Sunday, January 17, 2016

Sadly You Can Be Sure Australian E-Health Is In For Much More Of The Same. How Hopeless.

A job add appeared a day or so ago:

Chief Executive Officer, Australian Digital Health Agency

  • Newly created statutory authority
  • Flexible location – Sydney, Brisbane or Canberra
  • Strategic leadership, innovation and engagement
The Australian Digital Health Agency will be fully operational on July 1, 2016. This Agency will assume strategic management and governance responsibilities for all national digital health strategy, design, development, delivery and operations. In doing so, the Agency will transition the activities and resources from the National E-Health Transition Authority and the system operation activities of the My Health Record currently managed by the Department of Health.
Reporting to a skills-based Board reflective of the health community, the CEO will initially focus on establishing and transitioning activities to the new Agency. Beyond that, the CEO will be responsible for the strategic leadership, engagement, collaboration, innovation and operations of the national digital health systems.
The Position
  • Lead strategic planning, stakeholder engagement  and operational excellence 
  • Implement the National Digital Health Strategy as directed by the Ministerial Council
  • Maximise the effective interoperability of the public and private digital health systems
  • Ensure clinical safety in the delivery of the national digital health work program
The Person
  • A dynamic and innovative leader, with complex change leadership experience
  • Able to formulate national strategies with a focus on delivery of outcomes  
  • An understanding of and ability to manage major IT programs
  • Exceptional stakeholder engagement skills
  • Able to effectively manage within the political, private and public sector environment
  • Independent and accountable in delivering the digital health outcomes
 CLOSING DATE: Sunday January 31, 2016
Here is the link to the ad:
Summary - we are looking for a political IT expert who is a good manager and who is good at engaging with stakeholders (unspecified).
We are also planning to pop all of NEHTA’s functions and the operational activities of the PCEHR under one organisational roof and are hoping the new leader will be good at everything from operations to strategy.
There seems to also be a need to lead strategic planning - scope unspecified.
Astonishingly what is missing is any mention of expertise or experience in e-Health related domains. A small oversight? What do you think?
So it looks like we will get another banker, or the like, for the role. The more things change the more  they seems to stay the same!
David.

12 comments:

Anonymous said...

We are definitely making progress. It's now all about digital health, not e-health. Buzzword heaven.

So modern, so progressive. So naive, so vacuous. The spirit of Professor Halton lives on.

Anonymous said...

So what have we?
1. NEHTA to be dissolved.
2. PCEHR to be renamed MyHealthRecord.

3. 1 Million Australian’s to be compulsorily enrolled in two MHR opt-out pilots.
4. The ACeH to be renamed to ADHA.

5. The Department to cease being responsible for MHR
6. Some NEHTA and Department staff will move across to ADHA.

7. ADHA to have a skills based Board reflecting the health community.
8. A CEO to be appointed to oversee ADHA.

9. ADHA will assume responsibility for MHR strategy, governance, operations.

10. ADHA CEO to be responsible for strategic leadership, engagement, collaboration, innovation and operations of the national digital health systems.

11. Doctors must create some MHR summaries to receive ePIP payments.
12. The Ministerial Council will direct the National Digital eHealth Strategy.
13. The ADHA CEO will also formulate national strategies.

Anonymous said...

January 18, 2016, your summary, which seems to be correct, spotlights a fundamental error in the Department's thinking.

The two pilot geographies selected in which to roll-out the new opt-out version of the PCEHR, dare I call it the MHR, are intended to prove that the PCEHR works and that it will be useful and of benefit to doctors and their patients. Surely to goodness until these pilots have been evaluated there is no evidence available to support a wider roll-out of the PCEHR-MHR.

Yet, amazing as it might seem, the Department once again is getting ahead of itself by pre-empting the work of the the ADHA. Surely the first prudent step is to test and prove a couple of pilots but the department doesn't seem content to do just that.

Rather, it wants to extend, before proof-of-concept is established, its PCEHR-MHR push right across Australia by insisting that from May 2016 GPs will lose their entire e-health Practice Incentive Program payments if they do not upload upto 5 shared health summaries each quarter!

Where is the sense and logic in this?

Bernard Robertson-Dunn said...

Re:
"The two pilot geographies selected in which to roll-out the new opt-out version of the PCEHR, dare I call it the MHR, are intended to prove that the PCEHR works and that it will be useful and of benefit to doctors and their patients."

This is incorrect. There is no new version of the mHR. The version that was received with apathy and which was designed to be opt-in will be used, with no modifications, as opt-out.

The trials are to test the registration process, not the system itself.

There is a naive belief that the only reason the system is not being used is because "not everyone has registered".

At the end of the trial period, most people involved will have a populated health record but will not have a Nominated Healthcare Provider (which is decided by mutual agreement), will not have linked an email address (to get notifications that their record has been accessed) and will automatically have MBS and PBS data loaded.

And the record may well contain data that they would prefer not to be included.

And if anyone decides to opt-out of the registration process, they'll still have an mHR, details of which law enforcement and revenue protection people can trawl through. No warrant, no notification.

Of course some of the above could be wrong by the time the trials are conducted, the department has not been forthcoming about its plans.

Anonymous said...

January 18, 2016 5:46 PM said There is no new version of the mHR. The version that was received with apathy and which was designed to be opt-in will be used, with no modifications, as opt-out.

Oh. Surely the contradiction is obvious here. All the Department is doing with this ham-fisted lead-rod policy is fueling the fire and making their constituents (the doctors and their peak bodies)very angry. Under the circumstances there is no justification for enforcing the 5th leg of the ePIP payments until the two pilots have been assessed and proven.

It looks very much as though this policy is heading for a challenge in the courts.

In the meantime practices which are forced to lose all their ePIP entitlements under this policy will underwrite their losses by passing them on to their patients.

Anonymous said...

Last year the Minister announced the two pilot opt-out sites would be Far North Queensland PHN and Nepean Blue Mountains PHN. Certainly the 5th leg of the ePIP payments must apply in these two PHNs. Perhaps the doctors in FNQPHN and NBMPHN will make their participation conditional upon removal of the 5th leg of the ePIP payments across the rest of Australia until these two PHN Pilots have proved the value of the PCEHR. Most reasonable people would find that a reasonable compromise to adopt. Of course it all depends on the position adopted by the RACGP.

Anonymous said...

Bernard said "There is no new version of the MHR." Which means it's just a simple rebranding of the PCEHR which has worked hard at great expense to develop a really poor image necessitating a name change to the MHR. So burn one brand then replace it with another and push on regardless. That's no way to engender confidence in the product. How deceptive.

Anonymous said...

Bernard RE: "The trials are to test the registration process, not the system itself."

If the system is now OPT-OUT then everyone in the entire pilot geographies will automatically be registered regardless; presumably relying on each person's Medicare data. This leads me to ask:

What is there to 'test' in the registration process?

Being compulsorily registered perhaps they want to test the registration's 'OPT-OUT' procedures. Is this what you mean by 'to test the registration process'?

Is the Department legally entitled to use my Medicare data to compulsorily register me in the opt-out trials if I live in one of the pilot site geographies?

Has some special legislation been passed to allow the Government to use my personal data for purposes other than what it is currently being used for ie. Medicare.

Dr David More MB PhD FACHI said...

"Has some special legislation been passed to allow the Government to use my personal data for purposes other than what it is currently being used for ie. Medicare."

I fear so, that was the main reason behind the last round of legislation passed late last year....

David.

Bernard Robertson-Dunn said...

re "What is there to 'test' in the registration process?"

How many people decide to opt-out of the registration process.

Of course, they are not really opting out, they are just making their record unavailable to themselves and Health professionals.

It will still be available to law enforcement and revenue protection agencies.

It's worth noting that Customs was a revenue acquisition agency. By combining it with Immigration to form the Border Protection Force, the Immigration people will now have no trouble accessing health and other details of "people of interest".

Anonymous said...

Re: In other words it is testing "How many people decide to opt-out of the registration process."

This means that if few people opt-out the bureaucrats will say that that proves all those who don't opt-out are really happy to stay opted-in; quid pro quo - everyone wants to be part of the My Health Record system.

The bureaucrats will interpret that to mean 'the people have spoken' we had better get on with it and invest another $500+ million into the project and roll it out nationally very quick fast. The time line for doing this in theory is only a few months ie. after the optional period for opting out has passed when everyone else remaining 'registered' will be the base line for proving the quid pro quo argument.

Lethargy and inertia will win the day. Therefore the national roll out could begin anytime after the optional opting out period has ended.

In effect there is no choice - neither the patient or the doctors have any say in the matter.

Anonymous said...

Sounds like we need twitter #OptOutNow tag to spread the word ;-)