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Tuesday, February 12, 2008

NEHTA Decides it Needs Clinical Input – Four Years too Late!

The deeply dysfunctional National E-Health Transition Authority (NEHTA) is off on another frolic!

A day or so ago the following appeared via their web-site:

http://www.nehta.gov.au/index.php?option=com_content&task=view&id=275&Itemid=457

Clinical Team

Australia’s expert clinicians are invited to play a part in health reform through the development of a national e-health system.

The National E-Health Transition Authority considers the clinical perspective of experienced professionals vital to the reform agenda.

We are appointing a team of senior clinicians to provide advice on NEHTA’s development programs as well as support engagement and consultation within the healthcare sector.

A broader clinical network will also be developed through an online community to enable NEHTA to have access to a breadth of knowledge essential for the quality development and implementation of e-health programs.

The clinical leaders and the clinical network will be part of the following NEHTA programs in development:

    • Pathology;
    • Discharge;
    • Referral;
    • Medication Management;
    • National infrastructure projects:
    • Unique Healthcare Identification;
    • Clinical Terminologies;
    • National Authentication Service for Health;
    • Core Connectivity; and
    • Conformance, Compliance and Accreditation.

NEHTA will consult widely with leading clinician organisations and is assisted in the development of clinical networks by former Australian Medical Association President Dr Mukesh Haikerwal.

ROLE OF A CLINICAL LEADER

Clinical leaders will be assigned to NEHTA development programs and national infrastructure projects to provide input and guide the development teams on likely clinical issues and appropriate mechanisms for engaging with clinical stakeholders.

Clinical leaders will also be important facilitators within partnership projects, where their involvement on particular issues can provide a perspective independent from that of the business interests of all parties.

The clinical leaders will:

  • Advise NEHTA on engagement strategies for NEHTA’s work with clinicians and their representative organisations and to be involved in NEHTA’s engagement with stakeholder organisations as required;
  • Work with NEHTA staff to ensure the clinical perspective is understood and provide feedback from a clinical perspective (including clinical safety and quality requirements);
  • Work with NEHTA Managers, other clinical leaders, professional bodies, Royal Colleges and clinical opinion makers to anticipate the likely implications of NEHTA’s work on clinical workflow and professional practices;
  • Act as an advocate for NEHTA’s work on clinical issues, under the direction of NEHTA with key clinical, jurisdiction, vendor and health consumer stakeholders including professional bodies, Royal Colleges, clinical opinion makers and the media;
  • Provide input into the development of clinically-focused communication materials by NEHTA; and/or
  • Provide appropriate and timely responses to questions/issues as required.

To read more details about clinical leaders click here.

To express an interest in becoming a clinical leader click here This e-mail address is being protected from spam bots, you need JavaScript enabled to view it to:

  • Provide an outline of your interest in e-health or NEHTA's work and the area/s you would like to be involved in; and
  • Submit your curriculum vitae including professional qualifications and memberships.

Initial applications close on the 29th February 2008.

Email enquiries about the clinical leader program to clinical@nehta.gov.auThis e-mail address is being protected from spam bots, you need JavaScript enabled to view it

MEMBERSHIP OF A CLINICAL NETWORK

The new clinical network is an online community for clinicians who are interested in e-health and the role technology can play in improving care delivery and healthcare reform. Members of the clinical community will be provided opportunities to comment on NEHTA’s work from a clinical perspective and attend clinical forums and workshops where NEHTA’s developments are reviewed and discussed.

NEHTA is seeking a broad range of clinicians from a variety of specialties who have:

  • Tertiary qualifications in a clinical field with clinical experience or knowledge of the Australian health sector;
  • Membership of a professional clinical organisation such as the relevant Royal College;
  • Exposure to or an understanding of the e-health benefits to care delivery;
  • Willingness to share thoughts and provide clinical feedback for NEHTA’s developments.

To register as a member of the clinical network, please click here and describe your interest in e-health or the areas of NEHTA’s work that interests you the most, or would like to be involved in.

Contacts

Helen Murray, Manager – Clinical Engagement

Mukesh Haikerwal, Clinical Lead

This page describes what is expected of clinical leaders

http://www.nehta.gov.au/index.php?option=com_content&task=view&id=276&Itemid=461

CLINICAL LEADERS

The overall outcomes of the clinical leaders program will include:

  • Increased engagement, buy-in and support for NEHTA’s work from targeted clinical stakeholders;
  • Increased collaboration on NEHTA’s work outputs with key clinical stakeholders;
  • Conduits into key clinical representative organisations, ensuring support for NEHTA’s work program;
  • Increased dissemination of information about the benefits of the NEHTA’s work to clinical audiences;
  • Increased clinical safety and quality of NEHTA’s work outputs by the contribution of clinical expertise to clinical assurance process;
  • Increased clinical input into the development, delivery and implementation of NEHTA’s work outputs ensuring that it is clinically fit-for-purpose;
  • Increased coverage of the benefits of e-health to the media (including health and general media);
  • Demonstrable evidence of engagement of key clinical stakeholders and opinion makers through broad acceptance of NEHTA’s work; and
  • Increased clinical awareness for key NEHTA staff and in NEHTA’s work outputs.

Skills

In general, clinical leaders must demonstrate a good network of peer connections within key clinical representative organisations relevant to the particular task they will undertake for NEHTA; have a good standing in the clinical community; be able to contribute the required expertise for the task to be undertaken; and be able to convey the clear care delivery benefits of e-health and NEHTA’s work program to their peer network. The skills required of a clinical leader include:

  • Tertiary qualifications in a clinical field with demonstrable clinical experience or understanding of in the Australian health sector;
  • Membership of professional clinical organisations such as the relevant Royal College;
  • Exposure to or an understanding of the e-health benefits to care delivery;
  • Previous experience as an advocate for clinicians, e-health and/or healthcare reform;
  • Ability to identify mechanisms for successful engagement and approaches for dissemination of NEHTA information to clinical audiences;
  • Experience with and an ability to influence positive coverage of NEHTA’s work various organisations, professional bodies, Royal Colleges and clinical opinion makers including the media (in particular outside the specialist IT press);
  • Ability to influence key clinical stakeholders and opinion makers; and
  • Previous experience with representing the clinical requirements in projects by providing clinical involvement as a credible practicing clinician.

Scope of Work

The clinical leaders program will include a variety of clinicians with a range of skills and experience, to ensure that there is appropriate coverage for all tasks.

Some clinicians will be engaged on an as-required basis (for example, to participate in a one-off workshop on the implications of NEHTA’s discharge summary on clinical processes within hospitals). Others will be engaged on a part-time basis over a defined period of time on a specific task (for example, to work with NEHTA staff to review and provide clinical feedback at each stage of development of NEHTA’s pathology package; or to liaise with representatives from the Australian General Practice Network on aspects of NEHTA’s National Authentication Service for Health).

End NEHTA Text

First I guess we should all be grateful that four years after it was started NEHTA has finally noticed it is rather devoid of any real understanding as to how its principal client – the Australian Health Sector – actually operates and what it needs

This said the request for help seems to me to be wrong at an amazing number of cultural levels and to be going about what it wants to achieve entirely the wrong way.

For me the first big surprise is that they say they have decided they need a “Clinical Team” to assist them with Health Reform through the development of a national e-health system.

This statement triggers in me a range of questions like: What national e-health system? Who asked NEHTA to develop it? What will this new system look like, what will it cost etc etc. Is this just a slip of wording or have NEHTA developed some serious delusions of importance and grandeur.

Of course it will not have escaped regular readers this is to be an national e-health system developed by NEHTA and presumably Medicare Australia ably assisted by some part-time clinicians in the absence of an overarching strategy and plan. Good grief!

Second it is clear from the above NEHTA is seeking to shore up its influence and power by asking some clinicians to assist in the communication of their particular spin on things.

These paragraphs shows what is really desired from ‘clinician engagement’:

“Act as an advocate for NEHTA’s work on clinical issues, under the direction of NEHTA, with key clinical, jurisdiction, vendor and health consumer stakeholders including professional bodies, Royal Colleges, clinical opinion makers and the media”;

Experience with and an ability to influence positive coverage of NEHTA’s work various organisations, professional bodies, Royal Colleges and clinical opinion makers including the media (in particular outside the specialist IT press);”

“Ability to influence key clinical stakeholders and opinion makers;”

NEHTA still wants to be the old controlling authority freak we have all come to know and love.

Third it seems to me that what NEHTA actually needs is a cultural infusion of Health Sector values and priorities. Hiring a few part time clinicians may help – but not as much as actually hiring some real ‘health informaticians’ to be fully embedded in each of the major work streams to provide the ongoing input, support and clinical understanding that NEHTA so badly needs. Pity they are all leaving in droves as they realise what a poor employer NEHTA is!

Fourth what NEHTA probably doesn’t understand is that any active clinician who is influential enough to be able to help is not going to work “under the direction” of anyone. These people have professional reputations that NEHTA can’t afford I believe. They will insist on the freedom to do as they see best – not take “direction”!

Fifth I find it interesting that NEHTA is not prepared to come out and say they mostly actually want senior doctors rather than senior clinicians. As much as other groups may deny it – the senior medical professionals are still the key determinants of what happens in the health sector. I have yet to see any substantive change in the sector be achieved without medical profession support or at the very least passive acceptance. (Just a bit PC I guess! – Membership of Royal Colleges is the giveaway in the qualification list!). Having ignored both doctors and virtually all other clinical profession for the last four years there is a fair bit of ground to make up!

Last it is interesting to see how NEHTA is framing their current work-plan and how – somehow - the Shared EHR is not any longer on the top level list. Wonder what that means?

My take. This is much too little and it is much too late!

David.

6 comments:

Anonymous said...

Frolic? Frolic???

Thesaurus says:
Noun: a mischievous act: antic, caper, joke, lark, prank, trick, shenanigan
Verb: To leap and skip about playfully: caper, cavort.

You have chosen one simple word ‘frolic’ which describes NEHTA to a ‘T’.

‘T’ for Transition - transition to what? Chaos? Calamity?
‘T’ for Trying - trying to get NEHTA to ‘understand’ is like ‘t’alking to ‘t’urkeys
‘T’ for Trouble - yep, we all know NEHTA’s in trouble - except NEHTA.

Anonymous said...

NEHTA has never understood “how its principle client – the Australian Health Sector – actually operates and what it needs”.

NEHTAs approach at engaging the health sector is crude and clumsy. It lacks finesse. It is, as you say, “wrong at an amazing number of cultural levels”. NEHTA is “going about what it wants to achieve entirely the wrong way”.

This demonstrates once again that NEHTA just does not understand. NEHTA is simply adopting suggestions made in the BCG Review. Careful reading of the Review reveals a shallowness and lack of depth in understanding the Health Sector and its many cultures.

You say “what NEHTA actually needs is a cultural infusion of Health Sector values and priorities”. Never was a truer word uttered. Sadly, the approach described above will not achieve that. Dr More, you clearly understand. Dr Reinecke, why don’t you?

Anonymous said...

You said "Last it is interesting to see how NEHTA is framing their current work-plan and how – somehow - the Shared EHR is not any longer on the top level list. Wonder what that means?"

I think they have just realised that talking about Shared EHRs publicly is endangers their plans for world domination. I would guess that it is still there concealed within these brand spanking new programs:

# National infrastructure projects:
# National Authentication Service for Health;
# Core Connectivity;

Anonymous said...

All is well!!! A National E-Health Strategy RFT has been released today. See http://www.tenders.vic.gov.au/

Anonymous said...

I must be missing something - no instructions, no information! ?

Anonymous said...

I wish I could draw cartoons and post them-

(Image) a huge colourful NEHTA circus arrives with marching band at the dock but the SS E-Health has already sailed