This blog may well loose me many friends but I need to write it.
My thesis is that all the money NEHTA is throwing at ‘duff’ e-Health projects, like the HI Service, is preventing any quality debate as to just how sensible, rational and well planned what they are doing is.
It is really quite that simple, and we are all likely to suffer as a result.
Any e-Health program that, is centralised, denies individual’s consent, needs a major marketing campaign, does not provide clear-cut benefits for those who deliver healthcare, overstates the benefits for consumers and which attempts to spin that it is providing adequate and properly considered privacy and security for consumer protection when it has not actually tested and piloted the plan is doomed to failure is a spectacular and expensive fashion.
Many of those who know these ‘self-evident’ truths, that have been hard learned in the UK, Europe and the US seem to be strangely silent. A possible reason, they are having the meal ticket provided by NEHTA so what else can they do post the ugly GFC? Lie low and take the money I guess.
The level of anonymous but revealing and important posts confirms this view. I would argue the time to come out may have arrived.
The 'control freak' and secrecy mentality we see from NEHTA / DoHA hardly argues against my thesis!
I am probably wrong, and actually they are all carefully considered and thoughtful ‘true believers’, and all this is going to be wonderful, but unpaid and unbiased I really doubt it!
Tell me what you think, but I can’t understand why there is so little debate. I really want debate and discussion on this.
David.
4 comments:
A report on the Health Identifiers by Karen Dearne in today’s Australian said that NEHTAs chief executive Peter Fleming conceded in an interview with The Australian last month that:
1. the healthcare identifier system was built without input from local industry
2. but said engagement with the private sector was now being addressed.
3. "Clearly that's on my agenda for this year," he said.
4. "We're talking with software companies about the impacts (of integrating the UHI) on their systems and how they operate.
5. Certainly we hope to have some quite significant implementations by the end of the year, subject to the legislation being passed."
Well informed, knowledgeable health informatics specialists will comment on the above as follows:
1. par for the course, nothing has changed
2. same old line, year after year, empty rhetoric
3. same old line, year after year, empty rhetoric
4. duuhh - we are, we will be?. Same old line, year after year, empty rhetoric
5. Fleming said 2009 was the ‘year of delivery’! Same old line … only the year changes.
The country may have spent a shed-load of money on NeHTA. The amount of money that went into actual deliverables might have only been 10% and the rest was spent on spin. I don't care as long as the deliverables that this industry desperately needs are met.
1. Individual and Provider Identifiers. I'm sorry but we need these.
2. Standard Terminologies. BP in one system means BP in another. (SNOMED)
3. Framework and communication Standards
You might be right about the incorrect path taken to achieve these, but as long as we have them, we can get on with the job.
My cynical side thinks that alot of the 'NeHTA bashing' comes from people who make a living out of the current chaos that is our eHealth system.
Seriously people, Banks have been able to exchange data securely for as long as the technology has been able to provide it. We in Health are still stuck in the dark ages and we will make mistakes as we come out but we will eventually get it right.
P.S. I am not a NeHTA person.
I am a vendor that agrees (largely) with the preceding comment. The eHealth standards and tools that we are finally getting are critical to the success of eHealth.
The fact that it has taken so long and cost so obscenely much to get this fare only goes to demonstrate, yet again, why initiatives such as these should not be entrusted to government.
The performance of Halton and Forman at Senate Estimates last week (NEHTA did not even bother to show up) should be sufficient to convince anyone that DOHA and NEHTA have very little idea how to do this - but manage to consume hundreds of millions of dollars nevertheless. $51 million to develop three numbers? Puh-lease!
I believe the e-Health identifiers, standards and tools within the NEHTA workplan are important to furthering the e-Health capability in Australia. However, I am appalled at the lack of meaningful progress, the rubbery timelines and the excessive costs to date. The 'spin' evident at all levels from the Minister down does not engender confidence. It's truly a case of style over substance.
When will it end? At what point will someone with authority say.. NEHTA has failed to further the e-health agenda beyond the status quo?
It's an important question. When will NEHTA be deemed to have failed? Perhaps when the 'year of delivery' is transformed to the 'decade of delivery' (2011-2021), an extra few hundred million has been spent and the ability to exchange health records is unchanged from today? Perhaps then the penny might start to drop - but then again, I'm an optimist.
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