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

Wednesday, March 04, 2009

NEHTA’s ‘Year of Delivery’ Morphs into Commencing Two Pilots by December!

The following arrived just moments ago via 6minutes.com.au.

E-health a reality this year

by Jared Reed

Universal health identifiers (UHI) for patients and health professionals will be a major step closer this year, says the body in charge of e-health reform.

By December, the National E-Health Transition Authority (NEHTA) plans to have two pilot projects underway to test the usefulness of the e-pathology, e-prescribing and referral and discharge components of individual e-health records.

“[UHIs will] need to be ready to be rolled out but we still need legislation and other governmental interventions to make sure those things are…legislated for,” says Melbourne GP Dr Mukesh Haikerwal, NEHTA’s clinical leader.

Dr Haikerwal says NEHTA is also working to ensure projects are relevant to a clinical practice.

Read the full article here:

http://www.6minutes.com.au/articles/z1/view.asp?id=469811

Well who are we to believe on all this?

We have the Department of Health and Ageing – at the Secretary level no less – saying in Senate Estimates last week that (to briefly quote the Hansard transcript):

“Senator BOYCE—To summarise, the underlying components necessary to deliver e-health should be assembled by the end of the year. Is that what you are saying?

Ms Halton—Most of them.

Ms Morris—Many of them, I would say.

Ms Halton—Yes, many of them. The ones to do these functions that we have just talked about—starting to move discharge summaries, referrals and pathology results around. E-health can be quite narrow or it can be extraordinarily large. The bigger it is, obviously, the more complex and more expensive it is, and you have to start in a way which is scalable. You have to start with things which are achievable.”

And the article above merely talks in vague terms of two pilot implementations. It also makes it clear that without legislation and other Government action Health Identifiers (UHIs) are stalled or near there to.

What can one do but just shake one’s head in disbelief and the incapacity of those involved to actually get a straight story out – let alone actually deliver anything useful.

No one needs to “test the usefulness of the e-pathology, e-prescribing and referral and discharge components of individual e-health records”. Blind Freddy – on the basis of experience both here and internationally - can tell you this is all exceedingly useful!

What is needed is to get the various infrastructure elements legislatively enabled and operational and then start serious implementation of the relevant applications in the real world. Denmark, Sweden, Holland and a range of other places have most of this working, at significant scale, today – as do some messaging providers right here in Australia (think Medical Objects, Healthlink, Argus among others).

The grinding incapacity of the combination of NEHTA, DoHA and Medicare Australia to actually get their respective acts together and deliver coherent e-health outcomes is becoming a very sad joke. Again we are to be piloted to death!

The sooner we establish some overarching governance for e-Health and have the players knowing what each other is doing and having some co-ordination in the activity the better.

Minister Roxon – this is clearly your problem and it needs to be addressed and not just palmed off to a bureaucracy which is obviously out of control and lacks direction.

David.

4 comments:

Anonymous said...

In January 2002 Jane Halton was appointed as Secretary to the Department with overall responsibility for the corporate and strategic directions of the Department and portfolio.

On her watch we have witnessed one failure after another of numerous eHealth projects. On her watch we have seen ‘Pilotitis’ done to death ad nauseum. She has swung through the rafters promoting her different approaches as the whim takes her, ranging from the big bang all swinging all dancing national system to small random pilots scattered hither and thither.

On her watch, the Labor Opposition (now the Rudd Government) shone the spotlight on the ehealth mess, year after year, with a fervour and tenacity rarely seen in the Senate Estimates and Parliamentary Question Time. Her responses then were no different from today, unintelligible rubbish. And now, in this the most difficult economic climate we have ever seen in our lifetime the lady is setting out once again flip flopping around injecting her domain with another round of ill conceived, uncoordinated, piecemeal ‘Pilotitis’.

Is she so insouciant that she has learnt nothing from the many past failures over which she has presided.

Is the Minister so overwhelmed by her massive portfolio and reform agenda that she too cannot grasp the absolute imperative that underpins all successful IT projects - first step is to get the fundamentals right?

As you so succinctly stated - it is Minister Roxon’s problem and it needs to be addressed and not just palmed off to a bureaucracy that is clearly out of control and lacking in understanding and direction about the fundamentals of ehealth.

Ever so tragically it is Minister Roxon’s Health Reforms which will be most adversely affected.

You have consistently been highlighting the problems for a very long time - all to no avail it would seem. Sadly it seems Ms Halton does not want to know and will not listen, but the Minister might. Only when grass roots pressure is brought to bear will change occur.

Yes, it was January 2002 when Ms Halton began her ehealth journey and on her watch the outcomes she has delivered have been ............. ?

Anonymous said...

Since 2002 do you know how much has been spent during Ms Halton's watch for which she should be considered accountable?

How much has been spent developing HealthConnect? How much for MediConnect? How much for other failed projects?

How much does it all add up to?

What lessons have been learnt?

Anonymous said...

Like you, as software developers, we are also very concerned. We could do with the business that's for sure but piecemeal projects - no thank you. They do too much damage to our business. The much hoped for 'intelligent leadership', we have all been waiting for is looking increasingly like a figment of the imagination. Reviewing Dr Haikerwal’s slides it would seem you are right. He started off OK and got few fundamental points right, such as:

1. The Health Reform Agenda cannot proceed effectively without universal adoption of information technology.

2. Continuing and enhancing quality and safety in healthcare requires IT.

3. GPs and primary healthcare providers are critical to the success of ehealth nationally.

Well done, but then ooopps he seemed to get lost, nay vague.

4. NEHTA is supporting vendors’compliance to ensure adoption and implementation.

How should we interpret this? What is he trying to say?

5. Collaborating with the primary care sector to ensure that recommendations are fit for purpose.

Motherhood at its best. What is the model? What are the mechanics?

6. Summary Deloitte National EHealth Strategy - targeted investments.

Where and what are these targeted investments in foundations and solutions? Are they secreted away in the unpublished report?

7. NEHTA aims for two pilot projects by December 2009, plus two more in 2010, plus five more in 2011, plus additional pilots if demand and capacity permits.

Pilotitis is a chronic disease for which there is no known cure. It has a high morbidity and usually ends in death of the ‘pilot’ project. Often called the killer condition on the pathway to nowhere, and based on past experience if it does lead to anywhere at all it is back to where we came from!

Anonymous said...

Pilots are what you do when you don't know what to do. They attempt to give the impression of forward motion when there is none.

E-Health in Australia does not need more pilots. NEHTA should be directed to look overseas at what has been done, and adopt the best work.

Adopt. Not pilot, test, or trial. Adopt. Even if it's not perfect, at least it is moving forward.

The minister has been blinded by NEHTA putting itself forward as the gatekeepers to all things Ehealth, when, in reality, it has no ideas and no notion of how to move forward.