Editor's Note: Dr David More is recognised as one of the health informatics industry experts and we are pleased to carry his column in i2P. For this month we have selected his comments in regard to an article by Karen Dearne in the Australian IT online publication. It concerns the Pharmacy Guild and its efforts to monopolise the e-prescription market. i2P has often commented on this disturbing activity that is designed to feed on the greed of PGA executives, rather than fill any broader vision for e-health. David More makes a blunt comment, and as he says, " I am vitally interested in making a difference to the quality and safety of Health Care in Australia through the use of information technology. There is no choice.. it has to be made to work!"
And i2P adds the comment "How many more chances has NEHTA got?
When will it stop wasting money & time?
Hurry it up: Public tells NEHTA
Suzanne Tindal, ZDNet.com.au
15 October 2008 03:50 PM
Clinicians and consumers have told Australia's peak e-health body to stop conducting pilots and speed up the roll out of a national electronic health record project, according to a report released yesterday.
The report collated of issues discussed at recent round-table sessions in Brisbane, Alice Springs and Canberra, where over 150 people gathered to pass on their thoughts on electronic health records to the National E-Health Transition Authority (NEHTA).
NEHTA's level of community engagement was criticised last year in an independent review by the Boston Consulting Group.
The e-health group is the key central figure attempting to coordinate disparate state and federal government and private sector initiatives which are currently seeing billions of dollars ploughed into building e-health systems around Australia.
Round-table participants proposed a model where records with minimum information were rolled out — for example a health summary for involved individuals including immunisations, allergies, medications, problems, organ donor status, next of kin and contact details — until trust had been built up, when functionality could be increased.
"We really firmly believe — well, I certainly firmly believe that we have to have this in as soon as possible, and just suggested that yes, we won't get a perfect system up and running straight away, so let's get something up and running, and develop it as it goes," one consumer said.
His comments were echoed by a clinician. "I agree with the fact that we need to start, sort of, shallow and we need to get this out there now. The longer we wait, the more likely we are to have lots of little projects going on that are never going to talk to this project, so we need to get it out there," they said.
However, despite enthusiasm to get the show on the road, round-table participants wanted a high level of support along with the roll out, with concerns that parts of the health sector were not ready for implementation.
Just a few short comments.
First we have a 60 page report. How much is actual consultation report?
By my count all of 9 pages of excited quotes from anonymous consumers, clinicians etc.
The rest was all padding, attendance lists and so on. (Remember we had all these people flown to Alice Springs and elsewhere at some vast cost for 9 pages!)
Second each of the three gatherings was richly populated by NEHTA staff (about 10-15% of the attendance).
I wonder why when what was wanted was non NEHTA staff consultation?
I wonder where they there to make sure no hard questions were asked?
Third there is still no clarity about just what the proposed IEHR is and how it will relate to GPs, Specialists, Service Providers (Path, Radiology etc), Hospitals, Public Health and the like.
Fourth where we the non-NEHTA technical people who could ask the technical questions about the practicality and feasibility of the IEHR – not a one I could see.
Fifth, why does it take 5 months to write and publish up a nine page report when an organisation has over 100 staff and 20 who attended the sessions.
The meetings were mid June and it is now mid October. (The document was done by Mid September according to the .pdf)
I wonder is this release all about failing to be funded by COAG?
Sixth and very important is that without a real technical and functional design of the planned IEHR we can have no confidence as to what is actually proposed here.
Seventh and also important are all those who were not consulted.
The hospital sector seems to have been especially ignored.
Eighth it would be fair to say there is no real implementation plan etc.
A ¾ page next steps section hardly cuts it!
Last we are still to see all the privacy and security assessments – and to consult without clarity on those matters is really a waste of time and money!
All in all another shocker from a worryingly out of touch organisation that has no clue about e-Health and how it should be done.