So we are to have $460+Million to be spent over 2 years, with the possibility of some more if success is seen as coming, to develop Personally Controlled Electronic Health Records (or maybe Individual Electronic Health Records (IEHR) or maybe something in between).
As with all such announcements the only thing that is missing is any detail. Until that becomes clear this is so much hot air.
Worryingly, the lack of information on the following issues leave one wondering just how seriously all this has been planned and developed.
1. How on earth can a program of this size be kicked off and undertake useful work starting in only seven weeks?
2. What will happen after two years and who would bother if there is no confidence of some reasonable follow-on?
3. Who is going to deliver this national system? Public sector, private sector, a PPP or what?
4. Where is the information that is to apparently populate these records come from?
5. What will be the governance framework for these records?
6. What is the evidence for the actual value of these records to health outcomes – as opposed to provider EMRs?
7. What is NEHTA’s role and what is DoHA’s role to be?
8. What will be the management and organisational framework for delivery of these plans?
I anticipate the Department will make the answers to these questions available over the next week or so. They must know or how else can they say the spend – over 2 years – will be exactly $466.7 Million.
If this information is not forthcoming promptly we will all be able to draw our own conclusions about all this.
David.
Senator Boyce's work has only just begun.
ReplyDeleteThe 863-page PDF from DoHA subheaded "Purpose of the Health and Ageing Portfolio Budget Statements
ReplyDeleteUser Guide" is titled 'normal.dot' in my open-source Document Viewer 2.28.1.
In the real world there is significant work to be done in order for clinical systems to be able to provide the sort of information required for the personally controlled electronic health record and that is just in the acute setting. Primary and community care are going to be much harder. To make this happen there has to be a clear software architecture vision across the acute sector and this at a time where Kevin Rudd is promising further fragmentation through local hospital networks. The quality of information is going to be patchy at best for at least the forseeable future given the nature of hospital systems and continued reliance on paper records in many cases.
ReplyDeleteThis funding is going to disappear into a NEHTA black hole with little accountability or anything to show for it.
This is another thought bubble announcement.
ReplyDeleteWhere is the substance?
There is none I can detect. We need the details pronto.
ReplyDeleteDavid.
I honestly don't think Kevin Rudd, Nicola Roxon, Lyndsay Tanner or Wayne Swan understand. I'm not by any means suggesting they don't care - I believe the genuinely do care but have responded to political pressure to throw money at the problem and then let the Department work out how to deliver the solution. They know that the first thing they have to do is win the election then they can refine their thinking if they have to. Right now they want a political solution and that's what they delivered last night.
ReplyDelete"Primary and community care are going to be much harder."
ReplyDeleteI try and avoid these terms as they are too diverse and bundle a vast range of IT capabilities under one roof. However general practice for example, will have no problems uploading and downloading to/from a centralised IEHR repository SO LONG as the top dozen (4 would be more than enough in reality) clinical software developers that service this space are involved in the architecture of the system from an early stage, namely now if they want it up and running in any usable shape in 26 months. As the four vendors I'm thinking of also service the vast majority of the specialist practice market, I reckon it is actually the acute sector that will drag the chain, despite NEHTA being owned by the owners of this space.