Wednesday, March 30, 2011

Are We Just Kidding About Or Serious About E-Health? Who Knows. It Seems We Are Building a Playpen!

The following appeared in today’s Age On-Line. The paragraph in bold says it all!

Electronic health records planned

Kate Hagan

March 30, 2011

UP TO half a million patients, including the chronically ill, will be the first to receive electronic health records under Labor's radical plan to overhaul the way medical data is kept.

Federal Health Minister Nicola Roxon yesterday announced $55 million for nine projects, to be run by various groups including pharmacists, general practitioners and hospitals.

.....

The federal government's clinical adviser on e-health, Dr Mukesh Haikerwal, described the projects as "a playpen to see how these things could work".

Full article here:

http://www.theage.com.au/national/electronic-health-records-planned-20110329-1cexj.html

I am just awed that half a billion dollars can be spent on a “playpen”.

There are plenty of examples overseas about what works - a playpen is not needed. Some competence, leadership and governance are!

David.

9 comments:

Keith Heale said...

David, to be scrupulously fair, it's not half a billion dollars being spent on the playpen, but about $55M, or 12% of the total. Perhaps Mukesh will regret using the word "playpen" rather than something more formal and less evocative, like "pilot projects". Or as Minister Roxon put it, this is to "find out what works and what doesn't". It's a pretty safe bet that without embedded HI's, a working NASH, ubiquitous robust secure messaging and much more engagement with health professionals none of it will work. What we have to keep on repeating is that "ehealth does not equal PCEHR". There are many really useful things that we could be doing in ehealth and the PCEHR isn't one of them.

Anonymous said...

No David, that is not correct and you know it. “Half a billion dollars” has not been spent on a playpen. It’s only $55 million that has been spent on 9 projects in Wave 2 which equates to $6 million per project. That leaves $411 million in the playpen bucket, unspent.

Now each of those 9 projects has to do quite a lot of ‘work’ of one kind or another to spend $6 million. And they have to account for what they spend. And they have to go to NEHTA for that money. It is difficult to imagine, but not beyond the realms of possibility, that NEHTA will just hand over $6 million to each project when they submit their workplan and say terrific go spend it – have fun.

Then presumably they have to come back to milk the trough of some more of that $411 million which averages out to a feed of $45 million per project if they all get fed equally.

OR is it perhaps possible some of that $411 million will be spent on a WAVE 3 round of projects? And if so – what might they be?

For example there are many ehealth vendors who appear not to have been given a feed in the WAVE 2 round. A Few names are mentioned in the media release, some more than once like Michael Georgeff’s Precedence, but do we know who all the software and hardware technology suppliers are in each of the 9 projects?

There were a total of 90 applications, leaving 81 applications unfunded.

Who might those suppliers have been? Perhaps it would be wise in the interest of transparency when such a large amount of money is being handed out that a list of applications received should be made available and all the suppliers involved in each project, whether successful or not in receiving funding under WAVE 2, should be listed under each project.

If that information it is not readily forthcoming, and there is no good reason I can think of as to why it shouldn’t be, it could be very embarrassing for the Minister should some enterprising journalist dig out this information under an FOI, or should the opposition dig it out via the Senate Estimates. Of course that assumes the information does not fall under that bizarre circumstance relating to NEHTA being except from any FOI scrutiny.

Dr David More MB, PhD, FACHI said...

Guys, the budget allocation of 1/2 a billion is to be spent by June 2012. By then the project is meant to have shown benefit and further funds are to be allocated or the program cancelled.

Does anyone think these 12 projects are going to become a useful national system in 15 months and show it works and provides benefit?

Re the money $55M is still a fair bit for a 'playpen' but I take the point!

David.

Anonymous said...

"If that information it is not readily forthcoming, and there is no good reason I can think of as to why it shouldn’t be, it could be very embarrassing for the Minister should some enterprising journalist dig out this information under an FOI, or should the opposition dig it out via the Senate Estimates."

Well, in the post-wiki leaks world we don't need FOI. If every unsuccessful bidder that genuinely smells the rat of cronyism and tokenism in this mess (as opposed to feeling pissed off that they weren't picked) wanted to, they could elect to deposit their bids in a protected space (David you could do that). As some bidders will want to protect IP, then the only people allowed to look at the documents will be media. That would allow them to ask the questions they need to ask.

Anonymous said...

It is a playpen - for politicians to try to win votes and for senior health managers to serve their political masters!

The sad part is that the deserving public and dedicated health workers are all outside the pen watching tax payer money be squandered!

There is also no transparency! It would be great to be able to be able to actually assess the Wave 2 grants on merit (not political expediency) either with FOI or wikileaks;)

Anonymous said...

From the media announcements we know that:

Precedence, HCN, Best Practice and SmartHealth are mentioned twice.

FRED-eRx, Microsoft, iSoft, HealthLink, Zedmed, iCare, SIMPL, are mentioned once.

We also know that the 9 sites are located in:

NSW/ACT – Sydney - 3 sites
QLD – Brisbane – 2 sites
VIC – 1 site
NT/SA/WA – 1 site
TAS – 1 site
NATIONAL - Health Insurer – 1 site

Anonymous said...

NSW scooped the pool so to speak. Given the Liberal landslide last weekend it makes me wonder whether NSW got its 3 guernsey's just in the nick of time.

Anonymous said...

The NT project does *not* include WA in any meaningful way - it involved a vague inclusion of 6 hospitals who currently do very little electronically. WA was not included in the playpen - nor was SA - WA I can understand - I believe it is because NEHTA didn't realise that WA was actually part of Australia - this probably reflects the fact that NEHTA's knowledge of geography is almost as good as its knowledge of eHealth

Scot M Silverstein MD said...

The federal government's clinical adviser on e-health, Dr Mukesh Haikerwal, described the projects as "a playpen to see how these things could work".

I can suggest a less expensive solution to "see how these things could work": a few days at the library.

-- SS