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Just Why are NEHTAís Plans for the Shared EHR a Secret?

Dr David More
From a Medical IT Perspective

Issue 73: July 2008
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Editor's Note: Dr David More writes regularly on e-health matters and keeps a range of relevant press releases on his website. The followingpress release relates to NEHTA, the bureaucracy charged with the introduction of uniform standards for e-health across Australia. Recently, the organisation had a "sea change" and new people are at the helm. The culture, it seems, is still trying to catch up. The following is a mix of press releases with commentary by David More.

The following is adapted from the NEHTA web site (captured 22/06/2008)

http://www.nehta.gov.au/index.php?option=com_docman&task=cat_view&gid=130&Itemid=139

"Shared Electronic Health Record

NEHTA is working to develop specifications and requirements for a national approach to shared electronic health records. These records will enable authorised healthcare professionals to access an individual's healthcare history, directly sourced from clinical information such as test results, prescriptions and clinician notes. The shared electronic health record will also be able to be accessed by individuals who have received healthcare services.

Specifically, NEHTA will focus on developing:

* Operating concepts for a national approach to establishing and maintaining shared electronic health records;

* Policies, requirements, architecture and standards for a national approach to shared electronic health records; and

* A business case to substantiate and validate the proposed approach.

For the health system within Australia to reap the full benefits from the IT, governments and healthcare providers need to make the case for undertaking further investment including the development of a national system of shared electronic health records. The case for the required level of investment depends on the credible quantification of the costs and benefits of providing such.

Contact: Dr Andrew Goodchild - Shared Electronic Health Record Design

Fact Sheets: Shared Electronic Health Record Fact Sheet 19/08/2006

Context and Strategic Direction: Standards for E-Health Interoperability v1.0 - 08/05/2007
Review of Shared Electronic Health Records Standards v1.0 - 21/02/2006
"

What this shows us is that it is over 14 months since NEHTA has published anything on the Shared EHR.

However we have had Dr Haikerwal running around the country spruiking the plans for having a new electronic record implemented over the next few years – following the receipt of funding from Council of Australian Governments which is to meet in October this year.

Follow this link

It seems, from the reports I have received, NEHTA has been conducting briefings about such a plan to a collection of clinical and consumer peak bodies. (The last one was on June 18 in Canberra).

The obvious concern is just what they are telling these audiences and what commitments are being made that have not been subjected to any technical scrutiny other than the NEHTA staff. The situation we have here is that NEHTA (a publicly funded organisation) is providing private briefings on topics where it has by no means the monopoly on expertise trying to get very substantial ($billions I would not be surprised) funding to keep itself in existence while having been reviewed by the Boston Consulting Group recently as a failed organisation – especially in the area of Shared EHRs (now somehow renamed Individual EHRs).

In the meantime we also have the following:

3 years away">Surprise, surprise - e-health records >3 years away

17 June 2008

The Australian Doctor website reports today that Australia “is at least three years away from introducing shared e-health records for every patient — despite $150 million being sunk into e-health programs over the past eight years.”

Federal Health Minister Nicola Roxon, when interviewed by the Australian Financial Review last week, refused to commit to a 2012 deadline for a national e-health record system.Clinical leader of the National e-Health Transition Authority (NEHTA) and ex-AMA president Dr Mukesh Haikerwal told Australian Doctor, “There is no element of the reform agenda that can succeed unless we have a decent underpinning by a robust e-health system.”NEHTA is believed to be looking initially at a minimum-quality data set - limited to information such as allergies, hospital history and medical conditions to ensure there is enough information “to treat the patient safely”.

For more see:

http://wellingdigital.com.au/

Worse we have a National E-Health Strategy being developed by Deloittes which NEHTA is clearly making bets on the outcome of.
This is a governance and management farce. Either NEHTA or Deloittes are setting the direction for the future of e-Health.
I know which is should be and it isn’t NEHTA!

Deloittes need to be allowed to finish their work – have it made public for consideration by all relevant stakeholders - and at this point NEHTA should be invited to consider how it can actualise whatever is recommended.

I believe both Ms Roxon and Mr Hockey (the Opposition spokesman) should be asking some hard questions of NEHTA right now as to just what they are up to and how they justify it.

At the very least the public (and not just a select few) is entitled to know what they have in mind!

David.

 



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