The last 24 hours have been just amazing in what I am hearing from all sorts of sources!
Behind the scenes, in all sorts of ways, the agenda this blog has been trying to propose is receiving a better hearing than could have been imagined even a month or two ago.
The recognition that changes in NEHTA's approach to stakeholders is desperately needed seems now to be accepted. It is now also very clear, as a lesson, that really working collaboratively is critically important.
The black hats are recognizing their day in the sun is at an end and that change is in the wind. I wish I could share more - but what is going on is at a tipping point and I need to just let the actors play it all out.
I am sure in the next month or two policy will emerge that makes many of the readers of this blog much happier. The tipping point has arrived, I think, and we all need to be patient as the processes play out - hopefully for the good of all - we shall see.
Sorry I can't be more specific - but I have to respect my sources!
Be patient and keep doing the worthwhile stuff.. and I think there is a real chance of change.
I really hope I am right!
David.
11 comments:
Great BLOG Dr. More ... Keep up the good fight!
I was a tech consultant toward the end of the Santa Barbara RHIO run. Many technical advances with respect to Healthcare I.T. happened on that project (in my humble opinion). We were sowing the seeds.
Kind regards, -Richard
Let me have a punt.
Here's a clip from the current BMJ:
"News
UK will lose clinical trials if electronic records system is delayed, ABPI warns
James Butcher
London
The drug industry will carry out fewer trials in the United Kingdom unless electronic patient records can be deployed quickly throughout the NHS, warned Richard Barker, director general of the Association of the British Pharmaceutical Industry. Dr Barker was speaking last week at a meeting organised by the UK Clinical Research Consortium on the use of electronic patient records for research and to improve health. "
Maybe your jubilation, then, is based on hearing the global pharma may tip a couple of billion into our EHR project?
You say “the tipping point has arrived (I think)”.
But what or who is it that needs to be tipped?
The culture of an organisation comes from the top down. It is highly unlikely that NEHTA's approach to stakeholders will change until the culture within NEHTA changes.
What I see as tipping is the overall attitude to Health IT and its importance in enabling health sector reform and performance.
The conduct of governments and bureaucracies in the Health IT arena is becoming a matter of minor but significant political concern - which is much better than being totally off the radar - as it has been for a long while.
The pressure to do better overall is now rising and failure is becoming much harder to sweep under the carpet.
David.
Hi Teki,
The causes are much closer to home - believe me..
David.
To properly change NEHTA culture requires a change in board composition. Present jurisdictional interests are unlikely to want to give up a board seat in the interests of balance including private sector representation. There is hope if there is a board spill - which would have to be recommended by the CEO if he has the guts.
Hi,
What you need to do to fix things depends on what you think the problem is an who is responsible.
I leave the diagnosis as an exercise for the reader - (grin)
David.
David,
My own take on health IT has been with ordinary general practices, that have been led into this brave new world we were promised 7-8 years ago. Then, like Hansel and Gretel, they've largely been left alone in the forest.
I would strongly argue that any new policy direction has to look at the levels of support needs and upskilling these clinical microsystems require if the objectives of participation, quality data that will support public health improvements and continuity of care are to be realised on any widespread basis.
If the letter you published yesterday is anything to go by your tipping point may well be a long time coming.
I don’t think Mr Eccles meant that $128 Million had been spent “on providing an electronic health record for 10,000 people”.
What I think he was trying to say was that of the $128 million (?budgeted?, ?spent?) for e-health research, development and prototyping via the HealthConnect program the following has been achieved:
- 10,000 people in the Katherine region of the Northern Territory now have an active personal electronic health record
- and GPs in Tasmania are now notified by electronic means when their patients are admitted to any major hospital in Tasmania.
Surely the Minister and his Department cannot honestly believe that this letter is evidence they have done good works, achieved much progress or understand what they are talking about.
Enough said.
Bear with me while a non-tech medico, who deals with some of the most marginalised people, goes over the basics again.
Three groups want access to computerised health records.
1. Third party payors - Medicare and insurance.
2. Public health agencies.
3. Pharma and research.
What about that group reduced to that amorphous clump glorified by the title "patients". You know, MY patients? Well, for starters, ME (as the typical medico paid handsomely on the basis of transactions) only wants computerisation as far as it enhances my ability to charge fees. My customers/clients are not particularly interested in OWNING their own health info - like BP, serial blood glucose - even when they are truly sick and can be patronised into subservience.
If the public truly wanted records of accurate data on their own health, they would have been asking for copies of paper records (pathology, etc) so they could maintain their own longitudinal records at home. They do not. But, if they did, they would recognise the conflict between their needs, and the needs of the 3 groups who do want their data. The public would then demand legislators set up an independent agency to act on their behalf.
As it is, politicians know they only have to throw a bit of money around to keep a few disinterested parties off their backs, while acceding to the big lobbyists. It is most unlikely that any politician will move to pay for a structure that taxpayers are not demanding. But, in the end, this morass of political apathy and laziness will be its own undoing. Sooner or later we will experience a mammoth public health crisis. Just the other dsy. a letter writer to a daily newspaper observed that the early discharge she experienced because of the Kerang train wreck told her that the 'system' could not cope in a wider emergency. A pandemic of highly infectious respiratory would bring our public hospital system to its knees. In the US, at last their primary care physicians have not been lulled into false security by a malignant "assistant" like Medical Director. In the US, when they looked hard at the "pandemic flu" scenario, they were able to commit real money to researching systems for real-time surveillance. When the next influenza epidemic comes our way (and maybe Exercise Cumpston) emergency departments will be on their own, after their fax machines burn out. Disaster planning authorities have no way of knowing how many sick people in every ED have, say, fever and cough.
We are currently 'proceeding' under the delusion that the 'electronic health record' is a one-size-fits-all monster. But, the interested parties want only discrete slivers of data.
The only forward is for all those arguing in the public interest to agree on the case for that independent agency, a 'trusted broker'. IMHO.
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