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Tuesday, April 13, 2010

This Anonymous Comment Needs More Exposure and for Lots of Reasons.

Anonymous said...

David, not sure that this sort of "national enquirer" commentary really helps your status as a noted member of the e-health community.

Although I share your concerns, I simply don't believe that it is possible to divine the internal machinations of government by just looking at what is publicly released. There is SO much more happening behind the scenes that punters never get to see.

The tar-drip speed of progress can be mind-bending, but I am sure that the staff in government (including ALL of the people at DoHA and NEHTA who live and breathe this too) want to get it going. And they haven't stopped working yet. Nothing at COAG is final until the meeting is over.

Think more broadly for a moment: health identifiers are *really* close, national health reform is the dominant government story in the news right now, every health department is working at local e-health projects, PIP messaging vendors are making great progress, and the big defence e-health tender has just asked the open market to build a real implementation of almost all the technical elements outlined in the national e-health strategy.

There has never been a better set of circumstances to get the fire started. Don't let the smoke get in your eyes...

Tuesday, April 13, 2010 10:27:00 PM

----- End Comment.

Let us think what is being said here.

1. Anything useful that is happening is happening behind the scenes and no one other than the ‘in crowd’ can know.

2. The fact that the progress has been minimal for the last 5 years does not mean that great things are not close.

3. NEHTA and DoHA are toiling away on this and we should all trust that they will sort it out – and they don’t need anyone’s help.

4. You and the readers do not know what is going on and apparently nor should you.

5. Lie back, enjoy and trust us – and all will be well.

Now all this may be true, but the evidence we have from the press:

See here:

http://aushealthit.blogspot.com/2010/04/and-this-lot-think-they-can-implement.html

and from Senate Estimates seems to suggest it is just not true.

If you accept this stuff you must also believe in fairies in my view. I must be a ‘doubting Thomas’ who wants evidence, and after all these years I am one who has totally lost trust in the sort of person who thinks it is useful to post this material – but is so scared of their bosses they can’t use their name.

I am really rather ashamed of a country where this secrecy would be seen as normal behaviour – but maybe things have changed now we have Mr Rudd and Ms Roxon in charge.

It is now a decade since serious plans were outlined for a National E-Health approach with Health Online and we have hardly moved in terms of practical national delivery – accepting that some projects are seemingly making headway – but at a really ‘tar-drip’ speed - other than the essentially private initiatives around GP computing and messaging supported by some quite limited funds.

I also find it really silly that the details of any NEHTA / DoHA proposal to COAG or following meetings are not being discussed and reviewed openly. Perfect wisdom these people do not have – trust me on this small point! Let us be also totally clear the IEHR and Personally Controlled EHR proposals are both very bad and ill considered ideas that should not be funded.

Manifest leadership, strategy, governance, co-ordination, support, planning and so on are just absent - and in this environment we all know little of value is ever achieved.

Everyone knows who I am. Anonymous who are you to tell us you know better and that we should just relax and enjoy?

David.

6 comments:

Anonymous said...

Well said David. Points 1 - 5 are valid arguments.

There is I believe one significant element notably absent from all the discourse. It is that, apart from a recent comment or two by Medical Objects and ArgusConnect, it seems that all the other 'players' who diligently beaver away on developing ehealth software solutions (be it in hospitals, aged care facilities, or primary care) are either very content with the status quo or choose not to comment in public.

We have to assume they are all content with the status quo. If they are not then surely if they all attached their names to the same piece of paper expressing united concern they would be heard to their individual and collective benefit.

In many ways it's a bit like a class action to use an analogy. As stakeholders (shareholders) they remain silent at their peril; to step forward as one voice they, and those whom they hope to serve, can only benefit the common good. Is this not a reasonable approach?

Anonymous said...

Your ‘commentator’ said:
“I share your concerns”. You should find that reassuring.

“There is SO much more happening behind the scenes”. That is quite likely.

“health identifiers are *really* close”. That must mean the report in yesterday’s Australian is misleading and without foundation.

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

“There is SO much more happening behind the scenes”. That is quite likely."

I am sure it is - driven by the panic that comes of not having a credible plan that is acceptable to the PM. If it was don't you think it would have been announced?

“health identifiers are *really* close”. That must mean the report in yesterday’s Australian is misleading and without foundation.

Read the full article - the source was the DoHA spokesperson. Who therefore is misleading who here do you think?

David

jon patrick said...

The comments by Anonymous are truly disingenuous trash. The notion that there are people in ehealth not making any comment because they are content with current progress is the most ignorant argument of the greatest self interest I've seen in ehealth. As my essay on the failing of NSWHealth's rollout of Firstnet shows, people are screaming up the walls but nothing is done to solve the problems.
Silence is a matter of people given up commenting because of sheer scale and persistent of failings in the system and believe that nothing will be changed,

Anonymous said...

I am not sure we should expect the vendors to engage in setting e-health policy ( or get off side with potential customers doing it); their role in a competitive commercial environment, is to compete to produce as best they can, quality solutions that best satisfy the consumers' requirements.

The consumers should be clearly articulating their requirements and rewarding those vendors who provide the best solution with their custom. Sometimes this will be as individuals and sometimes as a group.

The problem consumers and the Federal Government currently have is that the engagement of end users and vendors in developing low risk, useful affordable solutions and progress towards usable interoperability standards is being blown out of the water by the larger, and higher impact e-health projects, instigated and managed by State Government bureaucracies, that are completely out of touch with what is required.

NETHA, based as it is upon State Health bureaucracies merely reflects this disconnect.

Anonymous said...

Wednesday, April 14, 2010 9:58:00 PM yes "State Government bureaucracies, that are completely out of touch with what is required".

So how can that best be addressed when the power and the money is in the hands of Federal and State government bureaucracies?