My Final Submission to the BCG Review of NEHTA

First thanks to those who made comments on the initial draft.

Here is the final version of the Executive Summary.

Executive Summary

E-Health in Australia is rapidly becoming a national disgrace and the opportunity cost of not addressing it in terms of both money and lives is rising relentlessly.

The following offers an expert, independent view of NEHTA’s performance to date and recommends two key steps to remedy the currently disastrous situation.

These are:

Urgently the governance of NEHTA needs to change. The Board needs to have 3-4 representative E-Health Experts (from ACHI, MSIA, Industry etc ) and one or two independent experts added with the Jurisdictional representation dropped to 2-3 members. The Board also needs a highly qualified technical and a highly qualified clinical advisory committee with real influence and teeth. Note: The Australian Health Information Council (AHIC) – which should also have broad stakeholder input - is the right entity to ensure NEHTA stays focussed on delivery in the context of an AHIC managed strategy which I recommend below.

Longer term – six months – A consultative, inclusive, national E-Health Strategy, Business Case and Implementation Plan must be developed. This will then need to be reviewed and properly resourced and funded – managing the state / Commonwealth divides etc. NEHTA should then be managed by the governance approach recommended in that strategy and take its priorities from there as well.

The strategy needs to be developed in a open, inclusive, pragmatic and realistic way – recognising local needs, understanding the impact on all stakeholders and allowing all those who need to provide input to do so.

I must point out that I do not, in any way, diminish the complexity of what is needed to get things back on the rails, neither do I diminish the importance of it being done properly.

I also believe NEHTA, in some appropriate form, has a significant and important role (indeed critical role) in assisting moving E-Health forward. However to play that role it requires a fundamental change of attitude as to the levels of transparency and consultation it provides for all stakeholders. The entire organisation needs to become much more outwardly focussed and to have a much broader representation internally of clinical and health sector skills.

I also do not believe the present senior management are sufficiently aware of the cultural ‘modus operandi’ of the health sector to be able to operate within the sector effectively and that they need to put in a concerted effort to address that deficiency.

Australia set out on the E-Health Journey in 1997 with a report developed by a House of Representatives Committee but, for a range of reasons, progress has been much less than might have been hoped for since. It is vital this changes.

We need a new plan and direction, learning the lessons of both overseas and local difficulties and successes. Once this is developed and agreed some hope and certainty may return to the E-Health Domain in Australia.

The following three URLs provide a very high level summary of the strategic priorities and issues I see as being worthwhile to pursue over the next two to three years.

http://aushealthit.blogspot.com/2006/03/australian-e-health-strategy-why-what.html

http://aushealthit.blogspot.com/2006/06/australian-e-health-strategy-outline.html

http://aushealthit.blogspot.com/2007/07/why-is-state-hospital-health-it-in-such.html

I may not have it exactly right, but I am sure I am more right than the present strategic vacuum!

While this is being done NEHTA can see how far it can move forward on its much more long term agenda, should that be assessed as reasonable following the present review.

Lastly, it needs to be pointed out that I have had early access to the information gathered from the Health Information Society of Australia’s survey of the views of the membership to NEHTA and its performance. Review of this data has confirmed for me the fact that the views I have expressed regarding NEHTA over the last twelve months are very much mainstream and that they must be addressed. I strongly recommend a close review of the final output of this HISA work by the BCG.

It really is hard to overstate just how important proper deployment of E-Health in Australia is and just how badly it has been handled to date.

The bottom line is that what NEHTA is trying to do is very badly needed, but the way they are going about it is deeply flawed in my view and the direction needs serious modification.

(I look forward to discussing the contents of this submission with BCG. I can be contacted via my blog by e-mail)

----- End Executive Summary

The complete 12 page document can be downloaded from the following link.

It is interesting that over the last week I have seen drafts from a number of organisations that are also planning to make a submission to the BCG. It would be fair to say that there is a very large degree of similarity with my submission in terms of the sentiments expressed, but it is interesting to see the different emphasis that is put on different concerns. I think it is also fair to say that none of the drafts I have seen have been at all supportive of preservation of the status quo.

The final outcome of this review will be interesting indeed, and will be a considerable test of the influence carefully considered views can have on the shape of public policy.

David.