Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Tuesday, January 27, 2009

E - Health In Australia is Behaving Like a ‘Headless Chook’!

OK, the first serious working day of the new year and we get this in the Australian today!

Uniform health system in the mill

Karen Dearne | January 27, 2009

LARGE-SCALE production pilots of a nationwide e-health system will start this year, with the National E-Health Transition Authority set the task of making this happen as quickly as possible.

NEHTA chief executive Peter Fleming has been given a mandate to create a uniform IT infrastructure, starting with an incremental build-out of existing clinical and communication platforms.

Federal and state government agreement on the urgent need for healthcare safety and efficiency gains - detailed in several recent reports - signals an end to years of under-investment and fragmentation as parties pursued their own technology agendas.

"Legislative changes are needed, but from a technical perspective we aim to be in a position this year to run some pilots," Mr Fleming said.

"We're in very close dialogue with a number of groups about trials of electronic medication management and hospital discharge summaries."

Late last year, the Council of Australian Governments approved $218 million in funds to extend NEHTA's operations.

Mr Fleming said the organisation was working with software vendors to assess their capabilities and move towards the goal.

More here:

http://www.australianit.news.com.au/story/0,24897,24966640-5013040,00.html

For another take we also have:

This is the year of delivery: NEHTA

Suzanne Tindal, ZDNet.com.au

27 January 2009 03:34 PM

The standards and foundations for nation-wide e-health solutions in Australia have now mainly been completed, according to National E-Health Transition Authority (NEHTA) CEO Peter Fleming, leaving implementation on the agenda for 2009.

"I've actually been pleasantly surprised at a lot of the work that's been done in the background around foundation standards. We're actually starting from a very good position," Fleming told ZDNet.com.au. in an interview last week.

"The reality is, though, that we have to move very quickly into a delivery mode and that means implementing. In my expectation, well, this is the year of delivery for NEHTA."

NEHTA had an "absolute mandate" from the Council of Australian Governments (COAG) to deliver in individual healthcare identifiers (which link electronic medical records together), Fleming said, which the authority has been working together with Medicare on. "Medicare is extraordinarily well positioned to do this because of its history and very keen to make this work," he said.

Although creating the individual healthcare identifier for Australians meant a "fairly substantial database", Fleming said the difficulties were created by non-technical issues. There were privacy issues, work flow issues and overarching consumer and government requirements, he said. Legislative changes would also have to be made.

This year would also see a number of pilots, according to Fleming. "I am expecting that as the year progresses we will move very quickly around some fairly reasonable scale pilots around medication management and discharge referrals, and we are talking to a number of groups about that at the moment," he said.

Those waiting for an all-at-once implementation would go home disappointed, however. NEHTA would move ahead incrementally, Fleming said, with the authority consulting states, peak bodies and vendors along the way.

More detail here:

http://www.zdnet.com.au/news/software/soa/This-is-the-year-of-delivery-NEHTA/0,130061733,339294585,00.htm

So we are to have NEHTA stitch together a serious of pilots in areas where we already have the more advanced States with already operational systems and, as usual, not plan in advance for how the piloted systems will be scaled and operationalised at a wider scope.

Why is it that I have this sense of déjà vu? We were here ages ago (2003/4) as I recall before NEHTA was even conceived of.

Last time the plan was scuttled when it was realised by the Department of Health and Ageing (DoHA) how much an organised basic national system (then termed HealthConnect) might actually cost. This time we have a budget to deliver some basic infrastructure and we are to conduct pilots in the absence of any committed funding. You and I can both guess where all this is heading.

Of course this is also not NEHTA’s mandate – the implementation of a National E-Health Strategy is to be undertaken by a successor organisation to NEHTA – and needs to be funded and executed as per the Deloittes plan to have a chance of success.

Of course that implementation has also not been funded and no-one seems to know who is doing what with whom.

More confusion is shown by DoHA issuing decrepit documents on Clinical Decision Support developed by the now defunct Australian Health Information Council as news!

http://health.gov.au/internet/main/publishing.nsf/Content/AHIC+EDSS+Report+

AHIC Electronic Decision Support Systems Report

The Electronic Decision Support Systems Report was developed by the Australian Health Information Council (AHIC) in consultation with several coopted experts. The report contains a number of key messages and guiding principles for the further development of electronic decision support systems in Australia.

Foreword

Electronic Decision Support was identified as a key area of importance for the Australian Health Information Council (AHIC) and as a result was the focus for the Council during its second term.

AHIC members identified the use and accreditation of EDSS; and medicines as being two important areas of Electronic Decision Support Systems (EDSS) for discussion. Several experts in the field, including Professor Johanna Westbrook, Dr Joanne Callen, Dr John Aloizos, Mr Michael Fitzsimons and Dr James Reeve provided valuable input into this report and I thank them for their participation.

Barriers to the successful implementation of EDSS have been identified and overcoming these barriers to maximise the benefits for health consumers has been discussed.

On behalf of AHIC, I hope that the development of this paper assists with advancing Electronic Decision Support Systems in Australia and as such can contribute to the use of safe, efficient and effective tools to support the skills and knowledge of health professionals across Australia.

I would like to take this opportunity to thank the members of the Council and the AHIC Executive for their valuable work and support in formulating this advice to AHMAC.

Professor James A Angus

Chair of Australian Health Information Council

Dean of the Faculty of Medicine, Dentistry and Health Sciences

The University of Melbourne

The rest of this report – dated mid January 2009 (but actually written late in 2007 – early 2008) can be found here:

http://health.gov.au/internet/main/publishing.nsf/Content/9B50F6B541401BBACA25753F007C283A/$File/AHIC%20EDSS%20web%20version%2012%20January%202009.pdf

I wonder how embarrassed the authors of this are that this has suddenly appeared recommending the development of a National E-Health Strategy that has already been done?

What we have here is the following.

1. A totally silent Health Minister – and, in contrast, the new US President sponsoring major e-Health initiatives.

2. A developed and sensible National E-Health Strategy the Government apparently won’t fund to implement.

3. NEHTA – without any ongoing guidance and control – simply floundering about seeking relevance and to spend the funds it has.

4. NEHTA having no mandate to do more that they are already tasked with (ID, SNOMED CT, Secure Messaging, NASH and Supply Chain). Where are the funds coming from to do the extra?

5. NEHTA pretending the Standards work is done when it is not.

6. NEHTA not acting to properly support the National E-Health Strategy with a focus on messaging as recommended.

7. There being no policy framework or legislation in place under which any trials or pilots could be conducted – legislation is not quick as Mr Rudd is finding out!.

8. A totally unrealistic time line to do anything at any scale and evaluate it in less than 12 months – as suggested.

9. DoHA – as far as E-Health is concerned – lost in the wood, out to lunch or whatever other term you like.

10. Medicare Australia will not have the Identity Systems operational until 2010 so how can pilots happen in 2009?

See:

http://www.medicare.gov.au/provider/pubs/news/bulletin/index.jsp#N100FA

This is all a travesty and bloody sad.

We need a Federal Ministerial Statement of Intent in the E-Health Space sooner rather than later so everyone can know where they stand and what is actually going on!

We also need the FULL Deloittes report made public! This Labor Government is as bad as the Howard crew on openness and transparency as far as I can tell.

David.

3 comments:

Anonymous said...

What a sad and sorry tale. If what you say is correct, and everything points to it being so, I have to agree with you:- it really does look like déjà vu. Mr Fleming might be new to the job but surely he has enough common sense to know it is fatal to try and pull the wool over our eyes. Hopefully he will step back, cut the rhetoric and have a long hard look at what really is the truth of the matter before he goes much further along the rocky road he seems have painted for us.

And what a pity the full Deloitte report has not been made public! Failure to release it after spending over $1.0 million putting it together undermines NEHTA. Hopefully someone in the bureaucracy will see some sense real soon.

Anonymous said...

You seem to be mixing your messages somewhat when you say:-

(a) this time we have a budget to deliver some basic infrastructure

(b) we are to conduct pilots in the absence of any committed funding

(c) this is not NEHTA’s mandate

(d) a successor organisation to NEHTA needs to be funded as per the Deloittes plan.

We would comment thus:-

(a) We need to work with the budget we have and to work with industry to deliver as much basic infrastructure as possible within budget.

(b) Committed funding to conduct pilots has not been announced; that is true, but you are not privy to what plans may be in place to secure that funding.

(c) NEHTA’s mandate can be changed or extended at any time to accommodate the changing environment. NEHTA is not fixed and rigid, nor is it set in concrete. NEHTA has a job to do and whatever needs to be done, to achieve that end, will be done.

(d) The Deloitte plan is just that, a plan. It may need to be modified to fit with these difficult times. Your push for a successor organisation may not be the only option. It may be more appropriate to expand NEHTA to fill that need and to fund it accordingly.

Aus HIT Man said...

All I can say is that if the comments are from NEHTA then a little public disclosure might be a very good thing. Hiding behind some secret plan is hardly the way Government should function in a democracy.

As I said in my post the Federal Minister needs to clarify just what the forward plans are sooner rather than later.

David.