Thursday, November 25, 2010

There Are Few Mess-Ups that Could Top This - Just Amazing!

The following appeared in the Australian IT On-Line yesterday.

Government allocates $55m to e-health records sites

  • Karen Dearne
  • From: Australian IT
  • November 24, 2010 3:59PM

THE Gillard government is offering up to $55 million for the next round of e-health sites, inviting applications for project funding from a range of healthcare organisations before Christmas.

Health Minister Nicola Roxon said the money will expand the number of GP divisions working on new personally-controlled e-health records from the initial sites, in Brisbane, the Hunter Valley and Melbourne.

"Applications are welcome from a variety of patient settings including Divisions of General Practice, professional and non-government organisations, the private sector and others involved in healthcare," Ms Roxon said.

"The second wave of sites will help lead the way for future planning of a secure, reliable e-health system, improving technology and identifying what works well and what could work better."

Ms Roxon said patients would ultimately control "what goes into their health record and who can access their information".

More here:

http://www.theaustralian.com.au/australian-it/government/government-allocates-55m-to-e-health-sites/story-fn4htb9o-1225960286343

I thought it might be fun to have a look at the application for funding - given so much money is up for grabs - and see just how well developed the design ideas and functional delivery plans were.

To behave like the tabloid journalist of old I can now reveal the following.

1. NEHTA and DoHA are clueless as to just what the PCEHR is!

To quote:

“Applicants should be aware that the Department of Health and Ageing (DoHA) is prepared to disclose an early draft version of the PCEHR conceptual design document to applicants to assist them in developing their application. The document is in draft form as it is yet to go through public consultation; the document is therefore likely to change as a consequence of this consultation.

In order for applicants to receive the draft version of the PCEHR conceptual design document it will be necessary for an individual person representing an organisation, partnership or consortia to sign a Deed of Confidentiality (Attachment A), and submit a scanned copy to PCEHR.ehealth.Sites@health.gov.au. Following receipt of the signed Deed of Confidentiality DoHA will provide a copy of the draft version of the PCEHR conceptual design document to the applicant.

In addition, other information relevant to the PCEHR Program will be published on the NEHTA website: www.nehta.gov.au.”

What on earth is going on here? How about deciding what you want to do, developing a ‘system’ to deliver same, consult properly and then go to the market for help?

This whole process, driven doubtlessly, by the political pressure to ‘do something’ looks more and more like a total train wreck.

Would you make a commercial offer to deliver something (and we don't know what), with all those onerous liability clauses the contract has, when what was wanted was not thought through and agreed well enough to properly define the project. I sure wouldn’t. This is an emerging repeat of ‘pink bats’ and the BER! Cart before horse in spades!

I really think that without using very great care taking this money could be a total disaster for the organisation involved given the vagueness of what they are being asked for.

2. Worse the selection criteria for the funds has the following contents.

The following evaluation criteria will be used to evaluate the applications:

Organisation

1. A track record for successful delivery of eHealth projects, ideally involving formal collaborative partnership arrangements and change management programs;

2. Capacity to undertake the proposed project in 2010-12;

  1. Demonstrated financial viability of the project; and
  2. Quality of the proposed delivery team.

Solution

1. Sustainability following cessation of the Commonwealth funding period;

  1. Ability to improve information flows within patient community with priority needs such as mothers with newborn children, those with complex and/or chronic disease conditions, older Australians, and Aboriginal and Torres Strait Islander peoples;
  2. Ability to scale project solutions and outcomes so that they can be deployed to other related parts of the Australian health sector;
  3. Able to deploy and comply with agreed national eHealth standards and services which will ultimately enable connection to the national PCEHR infrastructure;
  4. Support of information exchange across different parts of the health sector (e.g. primary care, acute care, aged care);
  5. Able to demonstrate strong clinical governance and clinical safety management; and
  6. Able to demonstrate national demographic coverage, and/or deep sectoral coverage, and/or early benefits, and/or innovation in the lead implementation site.

Delivery

  1. Includes a change management program within the project and across other organisations;
  2. Demonstrated clinical support and readiness and acceptance within the projects target care community; and
  3. Ability to deliver tangible and measurable project outcomes within a 6-18 month period.

---- End Extract.

Amazing is not the word for the expectations from DoHA here. Gob smacking fits way better.

You, as a grantee, have to deliver a financially sustainable solution that delivers benefits within 6-18 months. i.e. The money runs out but what you leave needs to go on!

And worse you will have to work under the guidance of the nation’s holders of the record for non- delivery!

This is just utter madness in my view and will set e-Health back a very long way.

3. Does anyone understand just why the draft design documents would be secret other than to prevent embarrassment of those who developed them - who ever that was!

I cannot believe just how naïve and incompetent this all is. Again we go back to the lack of leadership and governance in the space. I wonder will the new DoHA CIO be able to fix things?

David.

2 comments:

Paul Fitzgerald said...

David, most would fail on Selection Criteria number 1 - "...track record for successful delivery of eHealth projects.."
nice to see the taxpayers money being wisely spent! NOT!

Anonymous said...

It is really sad to learn how clueless they really are. This is more hair brained than ever before. It's also a little paranoid to keep the specifications secret!! It suggests they want to avoid public scrutiny, just like the NBN. It seems unlikely that having multiple sites, run by divisions is going to lead to a cohesive system. I have not seen any divisions people at a standards meeting of late and get the impression that many are even a little suspicious of standards!!! ( I mean they are a bit geeky)

The big learning experience of the last 10 years is how important standards compliance is in large distributed systems. The ability of the web to deliver amazing advances has been under pinned by a real focus on standards compliance in Browsers, javascript and html and its paying huge dividends in functionality.

55 Million dollars directed at standards compliance in Australian software systems could revolutionise our eHealth landscape, but no they are going to throw it away on projects run by organisations with little deep eHealth understanding, but a lot of experience at writing proposals with impress bean counters and actually deliver little real advances. They just do not understand that we need high quality standards compliant software and not another hastily written business plan that ticks some esoteric boxes in the mind of some public servant who knows nothing about making distributed complex systems work.

The short time frame is also silly, but I guess when you have to burn $467,000,000 dollars in 2 years there is no time for careful planning!