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E - Health In Australia is Behaving Like a ‘Headless Chook’!

Dr David More
From a Medical IT Perspective

Issue 79: February 2009
Page: 1 of 1 Author's Profile | Send to a Friend | Printer Version

OK, the first serious working day of the new year and we get this in the Australian today!

"Uniform health system in the mill -
Karen Dearne | January 27, 2009

LARGE-SCALE production pilots of a nationwide e-health system will start this year, with the National E-Health Transition Authority set the task of making this happen as quickly as possible."
More here:

For another take we also have:

"This is the year of delivery: NEHTA -
Suzanne Tindal, ZDNet.com.au | 27 January 2009

The standards and foundations for nation-wide e-health solutions in Australia have now mainly been completed, according to National E-Health Transition Authority (NEHTA) CEO Peter Fleming, leaving implementation on the agenda for 2009."
More detail here:

So we are to have NEHTA stitch together a serious of pilots in areas where we already have the more advanced States with already operational systems and, as usual, not plan in advance for how the piloted systems will be scaled and operationalised at a wider scope.

Why is it that I have this sense of déjà vu?
We were here ages ago (2003/4) as I recall before NEHTA was even conceived of.

Last time the plan was scuttled when it was realised by the Department of Health and Ageing (DoHA) how much an organised basic national system (then termed HealthConnect) might actually cost. This time we have a budget to deliver some basic infrastructure and we are to conduct pilots in the absence of any committed funding. You and I can both guess where all this is heading.

Of course this is also not NEHTA’s mandate – the implementation of a National E-Health Strategy is to be undertaken by a successor organisation to NEHTA – and needs to be funded and executed as per the Deloittes plan to have a chance of success.

Of course that implementation has also not been funded and no-one seems to know who is doing what with whom.

More confusion is shown by DoHA issuing decrepit documents on Clinical Decision Support developed by the now defunct Australian Health Information Council as news!

Unless I am the victim of a quite clever hoax it seems we have NEHTA’s attention on the site.That being the case the two NEHTA comments really provoke more questions than they answer.

Post 1 reads:

Anonymous said...

You seem to be mixing your messages somewhat when you say:-

(a) this time we have a budget to deliver some basic infrastructure

(b) we are to conduct pilots in the absence of any committed funding

(c) this is not NEHTA’s mandate

(d) a successor organisation to NEHTA needs to be funded as per the Deloittes plan.

We would comment thus:-

(a) We need to work with the budget we have and to work with industry to deliver as much basic infrastructure as possible within budget.

(b) Committed funding to conduct pilots has not been announced; that is true, but you are not privy to what plans may be in place to secure that funding.

(c) NEHTA’s mandate can be changed or extended at any time to accommodate the changing environment. NEHTA is not fixed and rigid, nor is it set in concrete. NEHTA has a job to do and whatever needs to be done, to achieve that end, will be done.

(d) The Deloitte plan is just that, a plan. It may need to be modified to fit with these difficult times. Your push for a successor organisation may not be the only option. It may be more appropriate to expand NEHTA to fill that need and to fund it accordingly.

Wednesday, January 28, 2009 9:55:00 AM

Post 2 reads:

Anonymous said...

It is wrong to insinuate NEHTA can just arbitrarily change its mandate. For our Constitution to be changed the changes must be proposed by the Board of Directors and put before the Members for approval.

Wednesday, January 28, 2009 12:02:00 PM

What I read here is that:

1. AHMAC have spent $1.3M on a well considered plan, but that NEHTA believes it knows better and is this choosing to follow alternative options – what they are being unstated. The evidence that NEHTA knows better than Deloittes I find severely lacking.

2. NEHTA by implication is satisfied with the governance of e-Health in Australia despite the fact there is no real input from the private sector and health industry other than through non-binding and un-representative Stakeholder Forums. Few would accept that.

3. That NEHTA thinks it can deliver substantial improvements to e-Health in Australia without explaining to stakeholders just what their role is to be in all this and who will pay for the components NEHTA is not funded for. This is a recipe for yet another e-Health disaster.

4. That NEHTA thinks it is not accountable to the public and stakeholders as similar organisations are in our Australian democracy, and that it can just ‘run amok’ with no appropriate checks and balances. That is just wrong and sooner or later those involved will be made to account.

NEHTA needs to wake up and properly disclose its plans so they can be subjected to appropriate scrutiny and, if warranted, criticism and modification. Just to announce it is a ‘year of delivery’ when all is being delivered is pilots and unfinished infrastructure is just joke.

This all feels like the ghost of the old regime coming back again!

If all this is being backed by DoHA and the Minister it is vital we hear from her/them very soon indeed. Additionally there needs to be a real review of NEHTA’s plans before they proceed or we can be sure it will be a total mess..as it has always been when DoHA has tried deliver outcomes over the last decade.

I had thought with the delivery of the Deloittes e-Health Strategy and the changes in NEHTA management we had entered a new era. Seems not!

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