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, December 01, 2009

A Draft Letter to Send / E-mail to Your Local Federal MP.

I am increasing convinced we need to apply some pressure to the polity to reign in and externally review NEHTA and its profligate and increasingly failed activities.

I am hearing informally that there is increasing internal concern that the flagship Identifier Projects are becoming less and less likely to be successfully delivered, if for no other reason that planning for how what NEHTA is developing will actually interface with the existing health system remains both vague and incompletely worked through. The deadlines for delivery of anything useful, if at all, appear to be increasingly extended.

Below is a possible form of words to assist in formulating an e-mail or letter.

Contact details for all MPs and Senators can be found here:

http://www.aph.gov.au/whoswho/index.htm

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Dear (Local Member’s Name)

Re: An Impending Very Expensive and Wasteful Failure of a Government Funded Entity.

The National E-Health Transition Authority (NEHTA) was established just on five years ago (as a company limited by guarantee with each State and Federal Jurisdiction as Shareholders) to improve the operation of the National Healthcare System through the use of information technology.

Despite the expenditure of now of over $125M dollars very little has been achieved to improve the health services received by the Australian Community.

Evidence is increasingly accumulating of deep organisational malaise within NEHTA which is being manifested by high staff turnover levels and a worsening culture of organisational threat and disempowerment as it becomes increasingly clear most of the organisations objectives are unlikely to be met without a dramatic relocation of the goalposts.

Health informatics experts with which I am in touch are increasingly sceptical of NEHTA’s capacity to deliver and it is important as little good money as possible is thrown after that already spent

As would be expected vested interests in the Commonwealth Department of Health, who have publicly supported NEHTA at forums such as Senate Estimates Hearings, have a strong desire to prevent any review that may suggest they have been less that fully frank about the current chances of the overall success of NEHTA’s objectives. This makes the need for such a review even more urgent.

What I am suggesting is that you ask the Federal Health Minister to ask the Auditor General to undertake a financial, performance and value for money review of NEHTA so that I and the public at large can be assured our hard earned tax dollars are not being wasted.

Whether you are from either Government or Opposition you clearly have an interest in having a very small percentage of the funds expended so far to ensure the money has been well and usefully spent.

Yours sincerely.

Joe Citizen.

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Maybe now the e-mail regarding climate change have settled we can have some impact in getting NEHTA back on some useful rails.

I really hope so.

David.

9 comments:

Anonymous said...

- if for no other reason that planning for how
- that NEHTA is developing will actually
- interface with the existing health system
- remains both vague and incompletely worked
- through.

The HealthSmart folks in VIC (who probaly have what is amongst the most throughly architected eHealth compontry already in place in Australia) have been working through with NEHTA how they would use the HI Service and seem happy enough that they can "interface" HealthSmart to it.

Just who has been saying there is a problem?

Dr David More MB, PhD, FACHI said...

GPs, Specialists and the others in the sector for starters who hardly even know NEHTA exists and all their software vendors who as we all know are spending all this money becoming NEHTA compliant - Not!. Just because one Government is on board there are a few more to go I believe.

Note even you say Cerner / VIC are working through rather than have 'worked through'.

Does Cerner know yet technically just how the HI service will actually work and have they committed to support it? - and if so how much is it costing VIC for all the customisation? Cerner does nothing for free!

I bet you can't (or won't) say.

David.

Anonymous said...

It really doesn't matter very much. By that I mean the bureaucrats are trapped, the users are trapped and the system is trapped into moving forward with what they have got. Too much money has been spent to admit mistakes have been made, that NEHTA has failed, that anything is wrong. That is the way the system works - always has, always will and those who might be competent and capable of speaking up do so at great peril to their livelihood. How many software developers in ehealth do you know who criticize and complain to anyone who will listen but never ever do so publicly? Therein lies the real problem. In a sense they are no different from the rest of the system - they are complicit in preserving the status quo.

Anonymous said...

As the previous commentator said "Therein lies the real problem. In a sense they (the software developers) are no different from the rest of the system - they are complicit in preserving the status quo.

One has to assume they are content with current progress. Is there any evidence to suggest otherwise.

Anonymous said...

If you are talking to various software developers, yes, there is great concern. If (when) the Medicare identifier plan falls at the legislative hurdle, what is Plan B? Before yesterday, there wasn't a lot of confidence around that the legislation would get up. Now there's a Opposition. What odds now on Australia Card Mk III?

And then there's NASH.

Do other commentators remember The Year Of Delivery? 2009. It's going to be a very busy 3 weeks.

Dr David More MB, PhD, FACHI said...

We do indeed and I have the list of what NEHTA told Senate Estimates in June what would be delivered by December, 2009.

Certainly confirms a busy 3 weeks!

David.

Anonymous said...

From the Senate Estimates Committee, Wednesday 21/10/2009
quote (underlines added.)

Senator BOYCE— Then I will go back to the one that is probably the big one, unique healthcare identification, which is also due in December.
Ms Halton—Unique healthcare identifier. Let us be clear about this. This is the notion of a number that each individual will have. It is under the rubric of being able to be identified, but the particular product is a unique healthcare identifier for each individual.
Senator BOYCE—Can I just read here what it said in the information that I was given at the last estimates: The individual healthcare identifier and healthcare provider identifiers for individuals and organisations will be designed, developed and delivered as per the contract arrangement with Medicare Australia.

That was to happen by December.
====================

Ms Halton—I met with the CEO of Medicare Australia, in fact, yesterday or the day before, and it is on track.
Senator BOYCE—When will people actually begin to have individual healthcare identifiers?
Ms Halton—It depends on which jurisdiction they are in when it is going to be rolled out, but the capacity will be there from December.
Senator BOYCE—Where would you expect it to be rolled out first?
Ms Halton—I do not know. I will have to take that on notice.
Senator BOYCE—Is there a schedule for the rolling out of it?
Ms Halton—It is partly a question of each jurisdiction and what they are doing.
...
Senator BOYCE—However, this community is feeling a little irritated by what they see as a lack of progress in this area. The view has been put to me that this authority was established in 2004 and the budget has been more than $200 million over that length of time. Is that the correct figure?
Ms Halton—I will take the quantum on notice because I do not have it to hand. I think people actually, if you do not mind me saying, just need to calm down a bit about this. What we are trying to do here—
Senator BOYCE—I think they have a sense that they have calmed down for several years.
Ms Halton—Actually, I think they are being unreasonable. What they actually want is a significant investment from government now to have everything happen instantly. The bottom line is we are trying to build a reasonable national system that will enable private investment and private engagement. The work that NEHTA is doing

—all of the work that is on the delivery
========================
schedule for basically the end of this
========================
calendar year, and is on schedule—
======================

is as good as you will get around the globe. Genuinely I think that. Okay, they might want several billion dollars more. That is fine as an ambition. But in terms of taking relevant, logical, ordered steps towards this e-world I think actually we are not doing too badly.
/quote

Anonymous said...

Ms Halton is the classic bureaucrat. She knows Senate Estimates is usually a circus with no real power most of the time (with the exception of events like the Gordon Gresh affair.

She also knows that the goalposts can be changed time and time again simply by blowing a bit of fairy floss in the air and saying boo.

Anonymous said...

- Does Cerner know yet technically just how the
- HI service will actually work and have they
- committed to support it?

Cerner have been talking to NEHTA, so presumably yes..... if they have bothered to listen! Cerner have never played nicely in Australia, they have a "my way or the highway" approach to just about everything (as a number of implementations have discovered over the years).

- Note even you say Cerner / VIC are working
- through rather than have 'worked through'.

HealthSmart is more than Cerner product and they are the ones who are working through their own approach for handling their own wide range of existing identifiers, and (gasp!) talking to NEHTA about it.

As far as costs go, why dont you give HealthSmart a call yourself and see what they say.