David Agrees with Dr Ian Reinecke – Readers Faint over their Weeties!

A day or so ago the following article appeared:

“Health resists IT, sticks to the script

John Breusch

The Australian Financial Review | 18 Jul 2007 | News

This country's health sector is looking like the last bastion of the old-fashioned paper trail, writes John Breusch.”

In the article the views of a number of commentators are reported. Sadly the reporting really does not live up to the expectations AFR readers have for insight into what they are being told. The general flow of the article is fine.

First it points out that there are simple health transactions that have yet to be computerised and notes that in virtually every other aspect of the ordinary citizen’s life has been impacted, usually quite positively by the deployment of Information Technology and the Internet.

The article then goes on to say:

“Everyone can see the extraordinary benefits that connectivity could deliver. After all, health care isall about knowledge: patients, doctors, nurses, hospitals and researchers all sharing information about what's wrong, how things are tracking and what needs to be done."

It is just after here that the wheels start to come off.

It is claimed that, on the basis of a” recent study by Michael Georgeff, director of e-health at the Monash Institute of Health Services Research, estimates that, in the field of chronic disease management alone, better information sharing could deliver benefits worth some $4 billion a year.”

This is a big call and it is hard to imagine a credible case for that scale of benefit can be put in a 19 page document (which is all it is)!

Further on in the article it is also claimed that a structured approach to reaching these benefits is not required. All that is needed is to connect everyone and that "The key message: don't spend time getting agreement on the data, don't spend time ensuring all the systems conform - get connected,"

I have to say that when Dr Reinecke says that we need rather ‘cooler heads’ to assess all this then I am 100% with him. He makes the point, correctly that the internet has been around for a good while and working e-health has not suddenly emerged out of nothing.

I am afraid Professor Georgeff – the director of the one man e-health unit of the Monash Institute of Health Services Research - simply does not appreciate the complexity of dealing with, communicating and safely processing health information.

I have a feeling that now Dr Reinecke has been at NEHTA for over two and a half years he, and his team, are starting to come to grips with just how hard and complex all this actually is.

E-Health in Australia does not need silly proselytising of unsupportable views about the self organising nature of E-Health – rather it needs clear pragmatic strategic planning and implementation.

Where I part ways with Dr Reinecke is his apparent belief you can develop a business case for the introduction of an (National Shared) EHR, which is apparently scheduled to go to the Council of Australian Governments (COAG) meeting next year (2008) without a clear definition of what the systems you are proposing are and what their capabilities need to be both centrally and our peripherally in the health system.

To date NEHTA’s studious avoidance of in depth engagement with the GP and Specialist Community leads me to think the capabilities and functionality required for these people has slipped well and truly under the radar. I hope I am proved wrong and that what is finally produced in the way of a business case is both complete, compelling, implementable and affordable. We will see in due course how on track their thinking is when the now rather delayed NEHTA Benefits Study is finally released in more detail than a few PowerPoint slides.

It also would have been good had the AFR done some more in-depth research to better understand the issues before going to print.

David.