Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


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

Monday, March 30, 2009

E-Health in Australia goes Political – At Last!

This is a really good piece of news.

Roxon lost on e-health, opposition claims

Suzanne Tindal, ZDNet.com.au

24 March 2009 10:56 AM

The Federal Government's lack of a true electronic health agenda had left an opposition offer of bipartisanship on the issue dangling useless by the wayside, Shadow Health Minister Peter Dutton said yesterday.

"[Health and Aging Minister] Nicola Roxon and I don't always have a perfect made in heaven relationship, but nonetheless, when I first sat down with Nicola coming into this portfolio only six months ago I gave her an undertaking that we would — on the issue of e-health — provide bipartisan support," Dutton said speaking yesterday at the Annual Health Congress in Sydney.

“We've seen no evidence of an agenda which we can support as we go forward”

Peter Dutton

The upfront expense and long lead times of e-health solutions meant that the benefits wouldn't be delivered for what was politically, a long time, according to Dutton.

Yet the offer was not being used, the shadow minister said: "I offered that bipartisanship from day one. The offer stands today, and we've seen no evidence of an agenda which we can support as we go forward."

His comments echoed those made by Booz and Company principal Klaus Boehncke at the conference. "It's fair to say that political leadership has not been exhibited here as it has elsewhere," he said, pointing to US President Barack Obama, who put e-health onto the agenda in his first address at the White House, the German Federal Health Minister Ulla Schmidt's spruiking of her country's e-health card and the tremendous drive in Singapore to get electronic health records up and running by 2010.

Much more here in a long and useful article


I have to say that one of the things I have been hoping would happen for a good while now was that the Opposition notice the hopeless way Minister Roxon is handling e-Health and bring some pressure to bear to have the game lifted.

She seems so determined to avoid any part in the debate that it has seemed to me for a good while now that only the Opposition could flush her out of her foxhole!

Heavens knows there is plenty of evidence that DoHA and NEHTA are both in desperate need of serious strategic leadership which they are simply not getting and which is leading to the saga’s that we saw play out in the blog over the last 10 days or so.

Minister Roxon on your to-do list for e-health over the next couple of months are the following:

1. Make sure the outcomes in the National Health and Hospitals Reform Commission (NHHRC) final report take full advantage and promise of e-Health and that e-Health is a key enabler of Health Reform.

2. Review in detail and then announce your response, and associated implementation approach, to the National E-Health Strategy which has been developed by Deloittes for AHMC.

3. Review the happenings in the e-prescribing domain and act to ensure that the public interest is being fully protected with what is going on.

4. Review the proposed PIP agenda to make it more practical and much more clearly linked to quality use of computers by clinicians and clinical outcomes.

These four areas would make for a very good start.

If you fail to ‘carpe diem’ ( see http://en.wikipedia.org/wiki/Carpe_diem ) and act to address these points dear minister, you are a very great risk of going down as one of the worst Health Ministers the Commonwealth has ever had.



Anonymous said...

We despair.

Anonymous said...

Peter Fleming is reported in Suzanne Tindall’s ZDnet article as saying at the IIR conference last week that only after NEHTA has had its business plan approved would it “go into consultation” over the fundamental issue of where “data would reside” in regards to the electronic health record.

He went on to say that “At this stage the current thinking is that we will not have one central electronic health record that everyone's part of. The expectation is that there will be multiple electronic health records around the country and that those health records will be provided by various players. In some cases it may be health insurers, in some cases it may be Google or Microsoft, it may be professional bodies."

"Where I think we will end up is that we will have a large indexing service not dissimilar to the type of web technologies we know today that knows where an individual's records are stored and can pull that data back as required. Given the current physical restraints, I think that index will also contain some summary data, things that might be required in an emergency.”

Well, have we advanced anywhere over the last few years? Not really.

I for one wouldn’t be giving him a single brass razoo for his business plan until:

(1) the fundamental principles of design have been defined
(2) consultation with industry has occurred
(3) the basic design has been published.

He already has been given more than enough money to undertake these steps.

Anonymous said...

In the most fundamental terms he is promoting consumer-centric, consumer controlled, health record banks, available through multiple service providers.

Microsoft (HealthVault), Google, Medibank Private, BUPA and similar Health Insurance Funds, and many commercial PHR vendors like My Vitals, MyMedicalRecord, and others will be delighted with this news. Bring it on Peter. Let the market decide.

This will lead to lots of competition, disaggregation, and fragmentation. Some might say the more the merrier. After the initial rush of enticing money making schemes seducing the punter to come on board ("bank where its safe" seems an appropriate catchcry in today's financially troubled world) many such offerings will collapse and die and a few will become stronger capturing increasing market share.

The consumer will be disappointed and Interoperability will become a dream of the past. Of course, if NEHTA can define the standards for what is required then perhaps ………………

If NEHTA can what?

Who needs interoperability? Proponents of the health record bank argue that a great deal of the interoperability issues will evaporate from contention because the complete health record for a patient will be stored in a single bank vault.

Anonymous said...

Yes, but hang about - Peter Fleming also said - that in place of a centralised repository he can see a large indexing service which “knows where an individual’s records are stored and can pull that data back as required”.

Now what is he saying here?

Is he referring to an individuals’ record being held in one place (on one repository albeit many of them for people to choose from)?


Is he suggesting different parts of a person’s record will be held in multiple locations and using the ‘centralised indexing service’ to execute a ‘go fetch now show’ approach where the ‘fetcher’ goes out to multiple locations to bring in the ‘required’ information.

I hope he isn’t thinking of the latter. Is he?

Anonymous said...

David, your To-Do list is a pretty good start. But how should the Minister go about it? She can’t rely on her bureaucrats because they will simply perpetuate the mess. And she can’t rely on the HHRC because they lack the expertise required to even have half a chance of getting ‘IT’ right.

Dr David G More MB PhD said...

My view is that we should establish an time-limited National E-Health Strategy Implementation Task Force (a mix of good skills from industry, health and consultants) and empower them, with the Minister's authority, to get on and sort these issues out for her.

She needs serious external and realistic input etc.


Anonymous said...

No one should argue with that she certainly does need serious external and realistic input, wise, pragmatic, strategic, competent, astute, are some of the qualities and adjectives which spring to mind.