How the Lack of a Plan Will Hurt E-Health in Australia.

Last week a useful summary of the state of E-Health in Australia appeared in the Australian – reporting on the submission prepared by the Health Informatics Society of Australia for our new Treasurer’s May 2008 budget round.

Australia's e-health in dire straits

Karen Dearne | January 18, 2008

THE Rudd Government should bypass the National E-Health Transition Authority and fund a key health stakeholder group to develop an "agreed vision and plan for e-health", the Health Informatics Society of Australia says.

"Despite recognition in most other advanced countries of the need for investment in and the use of IT in the health sector, Australia sits without a plan for how it will deliver its e-health future," HISA said in a pre-Budget submission prepared for the federal Treasurer, Wayne Swan.

"There is not even a clearly articulated and shared vision of what we expect our investments in e-health to deliver."

In the past two years, NEHTA has suffered from a lack of direction and has been criticised for its inability to engage with doctors and health IT providers, and its failure to deliver on work plans, HISA said.

"There is no doubt that the standards and infrastructure elements which NEHTA has been charged with delivering are important, but it's more important to ensure those elements will fit the requirements of patients, providers and the Government, and that they can be delivered by industry," it said.

The new group should be independent of NEHTA and the Australian Health Information Council, and focus on the "enormously complex task" of building a fully interoperable health system across state borders, which supports both private and public sectors, and is accessible by a diverse range of medical providers.

Continue reading here:

http://www.australianit.news.com.au/story/0,24897,23071592-16123,00.html

Last week I was also sent a copy of the following e-mail which was sent to ‘Undisclosed Recipients’ on January 2, 2008 by the Commonwealth Department of Health and Ageing (DoHA)

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Hello

Thank you for your Registration of Interest regarding the development of a Health Information Exchange.

The concept of a Health Information Exchange is to explore the potential of, and benefits from, the sharing of health information. It would see GPs, aged care providers, hospitals, pathology and imaging companies and other health workers communicating electronically and sharing information securely.

As previously advised the call for Registrations of Interest will be followed by an Industry Forum. At this forum, interested parties will have an opportunity to hear more about the program, and to seek further information. As you have registered interest an invitation will be sent to your nominated contact advising you of the date and venue in the near future.

Regards

Details Omitted

e-Health Branch

Primary and Ambulatory Care Division

Department of Health and Ageing

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The e-mail was also accompanied by the usual threats of dire consequences flowing if the public got to know what the Government was doing!

So what do we have here? We have NEHTA planning to have COAG fund the development of a Shared Electronic Health Record (Shared EHR) while we have DoHA seeking registrations of interest in developing Health Information Exchanges around the country.

Information and commentary on the apparent official NEHTA vision is laid out here:

http://aushealthit.blogspot.com/2007/12/nehta-is-planning-ill-conceived-e.html

and here

http://aushealthit.blogspot.com/2007/12/i-wonder-if-nehta-has-plan-b-or-should.html

(Note I say ‘apparent’ as our E-Health future is so important that we are not allowed to know what it is until the Council Of Australian Governments (COAG) – a collection of E-Health luminaries NOT! – have approved it. If they don’t approve it we will never know what might have been I guess).

The only thing that is certain out of all of this is that, unless because of the shrouds of secrecy surrounding all this I have missed something, both of these apparent approaches can’t proceed as they seem to be planned as they reflect strategically different approaches to making critical health information available where and when it is needed.

A key part of any National E-Health Strategic Plan needs to be some form of business, information and enterprise IT architectures that show how the business of health service delivery is supported by information and technology. To date I have yet to see such a document (current) from either NEHTA or DoHA. Has anyone else – it’s pretty important to have it to avoid waste, duplication and simple project obsolescence!

Despite NEHTA working for over a year to update their Interoperability Framework from Version 1.0 to Version 2.0 the actual shape of their suggested Enterprise Architecture (if it exists other than restatements of TOGAF and the like) remains shrouded in mystery.

Another classic in the right and left hands not knowing what the other is doing! It will cost us all – big time – unless sorted pronto.

David.