NEHTA has just published its 2006-7 Annual Report.
The document can be found here.
It is a glossy 48 page document which provides just three pages describing what has been achieved in the last 12 months.
The achievements are summarised thus (By NEHTA):
NEHTA Outcomes at a Glance
- The International Health Terminology Standards Development Organisation (IHTSDO) was created with NEHTA’s Karen Gibson as Deputy Chair, and held its first meetings in Chicago and Brisbane.
- Australia’s National Product Catalogue was released, with over 50 of Australia’s top medical and pharmaceutical product suppliers taking advantage of the improved ability to communicate up-to-the-minute information about their products directly to current and potential customers.
- A comprehensive examination of key privacy issues and risks relating to the establishment of unique healthcare identifiers (UHI) and the shared electronic health record (SEHR), which included extensive feedback from clinician, consumer and privacy advocate audiences.
- Significant development of the Australian Medicines Terminology (AMT), including establishing world-first processes for the documentation of editorial rules, and ensuring safe and reliable terminology development and maintenance. NEHTA’s efforts in 2006-07 culminated in the early release of the AMT to enable international feedback during the Brisbane IHTSDO meetings.
- Specifications released to standardise the content of electronic communications in the following areas – pathology requests and results reporting, discharge summaries, referrals between general practitioners and specialists/critical care units and diagnostic procedures and test results reporting.
- 110 (approximately 90%) work program milestones achieved.
- 77 public documents produced for review and feedback.
- Established the National E-Health Standards Catalogue, containing the e-health specifications and standards recommended by NEHTA to date. The Catalogue includes 36 NEHTA-developed specifications, and 75 NEHTA recommended standards or specifications.
These outcomes have been achieved with the following expenditure:
Salaries and wages 8,434,627
Contractors 3,169,354
Consultants 444,620
Depreciation 452,483
Amortisation of leasehold improvements 54,029
Lease expenses 656,877
Operating leases 30,997
Accounting fees 190,560
Audit fees 29,200
With various other expenditure the total spent has been $18,136,972 (Last year $9,741,516)
Thus, since it incorporated NEHTA has spent $27,878,488
A little arithmetic comes up with an interesting figure.
For example, each of the riveting NEHTA 2006/7 deliverables cost us $235,000 overall given that NEHTA has yet to deliver anything that actually does anything.
Here is the list of what has not been done.
1. The SNOMED CT core is developed overseas and there are no final Australian extensions yet available (e.g. Medicines Terminology still in beta as of late September, 2007) from NEHTA – so usable clinical terminology has not been delivered.
2. The planned Identifier Services are not yet available – maybe in 2009.
3. The Business Case for HealthConnect II has now been in development for two years and has a while yet to run (not due until COAG 2008).
4. The detailed privacy documents are not at all detailed or rigorous, and the feedback document is frankly a joke in my view (all of 4 actual pages of self congratulatory comment).
5. No one I am aware of has implemented, tested and proven to actually work a single electronic communications content specification.
6. The Australian Product Catalogue is operated by GS1 / EANNet. As NEHTA itself says “The data stored in the NPC is hosted by EANnet, developed by GS1 Australia. NEHTA will build on the NPC to develop a national approach to public health electronic procurement and business intelligence tools.” NEHTA’s role is largely co-ordination and the reports I receive suggest the scale of achievement claimed by NEHTA remains slightly optimistic (at best). It is clearly still a work in progress.
What we have here is an organisation which has yet to deliver anything much and has a productivity level that means it takes 1.2 man years to produce each document and has cost $27M + over 2 years.
We all deserve better explanations of just why it costs accommodation of less than 100 people costs $650,000+ p.a. and why accountants are being paid $195,000 p.a. to do the accounts.
More ominous is the following – note the report was finalised 19/10/2007
On page23 we find
After Balance Date Events
No matters or circumstances have arisen since the end of the financial period that significantly affected or may significantly affect the operations of the company, the results of those operations, or the state of affairs of the company in future financial years.
Future Developments
Likely developments in the operations of the company and the expected results of those operations in future financial years are in accordance with the principal activity.
I wonder what the Boston Consulting Group report will make of all this – and whether we will ever see it. Sounds like NEHTA is confident there will be no change other than minor tweaks around the edges. That NEHTA is underperforming was confirmed my multiple submissions to the BCG Review.
This report is really a model of self aggrandising obfuscation that I am sure many in the commercial sector wish they could get away with matching. Mercifully they can’t. The pages padded with useless lists and photos of the directors are a true joy to behold!
I really think that after two full years we should have more concrete and tangible outcomes for our almost $30 million.
David.
12 comments:
NEHTA SPENDS 30 MILLION DOLLARS
NEHTA EMPLOYS 100 PEOPLE
NEHTA DELIVERS 77 DOCUMENTS
Dear Dr More
If you had been given that $30 Million to spend over 2 years - how would you have spent it?
1.0 Project Description
1.1 No of people
1.2 Deliverables
1.3 Budget
2.0 Project Description
2.1 No of People
......... etc.
Hi,
Easy question to answer. Just read my blog. I would have developed a plan and then spent what was required to deliver the plan.
What I would NOT have done was spend $30 Million without a clear well considered National e-Health Strategic Plan that was public and which progress towards could be assessed.
David.
NEHTA was not tasked with developing a National e-Health Strategic Plan.
It was tasked with focusing on developing the building blocks required to facilitate the delivery of e-health solutions; such as National Identifiers, a National Catalogue of E-Health Standards, and a National Standard of Terminologies for Medicines and Surgical Supplies, and also Specifications to facilitate standardisation of information exchange across the health supply chain between health applications and service providers, including areas like pathology requests, discharge summaries, and prescriptions.
In theory, NEHTA’s view is that these things will all be useful when a National e-Health Strategic Plan has been developed. Horses for courses as the saying goes.
Hi,
And that is the problem. Who knows how useful and needed all this work is, and what priorities should apply, absent a plan to put it in context.
There is also the small problem that after two years of behind the scenes activity we have yet to see anything that has actually changed one clinical outcome or saved one life.
I am not prepared to take it on faith that the $30M has been spent wisely when I have not been permitted to know how any of it will actually work and who will actually be able to use what is being worked on.
The lack of openness and transparency about what is happening is just appalling.
David
Yes, I'm from the Government and I am here to help you. Jobs and consultancies for the Boys (and Girls).
Yes, this is about the Public Service.
If there is plan somewhere it is very secret - goodness knows why. We can only assume there is no plan because no-one has published one - not NEHTA - not no-one. And that, as you say, is a worry. At least it should be.
Only in the Public service could one get buy-off on the open-ended spending of such large sums of money in the absence of a clear and well thought-through plan which provides both a context and a structure to inform those providing the money how the work to be undertaken will be used, by whom it will be used, and what value and benefits it will provide to everyone who uses it.
Any responsible properly governed organisation which is accountable to shareholders would accept nothing less; unless the shareholders are powerless, ignorant or both.
Quite frankly I have a lot of difficulty with all this finger wagging - criticising the public service and NEHTA.
The ICT industry, the vendor community, all the consultants and experts out there should have a long hard look at yourselves. You must shoulder a large part of the responsibility for the status quo - you let it happen. The bureaucrats only made it happen. And now it's too late for you to do anything about it even if you wanted to.
Hi,
"The ICT industry, the vendor community, all the consultants and experts out there should have a long hard look at yourselves. You must shoulder a large part of the responsibility for the status quo - you let it happen. The bureaucrats only made it happen. And now it's too late for you to do anything about it even if you wanted to."
Sorry, but I did not just let it happen! I have been talking publicly for 18 months about the lack or a plan and that it was a major problem - and also saying their direction was wrong. Funnily I was just told to "shut up" by NEHTA heavy weights. Never once did they attempt to engage or discuss what we now know from the HISA survey were widely held concerns.
David.
Well said aus hit man. You are the exception. Many many apologies to you. The comment was directed at all those who spend their time smooozing their time away with those "WHO MADE IT HAPPEN" - bureaucats, NEHTA, Gov't - and not being confident enough, courageous enough, forceful enough and above all honest enough to say what you have been saying for the last 18 months.
Is it really too late? Surely something can be done? Yesterday's announcement by NEHTA's Chair suggested things would be changing for the better because:
* NEHTA was going to have a more transparent and consultative approach
* the BCG’s review will assist the board in "framing more precisely the future evolution of e-health in Australia
* NEHTA will now work (more closely) with the IT vendor community, jurisdictions and other interested parties
* NEHTA would be moving towards implementation and adoption after completing key components of its work program.
Hi,
All I can say is that the proof will be in the eating.
A good first step would be public the release of the BCG report so we can all see what we should now be expecting from NEHTA and by when.
David.
It is very clear from these comments that NEHTA’s “shareholders are powerless” , and that an unexpurgated version of the BCG report including submissions will never be made public. ............ unless it falls off a truck! .... and the only way to prevent that is to put it through the shredder. What then?
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