Is E-Health Getting Harder?

Today's post has been provoked by my having been sent a report into an e-health conference which was conducted in mid September 2004 in Sydney and which brought together many luminaries in the field. The tone of the meeting was quite optimistic but, while all the important issues were raised (privacy, change management etc), it seemed there was considerable confidence that success was just around the corner - and that by the end of 2005 concrete outcomes would be clearly demonstrable. Further optimism flowed from the fact that NEHTA had recently been established and that this would quickly make an impact in the standards area.

Eighteen months later we seem to have stalled in some important ways.

Firstly the time frame to get basic delivery of the management of the identify of providers and consumers has slipped to the end of 2007 and we have seen that it is now clear development of the required extensions for SNOMED-CT (covering medications, devices and some other areas) is also going to take until 2007.

To date the details of how each of these will be achieved has not been made public so it is hard to know just how high the likelihood of success is.

Internationally it has also become obvious that progress is slower than may have been hoped for. Examples include the delays now being experienced in the well resourced Connecting for Health Initiative in the UK, the slowness with which progress is being made to finalise both HL7 V3.0 and the ISO/CEN EN13606.

It seems intrinsically many major initiatives are more challenging than they initially appear. For this reason the start small and develop at a pace that all can accept is increasingly appearing to be better and better advice.

It is interesting that an article expressing a similar sentiment appeared very recently on the US Modern Medicine website entitled "Dr. McCoy to sickbay: Not 'stat' but with all deliberate speed".

It seems to me we need to select some important do-able goals, get them done, and then take the next step - remembering that in 2006 it is the human and cultural issues that will give the most trouble - not the technical ones.

David