Sunday, January 08, 2012

Welcome To 2012! - Normal Service Returns and A Few Predictions For the Year!

First of all welcome to all those who choose to tag along for what is going to be as interesting year as we are likely to see in a long while in e-Health!
I hope the year is a happy and prosperous one.
I was thinking it might be fun to pop up a few predictions for the following year and see how close I can be to what actually happens. So here goes!

PCEHR Related Predictions.

1. The presently proposed PCEHR Legislation will see more than a few changes before it gets passed if it actually does get through.
2. The Senate Community Affairs Committee Report on the PCEHR will wind up producing a split report - along party lines - with Labor saying all it needs is a little tweak or two and the Liberals saying it needs some major change. The Greens will have some concerns also if history is any guide.
3. The scope of what is actually delivered on July 1, 2012 will be a shadow of what was planned a year or two ago.
Comments like the following from an insider make it utterly clear!
“Anonymous said...
Being involved in one of the "lead site" projects for this, here are my observations:
The project is being run with only minimal basic project management principles.
Outcomes are vague, no real analysis of the current state has been done, and no methods are proposed to measure if the outcomes are achieved.
The lead site project I am involved with is being run for the benefit of the vendor, not the client or the public.
Basic project documentation such as a business case, business requirements, functional spec, etc are either non-existent, or so vague as to be useless
Time frames are artificial and unachievable given the current situation. If anyone says anything else, then they are in denial or worse. Something may be delivered in the time frame, but it will not be what is required, and will not achieve the outcomes required.”
Expect to see success and the scope of the PCEHR Program re-defined.
4. At some point there will be a major, but probably not disclosed, set of contractual revisions on most of the Implementation Partner Contracts.
5. There will be some form of review of the whole e-Health direction and levels of investment under the new Health Minister. This may or may not ever become public but the effect will be pretty clear - remember when the HealthConnect Program became a “Change Management Strategy” in 2005!
6. The absurdity of the pressured “Tiger Team” approach to specification delivery for the PCEHR will become increasingly apparent and the relationship between SA, IT-14 will become very strained and may break down entirely with so few SA volunteers staying to contribute.

NEHTA Related Predictions.

1. Actual implementation of NEHTA’s products will remain both slow and largely unused.
2. At least 2 of the State Jurisdictions will make very unhappy noises privately to DoHA and NEHTA about not getting value for money and indicating a desire to stop paying their ongoing contributions.
3. Substantial adoption and actual use of SNOMED-CT and AMT will continue to be a “while off” in 2012.
4. NEHTA’s Secure Messaging will continue to have very limited adoption in the real world.
5. As revealed in the most recent NEHTA Blueprint - we will still have quite a long wait for the widespread adoption of the National Authentication System for Health (NASH) - even by the end of 2102.
6. There will be some substantial issues with industrial relations and contractual arrangements become public during the year.
7. A new Governance Framework / Role / Leadership will emerge in 2012 with improved accountability and transparency.
8. The tight financial leash in which NEHTA is being held by DoHA will tighten in 2012.
9. There will be significant trimming of the NEHTA PR Budget and staff.

DoHA Related Predictions.

1. The e-Health Function of DoHA and NEHTA will be merged into a new - and separate - e-Health management and delivery entity.
2. Senate Estimates Committee meetings will become more ‘hard-nosed’ in the e-Health space.
3. There will be some career casualties because of the under delivery of the PCEHR program.

State Health System Related Predictions.

1. There will be ongoing issues with e-Health in Queensland Health over the year.
2. Reviews of State Hospital Systems Health IT will continue to happen and will continue to somehow remain ‘secret’. I wonder what the review of NSW Health IT revealed.
3. State Hospital supply chain automation will continue to lag other industries by years if not decades.
4. We will have a range of press releases from various States announcing plans and programs for the next few years which somehow always seem to slip.
5. Tasmania will admit they can’t do anything useful with so few staff in the Health IT area and start hiring again.

Health IT Industry Related Predictions.

1. Relationships between NEHTA / DoHA and industry will continue to be difficult.
2. There will be a number of failures of small companies in the e-Health space as the industry is ‘hollowed out’ by a rampant Government Sector that picks winners and penalises the others.
3. Some of those involved in the various Wave 1 and 2 sites will discover they have actually drunk of a ‘poison chalice’ in the form of NEHTA and DoHA.

Clinician Related Predictions.

1. The political representatives of clinicians will harden their attitudes to imposed additional workloads related to e-Health Initiatives that are not reasonably compensated.
2. Clinician frustration with poor leadership, governance and delivery in the e-Health domain will become increasingly apparent over 2012.

Consumer Related Predictions.

1. Voluntary registrations for a PCEHR will be quite low and usage of the system - if actually implemented will be very low for the whole of 2012
2. Consumer confidence in e-Health will be badly damaged by over-promising and under-delivery by the PCEHR program.
I look forward to readers adding their own ideas as to what 2012 holds!


Lagrimas de Luna said...

Hi David

I can add a few predictions of own about NEHTA:

- despite the chronic under-utilisation of its business analysts NEHTA will continue to recruit more

- despite the over-population within NEHTA of people who call themselves "Enterprise" Architects, NEHTA will continue to recruit more. The existing EAs will splash around in their self-indulgent pool, polishing their models and repeating the self-praise that their models are "the best thing that NEHTA has ever produced".

- As a corollary to the above prediction, the notions of "patient care", "patient outcomes" and "better health care" will be removed from all NEHTA documents with a promise that they might be reinstated in 2014.

- Private companies will eventually reach a point where no benefit accrues by cooperating with NEHTA. They will suspend all interaction and get on with solving the problems that are buried deep within NEHTA's models.

- As realisation dawns about their poisoned careers, a number of senior NEHTA employees will make a timely exit before the damage to their reputations is irreversible. Most will reappear at Qld Health.

Anonymous said...

…. and as lives continue to be lost through doctor shopping for S8-opiods and benzodiazapines the Department will rise to the occasion and begin the development of a national electronic medication record. De ja vue – MediConnect.

Anonymous said...

Any takers on what the next project will be called?

Anonymous said...

... how about NHSCA 'National HealthSecure Connection Authority'

Anonymous said...

SHENCA is better - it says it all - Secure Health Exchange National Connection Authority