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Wednesday, January 28, 2009

It Is Time for NEHTA to Come Clean with its Plans - Right Now!

Unless I am the victim of a quite clever hoax it seems we have NEHTA’s attention on the blog.

That being the case the two NEHTA comments really provoke more questions than they answer.

Post 1 reads:

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.

Wednesday, January 28, 2009 9:55:00 AM

Post 2 reads:

Anonymous said...

It is wrong to insinuate NEHTA can just arbitrarily change its mandate. For our Constitution to be changed the changes must be proposed by the Board of Directors and put before the Members for approval.

Wednesday, January 28, 2009 12:02:00 PM

What I read here is that:

1. AHMAC have spent $1.3M on a well considered plan, but that NEHTA believes it knows better and is this choosing to follow alternative options – what they are being unstated. The evidence that NEHTA knows better than Deloittes I find severely lacking.

2. NEHTA by implication is satisfied with the governance of e-Health in Australia despite the fact there is no real input from the private sector and health industry other than through non-binding and un-representative Stakeholder Forums. Few would accept that.

3. That NEHTA thinks it can deliver substantial improvements to e-Health in Australia without explaining to stakeholders just what their role is to be in all this and who will pay for the components NEHTA is not funded for. This is a recipe for yet another e-Health disaster.

4. That NEHTA thinks it is not accountable to the public and stakeholders as similar organisations are in our Australian democracy, and that it can just ‘run amok’ with no appropriate checks and balances. That is just wrong and sooner or later those involved will be made to account.

NEHTA needs to wake up and properly disclose its plans so they can be subjected to appropriate scrutiny and, if warranted, criticism and modification. Just to announce it is a ‘year of delivery’ when all is being delivered is pilots and unfinished infrastructure is just joke.

This all feels like the ghost of the old regime coming back again!

If all this is being backed by DoHA and the Minister it is vital we hear from her/them very soon indeed. Additionally there needs to be a real review of NEHTA’s plans before they proceed or we can be sure it will be a total mess..as it has always been when DoHA has tried deliver outcomes over the last decade.

I had thought with the delivery of the Deloittes e-Health Strategy and the changes in NEHTA management we had entered a new era. Seems not!

David.

(p.s. Sorry if this is a con! - Will be very impressed if it is - but I expect denials etc.)

2 comments:

Teki said...

Vern Hughes of Social Enterprise Partnerships wants to promote personal information management that includes health and social services. They are running a two-day conference in March, with Peter Shergold as one of the invited speakers. It would almost be worth the admission to go and ask Dr Shergold what he did for Health IT while he had the PM's ear.
The current head of PMC, Terry Noran, has "keen interest in the arts and culture", which probably means he isn't on Facebook, let alone has any understanding of info tech.

Teki said...

A paper asked Why is the use of clopidogrel increasing rapidly in Australia? and concluded (abstract only) The supply of clopidogrel increases with age, male sex and living in a major city. These same demographic variables were important for cardiac stenting, an indication which is currently not approved for subsidy by the Australian government, but which modelling indicated could account for between one-third and three quarters of clopidogrel use. A review may be required to ensure subsidised indications reflect current evidence and cost-effective use.
Right here is a good example where decent Health IT could provide up-to-date data on who is prescribing what to whom and why. But the latest PBS usage data from DoHA is two years old.
Clopidogrel is a huge profit-maker for Bristol-Myers Squibb and Sanofi-Aventis. Plavix is the second-best-selling drug in the world, but those profits will disappear in 2011 when patents expire and the cheap generics, already available, take over on our PBS.
Bristol-Myers Squibb, worth US$46b, is under play from Pfizer, bidding $68b for it. Or Bristol could synergise with Sanofi, currently worth $81b.
Bristol-Myers strategy has been to move into a small suite of specialities, including cancer.
The message from all this is that Pharma means huge budgets, huge profits and huge influence on governments' decisions. It also means much for Health IT. Put it this way, what if progressive reforms in Health IT meant more profits for Pharma? Would there be a need for this blog? Oh yes, Pharma is thirsty for health information, but entirely on its' own terms. There is published evidence that pharmaceutical support for research means that the data that is eventually published for peer review has been cherry-picked for the positive findings. There has been a recent call for all clinical trials data to be made fully accessible in Australia.
On the local scene, the Victorian Government has just announced more multi-million dollar funding for cancer research. That's money for detection and pharmaceutical research, not prevention. Why on earth would the pharma industry want to prevent cancers?
If the Health IT sector is competing with Pharma for government funds, who wins? A good social engineer, an expert in corporate pathology, could explain why Pharma likes Health IT just where it is, thank you very much.