The Australian Financial Review Article of the 13th April, 2007 entitled “National e-health would save $30bn” by Julian Bajkowski makes a few comments I really don’t think should go through to the keeper.
The article states:
“The study has increased pressure on the federal government to abandon a number of failing federal electronic initiatives, including the $128 million HealthConnect project, which has yet to deliver tangible results.”
I would suggest this is wishful thinking as we see the grossly overfunded non-strategic trials which are being still being conducted by HealthConnect SA and HealthConnect Tasmania. It would be good however if this was an outcome and they were canned.
The article states:
“ Doctors, clinicians and hospitals have long sought electronic health and medical records that could be used across Australia's different state health systems.”
This really misses the mark. Most care (95%+) is delivered within a patient’s local area and virtually all care is delivered in the state of a patient’s residence. Doctors would be very keen to see records for their patients able to be used between the local practice, the local hospital and the local investigatory providers. The rest would be a cherry on the icing on the cake I would contend.
The article states:
“But developing the standards has been a battle because of a series of bitter quarrels between technology suppliers and standards bodies.”
This is largely just wrong. Between NEHTA and Standards Australia’s (SA) Health IT working parties there have been tensions and a lack of quality two way communication – but the Health IT industry has, for the most part, very good relations with SA. Relations between the Health IT industry and NEHTA are dodgy, at best, despite anything NEHTA may say.
The article states:
“NeHTA recently recruited the former head of Queensland-based Cooperative Research Centre for the Distributed Systems Technology Centre, Mark Gibson, as its chief technology officer.
The hiring represents a coup as it will ease NeHTA's access to a vast repository of e-health-related intellectual property held in trust by the shareholders of DSTC after the group's funding was terminated by the federal government in 2005.”
While not commenting on this particular appointment directly, I seriously doubt there is much useful intellectual property held in trust by DSTC given the failed and never properly reported HealthConnect trials it was involved in.
I hope these comments assist in understanding where things currently sit.
David.
8 comments:
How right you are in observing - “ This really misses the mark. Most care (95%+) is delivered within a patient’s local area and virtually all care is delivered in the state of a patient’s residence.”
Wouldn’t it be helpful if NEHTA made a statement regarding your comment - “I seriously doubt there is much useful intellectual property held in trust by DSTC given the failed and never properly reported HealthConnect trials it was involved in.”
If 95%+ of all care is delivered within a patient’s local area surely a lot more progress would be possible if Gov't and NEHTA focussed some of their energies and resources in that direction.
Hi David
It may be a bit unfair of me to say .. but in my dealings with Health in IT through a trial which involved HealthConnect, QLD Health and DSTC I couldn't help but notice the tendency for the same names to appear again and again in high management roles - a bit like shuffling deckchairs on the Titanic - now we have come full circle with NeHTA effectively absorbing DSTC's severely limited technology via another recruit with a less-than-successful track record - when are these organisations going to get some new people and new thinking?
David
If I recollect correctly there was a similar comment made on one of your blogs some time ago referring to the 'same old names and no new blood' and the titanic's deckchairs. Maybe the game should be renamed to 'pass the parcel' or 'drop the hankey' to take advantage of the 'full circle'. It would be very difficult for 'these organisations to get some new people and new thinking' because that could threaten their status quo.
did anyone from these circles who know how to fix the issues ever apply to NeHTA to assist?
I decided to break the trend and put my name to this.
Some of us have been trying to assist for many years. As a career professional in health ICT I have been extremely interested in HealthConnect since the beginning of the process, starting with the initial consultations.
I have spent many (unpaid) hours submitting comments on the voluminous draft documents such as the Business Architecture, discussing the issues with HealthConnect and, later, NeHTA staff at conferences and online, and participating in the development of (unsuccessful) applications for project funding. I would call this assistance - and it was entirely voluntary.
Please don't reply that I am taking a position because I am bitter about not being successful in attracting financial support. It is true that I am unhappy about this, but I have not changed my position on the issues as a result. I believe I have been consistent in my criticisms (and occasional praise) of HealthConnect/NeHTA since the beginning.
Part of the problem here is that this is a disagreement about the philosophy and direction of the process. In other words, it is political. Human nature being what it is, people with differing views can be perceived as posing a threat to those in control of the bureaucratic structures and there is a tendency not to treat their advice on its merits. The baby can be thrown out with the bathwater. It is also an unfortunate fact of life that unpaid contributions are not afforded the same respect as those of the people who are paid to do the job. I believe that there is a general lack of openness, both openness to new ideas and to exposing current thinking to scrutiny.
Usually, significant public investments are undertaken only after initial pilots have been thoroughly evaluated, exposed to public scrutiny and broad agreement reached on the directions forward.
I believe that an effective strategy for managing change is vital to the success of initiatives like this, and would like to see an evaluation of the approaches taken with HealthConnect pilots. I interpret the information available (mainly the MediConnect report) as showing that NeHTA still has a lot of work to do in this area. I would like to know what NeHTA is thinking about strategies and resources required to address this, but can find little detail on this in their current publications. I would be happy to be advised otherwise (with links).
I believe there are questions outstanding about the value, practicality and scalability of a key component of technology that appears to be under serious consideration, OpenEHR.
Given the lack of information available about the evaluation of HealthConnect pilots is it any wonder that people are skeptical?
I am a newcomer to this domain but it is my job to keep a watching brief on what NEHTA are doing. I thank Jon for his honesty in his reply. From my reading I am not too clear on who or how many contributors to this blog are supportive of NEHTA and its endeavours...
From what I read I agree NEHTA has work to do but not so much in EHR work but more in the bits and pieces that can make this happen (if indeed it ever happens), and I am lead to believe this is what they are doing presently (leap of faith maybe).
Unfortunately my gut feeling is this blog tends to read like a smear campaign against NEHTA. Opposing opinion is one thing, but there is far too much negativity here to be helpful IMHO.
I don't know if anyone from NEHTA reads this blog? Perhaps you know the answer? But I could understand them having difficulty extracting the helpful parts amongst the spraying of negativity to their work.
Hello Anon,
I will make your job a bit easier.
The summary of what you will find here is a strong majority view that what NEHTA is trying to do is very, very important for the whole Health System.
However, many who contribute think, as I do, they are going about it the wrong way. Much of what I write offers suggestions as to how I think they could do much better.
And yes, many at NEHTA read the blog, and some even agree with a lot of what is said here I am told.
Thanks for commenting
David.
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