A few weeks ago your humble scribe was told that the Australian Health Information Council (AHIC) was not dead but that it was, as we were told in Monty Python, “just resting”! More recently I have heard that there have been soundings taken regarding the membership of the new improved AHIC and who might be a suitable chair. It thus seems just possible there will be some good news soon and that AHIC will have only suffered a “near death experience”.
For those who came in late AHIC is the peak advisory body for Health Ministers in the domain of Health Information and E-Health and so has a critical role in developing a sensible national E-Health Agenda. If any serious progress is going to be made on a National E-Health Agenda and Plan AHIC will be an important player.
It is interesting the note that in the US, there is also a peak E-Health body whose acronym in AHIC. In the US AHIC stands for the American Health Information Community. This body was established about a year ago and has already commenced work and established very productive working parties in a large number of key areas (Privacy and Security, Quality, Biosurveillance, Consumer Empowerment, Chronic Care and Electronic Health Records).
Refreshingly the US version conducts monthly public meetings that are available both in transcript and web-cast with a lot of industry, consumer and technical input. The Community is also chaired by the Secretary of Health and Human Services (HHS) Mike Leavitt who is a member of the Bush Cabinet and who is responsible for the disbursement of one quarter of the Federal Budget.
With this in mind it would seem to be reasonable to hope the new improved AHIC might have the following attributes:
1. Be chaired by a Cabinet Level person (The Federal Minister for Health would be the obvious choice) so its importance is clear.
2. Operate in public with public testimony provided by relevant domain experts on a monthly basis so progress can be properly tracked.
3. Be made up of members with relevant senior specific E-Health or Health Service Delivery expertise on the Committee as well as having appropriate “super-expert” sub-committee’s to develop policy and plans in areas of need.
4. Have a clear charter and set of objectives around the need to better use Information Technology to provide patients with safer and higher quality care.
5. Be commissioned to develop a National E-Health Business Case and Implementation Plan within nine months.
6. Have a substantial secretariat to ensure the routine detailed work can be achieved quickly and with high quality.
7. Have a good mix of old and new blood to ensure the failed strategies of the past (and we have had nearly a decade of those) are not repeated.
8. Have NEHTA directly accountable, in public, to the new AHIC for all its recommendations and decisions.
I wonder what we will actually see when the new AHIC is announced – if it ever is?
David.
4 comments:
You are right, David, in the respect that to get moving, the body would need to be driven from the top with energy.
Off the top of the head, what you have outined would chew a big hole in $10m, just for (almost) a year's work. Guesstimate based on the $50m over 5 years a previous Minister dropped into the late, lamented Safety & Quality Council.
However, the logical end-point of the process would be where 'AHIC' sticks out its hand for $10b. Without knowing how much the private wing of the inevitable public-private partnership will be good for, it's hard to believe a non-suicidal Minister would want to be involved.
I believe the situation of Leavitt's agency is quite different - they already know nothing much will happen without a huge investment from the private sector.
On a more positive note, the issues paper from ALRC's Privacy Inquiry makes argument for a single set of national privacy principles, instead of IPPs and NPPs. Somewhere in the 600 pages is discussion of the concept of data trustee. That's the key requirement.
So you believe that it is OK to be comfortable with the inefficiencies and lack of safety in the current health system, and to not invest in Health IT. Is that what you are saying?
David.
No, I believe there is a lot to be gained from from investment in Health IT.
But where is our champion for change likely to come from?
The political sector? Not right now, with $1b promised for immediate drought aid to the rural sector, followed by another billion for short-term remediation, the stronger possibility of Bill Heffernan's northern development plan getting off the ground and attracting more billions, and one of the few bright lights driving the grand water plan (Turnbull).
From the health admin sector? Not likely, since the billions to be saved by better IT will have to come out of jobs in that sector.
From the medical sector? Possible, but not likely while the Colleges are so powerful. For instance, who gains from overuse of pathology tests? Not likely, unless a national figure stepping away from a highly lucrative practice can be guaranteed comparable income for time spent on IT, and facility to go back to clinical practice after a five or seven year contract.
From the consumer sector? The least likely of all, since personal health records do not rate a high priority.
From the IT industry? Possible, along the lines of the Richard Granger model. But who will push for broadband access as a national health care need, with Telstra like it is, and the media laws on the verge of radical change?
From the consultancy sector? Highly likely, but in the background and only by default. If this happened, the outcomes would be worse than no changes, IMO. Governments love the outsourcing model, because they can carve jobs out of the public service, and hand the "saved" budget over to the private sector, and sucker the voters into paying more over the long term. The alliances between the Big Four and IBM, Microsoft, CSC, EDI, etc, are probably strong enough to subvert initiatives from governments that do not have sufficient 'buy-in' from one or more of the other sectors.
Some good may come out of Study to Establish the Feasibility of Introducing an Electronic Continuous Client Record for the Community Care Sector.
The hospital sector will attract the limelight, though. Victoria has a State election in a few weeks. I look forward to our Premier showing off another electronic gee-gaw, like the tablet PCs he photo-opped four years ago. I believe the business case for that so-called prescribing initiative was led from the front by the judicious application of sporty hardware. I would like Mr Bracks and Mr Abbott, and their shadows, to come to a community clinic where effective IT would make a huge difference. At the moment, it takes 4 (FOUR!) separate logins to get any use out of Medical Director.
Smaller, geographically discrete projects may have the best chance of providing evidence that investment in IT is worthwhile. Perhaps coming out of Request for Proposal - Indigenous Community Health Brokerage Services. But not until someone gets on to the case for Identity Management.
Hi Teki,
We are in violent agreement. Without political sponsorship at the top level - just forget it!
I agree we need to start small and build also..but there needs to be focus on getting some really useful stuff working ASAP.
Thanks for your comments.
David.
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