Some will be aware that in the last month or so NEHTA has been running a range of sessions to brief clinicians on its plans for Health Identifiers and the Individual EHR.
As many will be aware for some reason the Health Informatics Community was not represented at these briefings.
For this reason I thought it would be a good idea to let the readership of the blog see some of what was presented and discussed
Please download the information from this link.
http://www.moreassoc.com.au/downloads/NEHTA eHealth Summit.zip
There seems to me to be a good deal more detail on all sorts of things than we have seen to date, and certainly NEHTA has updated the house documentation style dramatically.
I would really love views (as comments on the blog) from Health Informatics professionals on the plans outlined here. NEHTA still seems to think it can speak ‘ex-cathedra’ rather than getting expert comment before asking clinicians and the public what they think.
I can’t see any restrictions on these documents so I think it is good to have them more widely distributed.
Anyway NEHTA is a publicly owned company and we own them so we are entitled to know just what it is they are up to! – Unless there is financial risk to the Commonwealth – and there is not -they have no right to be so secretive.
Enjoy!
David.
Thank you for making these documents available to us.
ReplyDeleteIt seems most odd that - if what you say is correct - that the briefing papers were not made available in the publications section of NEHTAs web site. What good reason would NEHTA have for not making them public?
The change of style is welcome and these documents read much more easily and contain far less repetition than those released under the Reinecke regime.
It is possible NEHTA is not speaking, as you say, completely ‘ex cathedra’. They seem to suggest they have been seeking input from a wide variety of sources - they can’t talk to everyone of course.
If there are major holes or deficiencies you and others should speak up and say so now - before it is too late.
We know you don’t agree with the NEHTA approach but the jurisdictions have delegated NEHTA with the responsibility to lead the way. What is it to do? If it doesn't lead the way - who will? What alternatives do you suggest?
This brings us on to the subject of leadership. What sort of leadership is required? What qualities? We learnt, ever so painfully, about leadership style with the previous CEO - his deficiencies were obvious and they, more than anything else, undermined everything NEHTA stood for.
We know nothing about the new Acting CEO Andrew Howard so we cannot pass comment or judgement. Revamping NEHTA will be fraught with difficulty and that is his first task.
Building a national ‘IEHR’ seems inexplicably to be a foregone conclusion in the minds of the jurisdictions and NEHTAs. Is that appropriate? Is it necessary? Is this what NEHTA should be doing?
It is on this subject that the real debate should be held and it should certainly be held before COAG allocates the vast sums that will be required to bring it about. But that will not happen - will it?.
You raise a lot of issues - thanks. My key points are two. First I do not believe major centralised projects like the IEHR are the right way to go.
ReplyDeleteSecond I don't think this NEHTA proposal is well enough thought out - reasons here.
http://aushealthit.blogspot.com/2008/07/post-500-nehtas-individual-electronic.html
I want a strategy for e-health implementation that is standards driven where it needs to be and then is grown locally like the US RHIO model. Much less risk and cost and same benefits I believe.
David
Not an IT pro, but here's another anecdote from the coalface of one of Victoria's HealthSmart projects.
ReplyDeleteAs noted previously, one of the glitches associated with the installation of TrakCare across this multi-centre Community Health Service is duplication of records in HCN's Medical Director. That problem persists, but yesterday MD was down for the WHOLE DAY. I managed by the seat of my pants, but I do not know how others did. Also, GPs have abandoned TrakCare's appointments system, going back to the original. However, I'm told that printings from the bookings suite, essential for some of the billings, is not working.
The geniuses at management decided to cut the full-time IT support position a while ago, thinking they could get away with part-time, after-hours support from an adjacent service. This week, though, they have "come to the conclusion that we need permanent staff on site" and are advertising.
Bracket that with an article on EHR by Chris Miles in the insert of the latest Australian Family Physician.
"Meanwhile, there may be progress on the shared electronic record front. Earlier this year, NEHTA signed a contract with Medicare to development [sic] a 'unique health care identifier', a vital step forward in implementing a shared electronic health record and a way of joining the dots in the bigger public health picture."
'Cranky anonymous programmer' here (the irrelevant one).
ReplyDeleteIn terms of the strategy, it looks fine to me. Centralized systems are considerably easier to administer than decentralized ones, and a single point of failure (bad) does at least give us a single responsible party (good).
However, their claim that the software industry is ready for all of this is ambitious at best. Assuming that they proclaimed their strategy fully-formed (with specifications) tomorrow, you still wouldn't see the result for a couple of years.
Top down IT developments don´t have great track records for succeeding in health. If the recent ´consultation´ is meant to be the clinician and end-user input, without any commitment to a clear structure to how this will be integrated at each step of the way, then we might as well forget about it.
ReplyDeleteProf. Protti has made that point ad nauseam.
Also to ignore the expertise of those who´ve been involved in health IT over a long period, and who will continue to be providing systems to clinicians regardless of NEHTA, will also risk dooming e-Health, if not just unnecessarily delaying the development of working e-Health systems.