Sunday, December 20, 2015

A Brief Review Of Australian E-Health In 2015. Not All That Pretty I Think.

Well it is the time of the year when we look back over the last year and try to come to grips with what has happened.
In any necessarily brief review I can only cover the highlights as I saw them. The activity can reasonably be divided into three areas.
1. National E-Health Plans, Initiatives and Outcomes.
On the national level I would nominate three key events.
First there was the funding of the PCEHR for a few more years and the adoption, by the Government, of most of the recommendations of the Royle Review leading to the instigation of trials of ‘opt-out’ in North Qld. and the Blue Mountains.
There is a summary of the Royle Review here:
All the information you might need to start seeing what the Government is planning is found here:
Second there was the passage of updated legislation enabling the trials, followed by nation-wide adoption of ‘opt-out’  along with a whole lot of other changes.
Usefully the updated integrated legislation is available here:

My Health Records Act 2012

- C2015C00602
Act No. 63 of 2012 as amended, taking into account amendments up to Health Legislation Amendment (eHealth) Act 2015
An Act to provide for a system of access to electronic health records, and for related purposes
Administered by: Health
Third there was the announcement recently by Martin Bowles - the Health Department Secretary - on a trip to New York (Why New York?) that the Strategic Direction of eHealth was changing from support of clinical service delivery to administrative data mining for management purposes. No wonder this was not announced and explained by the Health Minister.
You can read all about this one here:
Between all these three highlights we had a range of smaller little accidents and system outages.
The unifying aspect around these big three was the total absence of evidence for or evaluation of what was going on and how it was justified. To me this is a real blight on the landscape.
It seems to me more than likely that the trials of ‘opt-out’ will be an administrative and privacy disaster that will be obfuscated into a raging success and rolled out nation-wide in 2017. The process will be very interesting to watch.
2. Jurisdictional Initiatives, Plans and Outcomes.
With the jurisdictions it is hard not to be amazed how many issues seem to have arisen.
Queensland developed a new spending plan for its e-Health and was told by the courts that it could not sue IBM for the long running payroll fiasco. IBM is now planning to sue Qld Health
WA had ongoing issues with the Health IT as the new Fiona Stanley Hospital was commissioned and continued to be rather behind the curve with clinical hospital computing.
Poor old NT was told to get rid of a working state-wide shared health record and replace with the legendary and unproven PCEHR by NEHTA. WTF is all one can say.
South Australia seems to be in an endlessly stalled roll out and lost the bloke running it this year. They also seem to be having some contract troubles with a provider.
NSW Health got audited late in the year and was asked to explain why all their systems seemed to always run late.
As far as anyone know Victoria is still trying to work out what to do after HealthSMART.
Last I heard Tassie was still working on a scanned EHR - updates from the Apple Isle welcome!
Feel free to provide updates - it really seems to have been a pretty ordinary year.
As a point of interest does anyone know how many of the jurisdictions paid NEHTA for its services last year?
3. Private Sector Initiatives, Plans and Outcomes.
The biggest news in the private sector has been Telstra Health hoovering up many of the more promising e-Health providers and then proceeding to undertake some implementation - which by some reports seem to have gone pretty well.
We have also seen some steady progress from many of the GP / Specialist system providers who are still being harassed to communicate with the PCEHR but not be paid for their efforts at anything like a fair rate.
Frankly I see the private sector as the hope for the side in terms of delivering useful and needed improvements that are somehow not seen as wanted or useful by our betters. After 20 years of messing it up it is hard to see the Government getting its act together!
So there you have my warped summary - and a wrap for the year!
See you in 2016 - unless some really interesting stuff breaks!
Have a great Festive Season!
David.

1 comment:

Oliver Frank said...

Dear David, Thanks for all of your hard work in bringing news and your and other people's views about Australian health informatics to us for another year. Best wishes for the summer break!