Thursday, November 17, 2011

The Parliamentary Library Of The Commonwealth Government Publishes A Review of E-Health. Must Read Stuff!

I was told about this review, which was published today, late in the afternoon.
The title etc. is.
RESEARCH PAPER NO. 3, 2011–12 17 November 2011

The e health revolution—easier said than done

Dr Rhonda Jolly
Social Policy Section
Parliamentary Library.

Executive summary

E health is seen by some as possibly the most important revolution in healthcare since the advent of modern medicine. E health makes use of developments in computer technology and telecommunications to deliver health information and services more effectively and efficiently. As such, it requires a different and radical way of thinking about the delivery of health services.
Since the 1990s, the potential of e health has been discussed globally, but it remains a work in progress everywhere, albeit that some countries have had more success instigating measures than others. There are many reasons for the slow adoption of e health. These include: the fragmented funding and governance of healthcare services, resistance of professions to changes in existing models of care, a lack of rigorous research evidence on the benefits that might drive change and a reluctance of politicians to be seen to be tampering with a politically-sensitive service. There may also be concerns about the costs and complexities associated with e health implementation and the need to resolve issues about how it will affect practitioners and consumers alike.
This research paper does not attempt to discuss all the aspects of e health in depth, for the subject is extensive, both technically and in policy terms. The paper provides instead an introductory overview of some of e health’s critical aspects. In so doing, it looks briefly at certain aspects of the overseas experience of e health policy development and considers some practical application case studies. For the most part, however, the paper concentrates on the evolution of e health policy in Australia.
For Australia, e health holds great potential in many areas, such as resolving the tyranny of distance or reducing the costs associated with caring for an ageing population. This notwithstanding, policy makers have discovered that there are many obstacles to developing national e health policies and programs. Some of these have been resolved; others persist; still others are only just beginning to emerge. While the paper discusses most of these in a broad context, it also focuses on particular issues, such as concerns about how e health will affect patient privacy.
The paper concludes that e health does indeed have great potential, but harnessing that potential has, and continues to require finding and negotiating a delicate balance between many interests and issues.
I am a bit worried I seem to have a little too much to say! The report tries to present a balanced view and is really worth a read to see all the divergent views that are out there!
Thanks for the support of others who are also acknowledged in the report for support in the positions I have tried to put.


B said...


If one were to do a root cause analysis, rather than a full detailed examination, I would suggest that the following statement will explain the train wreck that will be the PCeHR:

"An important recommendation made by Deloitte was that an independent national e-health body was established to undertake the oversight of strategy, management, execution of work programs and standards development and compliance functions. Given the success of such a body in Denmark it is interesting to note that despite the Government’s enthusiasm for the overall Deloitte plan, this recommendation was not adopted"

The lack of "..oversight of strategy, management, execution of work programs and standards development and compliance functions." will result in so many problems with the current approach that it will be unworkable.

As I've said before:
Unstable requirements -> project failure.

Unstable requirements is a direct consequence of a lack of strategic oversight.

And if you want even more evidence of unstable requirements, read "The verdict on the proposed PCEHR" Dr Steve Hambleton

So many issues have not yet been resolved, it makes the decision to build the PCeHR infrastructure very foolish.

EA said... worth noting for
As is often the case, errors in interpreting the specifications often are not detected by the receiving EHR. Instead, the receiver simply omits a datum or files it in the wrong place in its database. The errors are only uncovered when someone looks at data on the screen and says “that’s not right” or “they didn’t send us the information the said they would.”
Am trying to imagine DoHA answering a question to a Senate Committee about errors.