Tuesday, May 17, 2011

I Might Be Getting Ahead of Myself - But I Feel A Singularity Is Almost Upon Us!

I have been busily updating and hopefully improving the Submission which I am planning to send to DoHA on the PCEHR.

As I have been doing this I have been having all sorts of very valuable input from all sorts of experienced and caring people. Some want to stay in shadows - so they can keep feeding their nippers - and other are quite happy to be quite open about their views.

While I am not going to reveal any private discussions I have to say that to a person there is very great disquiet about the way the PCEHR Program is proceeding and concern it is pretty misdirected and directionless.

Another frequent discussion point has been just when there will be either a major collapse of what is happening or a major change in goals and objectives - responding to the realities that the present plans are really gross over-reach. We all remember what happened when the then Health Minister was told by the then Minister for Human Services (Tony Abbott and Joe Hockey respectively) that the HealthConnect Program was likely to cost well north of $1 Billion.

We suddenly went from having an actual Health IT program to having a ‘Change Management Strategy’ as it was termed that cost essentially nothing - and all serious work went onto the backburner.

Right now we seem to have:

1. 13-14 Months of remaining funding available - contingent on delivery of something useful - and we know that won’t happen. (So success will need to be redefined).

2. Reports from the HL7 Meeting in Orlando, Florida that there is a sense that HL7 Version 3.0 is imploding under its own complexity and rather large big upfront design approach.

3. Suggestions that even some of the NEHTA attendees at the same conference are a bit concerned about how it is all playing out to support their grand plans.

4. Lack of any agreement or clarity on which standards foundation the PCEHR is to be built.

5. Continuing lack of engagement, transparency or production of credible planning documents

6. All the other issues around the PCEHR as outlined in my Draft Submission.

See here if you missed it.

http://aushealthit.blogspot.com/2011/05/new-and-much-updated-version-of-pcehr.html

If ever we were to be likely to see Government / DoHA / NEHTA / Ms Roxon move the goalposts to redefine what success is, this looks to be pretty close to it.

Tipping points exist and maybe we have just arrived at one!

This comment says it all I reckon:

“At the moment we appear to have a complete lack of design after years of complete over design. The pendulum needs to swing to supporting what’s working and improving things incrementally but it appears that we will have to wait for the big implosion before that will occur.”

What to call the point we are coming up to? The “Great Implosion”, the “e-Health Swan Dive” or whatever. Suggestions welcome!

David.

4 comments:

Anonymous said...

David, It will be very depressing if what you are forecasting comes true.

There has been a massive effort by 100s of people within NEHTA and DOHA to produce a new vision for eHealth in Australia that will enable us to 'leapfrog' other nations like the UK, USA and Israel.

It will be truly humiliating for the authors of the National eHealth Strategy and the PCEHR Concept of Operations if that brave new model of eHealth falls over.

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

"It will be truly humiliating for the authors of the National eHealth Strategy and the PCEHR Concept of Operations if that brave new model of eHealth falls over."

2 Points.

1. The National Strategy and the PCEHR are unrelated documents and conceptually unrelated in my view. It is only spin that links them not substance!

2. There is little doubt in my mind the proposed 'brave new model' is a deeply flawed one and needs to be dramatically changed to be successful.

Other people's mileage may vary!

David.

Anonymous said...

On Wed Anonymous said: " There has been a massive effort by 100s of people within NEHTA and DOHA to produce a new vision for eHealth in Australia that will enable us to 'leapfrog' other nations like the UK, USA and Israel."

I suspect there will many more millions wasted on politically motivated ivory tower eHealth visions before there is any actual improvement at the coalface of health care provision. With a bit of luck by then technology will have provided much better and cheaper solutions!

Anonymous said...

One would think an article like this one is only just around the corner for Australia.


http://www.ihealthbeat.org/articles/2011/5/18/audit-slams-british-ehr-program-for-being-largely-unsuccessful.aspx

But alas, there's so little accountability and scrutiny of NEHTA/DOHA's existing track record of abject failure, it may be a long time before the absurdity of the current plans are revealed.