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H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Monday, April 21, 2008

NEHTA has not Changed Yet – And It Does not Have Much Time Left!

The Boston Consulting Group gave their review of NEHTA to the organisation’s Board on 25 October of 2007.

The report can be found here:


It is now six months since that report was received and over four months since NEHTA released the BCG report and its response.

How is it going? Let’s work through the recommendations and score the change from the vantage of a slightly informed observer.

Recommendation 1: Create a more outwardly-focused culture

This does not seem to have happened yet. We have no more openness and transparency and we have the CEO simply resigning with no explanation! Either he was fired by his Board – and the Board should have explained why or he decided to leave in which case even the briefest of reasons why would have been useful. What we got was a fawning eulogy! Score 0/10

Recommendation 2: Reorient the work plan to deliver tried and tested outputs through practical ‘domains’

Hard to tell on this one. There are certainly no significant projects underway to prove up the work done in any of these domains so far, indeed I frankly doubt most of this work will ever see any implementation – despite NEHTA claims.

The endless issuing of 40 page specifications to define how an adverse event or a clinical problem will be described gets no one anywhere I my view when we can’s interoperably move the simplest of clinical document between practitioners.

The domains described (pathology, referral, discharge summary and prescribing) don’t need endless data specifications they need basis implementation of the simplest possible approach to get started and then work to refine can go on from there. This is a situation where perfection is clearly an enemy of the perfectly workable! Score 1/10

Recommendation 3: Raise the level of proactive engagement through clinical and technical leads

NEHTA said 4 months ago “NEHTA has committed to significant culture change, additional resources and the development and implementation of open and transparent engagement programs, particularly with clinical and industry leaders.”

Well all I can say is soundings taken with the various stakeholders I speak with on a regular basis say the old NEHTA culture (of secrecy, arrogance and opaqueness) is alive and well and that the issues of who is doing what with whom and for whom remain as unresolved as ever.

And of course the newly appointed “Clinical Engagement Manager” is now off on leave soon. I hope a replacement is announced soon as there is still no announcement of who is going to assist the manager either. Score 1/10

Recommendation 4: Accelerate resourcing through outsourcing, offshore recruiting and more creative contractual arrangements.

I see lots of advertisements for what are now progressively shorter contracts – ending June 2009 – but not much evidence of a huge takeup.

Don’t you love how we now find out (via an advertisement) there is now a “The NEHTA Privacy & Internal Policy (NPIP) Initiative has been established to ensure that privacy is effectively managed across the entire NEHTA work program”. George Orwell would have loved this one! I wonder what it is actually is and why it wasn’t announced publicly. Of course we have also to be told about the National Authentication Service for Health (NASH) and what it is to do.

NASH, NPIP…when will it end! Score 0/10

Recommendation 5: Reshape the NEHTA organisation structure to address revised work plan priorities

There is no evidence I can see on the NEHTA web site that the structure has been changed. All that has happened is that all the lead positions have vanished and now only points to Clinical Team – with no announcement of who is appointed six weeks after applications closed.

I really despair of how an organisation that has full time ‘spin doctors’ and over a hundred technical staff can’t provide a current, up-to-date and informative web site. Score ?/10

Recommendation 6: Add a number of independent directors to the NEHTA board to be broader advocates of e-health, and to counter stakeholder perceptions of conflict of interest.

We all know what has happened here – so far exactly nothing! – Score 0/10

My view is that there are weeks left for NEHTA unless the public gets to know a great deal more about what they are doing, why and how it will make a difference. Right now it is scoring a pathetic fail.

The irony of NEHTA sponsoring Open Health Tools (http://www.openhealthtools.org/index.htm), when they are one of the most secretive organisations in existence, should not be lost on anyone.

The clock to annihilation for NEHTA is ticking – and if we don’t see some substantive change soon maybe that would be a good thing.



Anonymous said...

Your scores present a pretty accurate representation of the status quo. They are not unkind by any means. This sorry state of affairs reflects a rudderless organisation wallowing in ‘limbo-land’.

(Score 0/10) - No evidence of a more outwardly-focused culture
(Score 1/10) - No evidence of workplan re-orientation
(Score 1/10) - No evidence of cultural change
(Score 0/10) - Resource management
(Score ?/10) - Organisational restructure & revised workplan priorities
(Score 0/10) - NEHTA Board stagnant

Of all of these the No 1 priority must be to establish effective, competent, compelling, open, and relevant lines of communication with the ‘OUTSIDE’ world, and No 2 priority must be to quickly restructure and revitalise the NEHTA Board.

Until these two tasks have been accomplished satisfactorily everything else is really of little relevance.

Anonymous said...

The fact that the CEO resigned (for whatever reason) and his departure was followed, as you say, by a ‘fawning eulogy’ just goes to show how far out of touch is the NEHTA Board with the real world .

By Monday 7 April, the Board and its Acting CEO had already had one full week in which to prepare, for release on the Monday following the CEO's departure, a clear and precise one page ‘positioning’ statement devoid of word-spin and irrelevant garbage. The statement should have been directed at giving all stakeholders the confidence that THE BOARD WAS FIRMLY IN CONTROL. It is probably not unreasonable to conclude that little if anything of any relevance has been forthcoming because the Board hasn’t got any clear idea of what to say or perhaps even worse, what to do. Ever so sadly the incoming CEO, albeit Acting, has not yet appreciated the need for any public comment either. Very, very sad indeed. This does not bode well for the future.

Anonymous said...

It is time (well time has passed) that they pull their heads out of the sand and face the music. They lost some good resources already, business architects, solution architects, doctors and the like, simply due the fact that they are not allowed (by management) to collaborate with the “real world”. When is management willing to migrate out of “la, la land?”

If that does not happen, than Australia is a dissolution richer. Money well spend????? Do not think so.