As reported late last week, on Wednesday July 30 2008, NEHIPC convened a forum to review their latest draft of the National E-Health Strategy being developed by Deloittes.
I have now had a chance to browse the slides and form some preliminary views as to where this is up to.
Before saying anything I must point out that the slides are still strictly discussion drafts only and all subject to change.
First the good.
1. There are actually the germs of a real plan contained in the slides.
2. They are working on it!
My comments thus far (and I am still thinking about it all) are as follows. These are encapsulated in an e-mail to Deloittes sent on August 3 2008 are.
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I have reviewed the document provided to the NEHIPC on 30 July.
Attached is a commented file with about 30 comments and suggestions.
A core issue you face right now is alignment of all that is going on in a totally strategy free - NEHTA inspired - environment from where we need to be and how the migration to a more sensible guided but still innovative outcome can be achieved. The balance between controls, incentives and involvement is difficult indeed!
I also worry the depth of the current state and strategic option development process have both been a little blinkered - especially the latter.
I am also deeply worried about all the repository proposals contained in this before we have decent information in the operational systems at the coal face - this issue is a 'show stopper' I believe unless carefully rethought.
Lastly the lack of detail on planned applications, timeframes etc I assume is because the work has not been done yet..but a business case for the entire process requires clarity as to what is really planned - not the 'fudge' that NEHTA tries to perpetrate with diagrams with no axes and no meaning.
Happy to discuss. Acknowledgment you have received the comments appreciated.
Cheers and thanks for reading
David.
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Frankly – right now this feels to be a too centralised, too controlling approach to me.
I wonder what others think?
David.
7 comments:
If it's not centralized and controlled, it'll never happen. Implementation of messaging standards hasn't been centralized and controlled, which is why they still haven't been implemented properly - 10 years after the standards were published.
May be so - but command and control approaches in e-Health have not really worked elsewhere in the world. Why would Australia be different?
David.
More harm than good will be done if the plan does not acknowledge that market forces will prevail and in so doing focus on establishing strategies which harness market forces without attempting to impose centralised control. That is a very tough but it must be so.
In your psoting you mentioned that you had made over 30 comments on the document.
Are you able to share your detailed comments?
Deloittes has the comments and have already discussed some of them with me. My comments are now a little out of date with respect to where they now are and so are really not relevant. I am hoping to be able to share more current information in a week or two.
David.
I agree - letting market forces prevail is an absolute imperative if we are to see any real progress. Otherwise, as the saying goes ...... the dead hand of bureaucracy will be just that. The role of the bureaucracy (government) should be one of facilitation without intervention.
How good would that be?
You have good cause to be "deeply worried about all the repository proposals contained in this before we have decent information in the operational systems at the coal face - this issue is a 'show stopper'."
It certainly is. But it is unlikely much attention will be given to your concerns, because, let's face it - big business and public servants will drive hard to get repository projects underway. Worrying about coalface issues doesn't hold much appeal. It is much more exciting to get big complex projects underway - that means lots of work for lots of people and a lot of managing and administering for the bureaucrats - and lots of money to be spent. Big projects are so alluring provided one turns a blind eye to history.
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