Dr Zoran Milosevic is obviously a smart man. With the job of managing the NEHTA Interoperability Framework you would need to be!
Further evidence of his talent is revealed in a recent e-mail which was published in the Australian College of Health Informatics (ACHI) e-mail list. Among a range of comments came the following:
“5. Regarding your comment on the lack of national vision, I believe that this is now prime time for us all (NEHTA, jurisdictions, clinical experts, clinical informatics people, and many other stakeholders) to work on such a national vision while leveraging the past efforts, including HealthConnect.”
Implicit in this comment is the acknowledgement that such a vision, and associated plans does not exist at present. One must wonder if Dr Milosevic had cleared this comment with his CEO or is it just possible that Dr Reinecke agrees?
I certainly hope so, as while there were many aspects of the Interoperability Framework I was not happy with (See the Blog entry of April 4 for details) the key deficiency that concerned me was that the document did not provide details of the strategic context and environment for which it was intended.
Clearly I wish all power to Dr Milosevic’s arm! If he can persuade NEHTA to undertake the consultative and open process he seems to foresee to develop a National e-health Vision (and subsequent Strategy and Implementation Plan) he will be the friend of many.
While he is at it he might also like to suggest the other components of NEHTA’s work are also opened up to similar discussion and review. Were that to be achieved we would all be encouraged progress was really possible.
David.
1 comment:
David More’s observation that a national e-health vision and associated plans do not exist should be of concern to everyone interested in the advancement of e-health.
This brings to mind the words of Sir William Osler (Canadian Physician 1849-1919) “To study the phenomena of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all.”
The vision and plans called for by More are essential to the successful navigation of e-health's uncharted seas.
Over the last five years or so, the vision that was developed provided a foundation upon which to justify the establishment of one project or another with an e-health flavour and focus. Even so, many projects have failed whilst others have been re-invented and re-positioned without much success.
Was the vision at fault? Would we have enjoyed more success without one?
Whether or not the vision can be held accountable is debateable. It is probably fairer to sheet home the reasons for the failures to a combination of factors, such as irrational exuberance, poor project management, too little pragmatism, inadequate insight into the complexity of many issues – political, cultural, technical, commercial, organisational.
In large complex projects the devil lies in the detail. As is so often the case the detail is all too hard to focus upon, particularly for visionaries impatient to reach out to the next horizon. Learning to crawl, climb, stand, walk and then run is something we see evolving every day as babes and young children develop their motor skills. The evolution of start-up companies into successful mature organisations usually follows the same incremental learning pathway.
It should not therefore be unreasonable to expect that the same should apply to the development of a far-reaching e-health vision – imagined by many, realised by few. Plotting the detail of the steps to be taken along the maturation pathway towards attainment of the vision is critical to success, and this approach should underpin the development of Australia’s e-health vision.
All too often the incremental approach is rejected because it is perceived as not being exciting or challenging enough or not reaching out far enough ahead to satisfy the visionaries. History has shown that when the blue sky visionaries are permitted to take control of the process it leads to unrealistic expectations, unachievable goals and large sums of money being allocated to underwrite their attempts to build a pathway to the very, very distant horizon.
Think back to 1991/1992 - the origins of HCN (Health Communications Network), to 1997/1998 the PIDP (Pharmacy Intranet Development Project) and to 2000/2005 HealthConnect/MediConnect and one should have little difficulty concluding that there has to be a better way. More’s call to develop a vision without delay demands attention.
Dr Ian Colclough
Integrated Marketing & e-Health Strategies
Balwyn North VIC 3104
(m) 0412 059 392
(e) ihsipl@smartchat.net.au
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