Sunday, March 22, 2015

Now This Has To Be A Real Worry Unless A Few Important Lessons Are Taken On Board!

I noticed this rather interesting announcement a few days ago.

Health ministry to set up National eHealth Authority to develop Integrated Health Information System

Ramesh Shankar, Mumbai
Friday, March 20, 2015, 08:00 Hrs  [IST]
The Union health ministry will soon establish the National eHealth Authority (NeHA) which will be the nodal authority that will be responsible for development of an Integrated Health Information System (including Telemedicine and mHealth) in India, while collaborating with all the stakeholders, viz., healthcare providers, consumers, healthcare technology industries, and policymakers.
The Authority will act as a promotional, regulatory and standards setting organization to guide and support India’s journey in e-Health and consequent realization of benefits of ICT intervention in health sector in an orderly way.  It will be responsible for enforcing the laws & regulations relating to the privacy and security of the patients health information & records.
One of the major goals of the Authority is to guide the adoption of e-Health solutions at various levels and areas in the country in a manner that meaningful aggregation of health and governance data and storage/exchange of electronic health records happens at various levels in a cost-effective manner. It will facilitate integration of multiple health IT systems through health information exchanges.
Another mission of NeHA is to oversee orderly evolution of state-wide and nationwide electronic health record store/exchange system that ensures that security, confidentiality and privacy of patient data is maintained and continuity of care is ensured.
The NeHA has been envisaged to support formulation of policies, strategies and implementation plan blueprint (National eHealth Policy/Strategy) for coordinated eHealth adoption in the country by all players; regulation and accelerated adoption of e-health in the country by public and private care providers and other players in the ecosystem; and to establish a network of different institutions to promote eHealth and Telemedicine/remote healthcare/virtual healthcare and such other measures.
More here:
Talk about a sense of déjà vu!
All they seem to have done is drop the letter “T” from our old friend NEHTA!
One has to hope NeHA can learn from all that has gone before.

Here is another link that provides a lot of details on the plans:

http://www.dailymail.co.uk/indiahome/indianews/article-3005690/NeHA-s-helping-hand-sick-Records-government-hospital-patients-available-online.html
Reading through this article I am really worried about the level of confidence and optimism expressed. Certainly the other countries cited (UK, Aus. and Canada) have yet to make a great fist of it in countries that are much smaller and much less diverse!

All I can hope is that this new organisation takes the suggestion to do a few things as it starts up - noting that the idea of NeHA is very new and there is a very long way to go..
First it needs to have a close look at all the reports done on NEHTA over the years from Deloittes and the Boston Consulting Group etc - given the similarity of the initial mandate.
This link will provide at least a start on what is needed!
Second they need to have a look at the way the US Office Of The National Co-ordinator for Health IT operates in terms of transparency, openness, consultation, standards setting and industry engagement. The ONC has done a good job in these areas.
Third they really need to get on the ground all over the world and research what has worked (or not) and see what has the best chance to work in a huge country like India.
Fourth they need to be very clear projects like this are very hard to get right and always take a great deal longer than anyone anticipates.
All I would do is wish them luck and encourage them to work very hard to learn from history!
David.

1 comment:

Anonymous said...

Well we should have called ours "NEHDA" for National e-heath Destruction Authority as all we have transitioned to to is a smelly quagmire so far off the path into the weeds that hopes are fading for any rescue.

What we needed was some governance, if you are doing eHealth then you have to be compliant with any standards you use. That would solve many of the problems we have. Instead we have a bunch of unworkable quasi standards that were driven through the standards process with a sledge hammer and help no one.