the unnamed executive is or if they know who it is but won’t print their name they deserve to go under.

It shouldn’t be too hard to figure out. How many layers of executives does the hospital have? 3-4? How many people in that group? And Katy Gallagher let slip in her interview on the ABC news that it was a “she”. Find an org chart, figure out who is likely to have been responsible for ED statistics and bingo, you have it.

Then fire them and the executives they report to for allowing such slack processes to exist and continue for so long.

That’s right let us turn to vigilantly tactics. What could possibly go wrong?

Get off your high horse! Where did I advocate vigilante tactics? All I’m saying is it should have been very easy to figure out the name if anyone bothered with a bit of basic research.

The firing is for the director-general of Health and Minister of course. But as they fall in the firing line for firing its hard to see anyone taking a bullet for this other than the one guilty executive/scapegoat.

The real issue here is not the culture that creates the pressure to improve the figures – that is well-known and the blame is shared by everyone. The real issue is the fact that the culture within at least the health directorate is such that they felt that doctoring the figures was an appropriate response or an action that they felt there was a reasonable chance that such tampering would not be discovered, or if it was, any disciplinary action would not be so serious as to act as sufficient deterrent to prevent the doctoring in the first place.

Some public servant has changed the numbers, and now they’re making sure it can’t happen again. Let’s spend this money on getting more nurses and doctors instead.

I actually find the references to Zed in this thread hilarious, as the only people who have tried to turn this into a scandal are the people justifying what Zed did.

JerryJohnson9:13 am 04 Jul 12

Ian said :

banco said :

If the canberra times either can’t establish who the unnamed executive is or if they know who it is but won’t print their name they deserve to go under.

It shouldn’t be too hard to figure out. How many layers of executives does the hospital have? 3-4? How many people in that group? And Katy Gallagher let slip in her interview on the ABC news that it was a “she”. Find an org chart, figure out who is likely to have been responsible for ED statistics and bingo, you have it.

Then fire them and the executives they report to for allowing such slack processes to exist and continue for so long.

That’s right let us turn to vigilantly tactics. What could possibly go wrong?

banco said :

If the canberra times either can’t establish who the unnamed executive is or if they know who it is but won’t print their name they deserve to go under.

It shouldn’t be too hard to figure out. How many layers of executives does the hospital have? 3-4? How many people in that group? And Katy Gallagher let slip in her interview on the ABC news that it was a “she”. Find an org chart, figure out who is likely to have been responsible for ED statistics and bingo, you have it.

Then fire them and the executives they report to for allowing such slack processes to exist and continue for so long.

gooterz said :

As an aside..

If they used generic logins, what other fraud happened!

I’ll tell you what has happened at the federal medical data entry level – someone of my acquaintance was employed, about seven years ago when under 16, by a parent connected with her Sydney school – who was recruiting the kids from among her own child’s schoolfriends to do data entry for her medical company. Said “still-child” was keying private medical information into an online database from home, on a standard, probably uncrypted internet connection, for $14 an hour. I don’t know much about it, except that it spooked me at the time, and was unquestionably dodgy, if not illegal.

As an aside..

If they used generic logins, what other fraud happened! I wont believe that the waiting times are the only thing that was altered.
11k records of one type.. what are the numbers for the others. Surely something more profitable was more appealing!

Can we have an art work installed somewhere that makes us quickly forget about this ‘little’ issue?

I suggest a 40 foot high Chief Minister with her head up her bottom.

If the canberra times either can’t establish who the unnamed executive is or if they know who it is but won’t print their name they deserve to go under.

“Police have no plans to lay charges” – seriously, folks, if a government decides that falsifying government records doesn’t even warrant a slap on the wrist, it’s time that government was voted out.

Makes Zed’s flex sheet mistakes look extremely trivial.

How many died because of Zed’s flex sheets Katy?

Why does TCH need to “commission advice on best practice data security systems to be implemented as soon as practicable,”
The auditors said the existing system at TCH is used by other hospitals and it works just fine.
It is the people and their motives that are the problem.
Has anyone made any suggestion on why the stats. were “doctored” yet? If is wasn’t for financial gain then it must have been to make someone look good. Wonder who that person was?

The people running the show should be sacked. This has been going on for some time, and it’s not just the auditor that knows about it. Suggesting that this is in any way ‘isolated’ is laughable.

JerryJohnson6:21 pm 03 Jul 12

I’d add that the Liberals have an obvious interest in trying to draw a long connection here. But its what’s actually going on on the ground that matters.

The hospitals and their staff are great and a lot of money has been pumped into these services over the last 10 years. The twisting of the numbers is alarming and needs to be straitened out. Sounds like thats what is happening right now.

Why yes, in the face of massive systemic data fraud anecdotal evidence is what you want to be falling back on!

JerryJohnson6:04 pm 03 Jul 12

Looks like the government is responding to the ‘controversy’. There is an issue of reporting here and a break down in what hospital officials were actually telling their own agencies and the government.

A few of my friends have gone to hospital over the last few years and the emergency staff were great.

People seem to be getting a little carried away with trying to apportion blame and not paying attention to the fundamentals which is that health care is pretty good in the ACT. I’d rather be on this side of the boarder.

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