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Monday, August 23, 2010

NEHTA’s Blueprint – Do We Learn Anything New or Useful?

The following appeared on the RSS feed a few days ago

NEHTA Blueprint

The NEHTA Blueprint is a reference document intended to familiarise readers with major e-health capabilities that NEHTA is promoting for national adoption.

The Blueprint brings together and summarises the key design documents from across the NEHTA work program into a single document, explains how they fit together and how they fit within the broader strategic direction.

The Blueprint covers a range of capabilities including identifiers for individuals, providers and organisations, authentication, secure messaging, clinical terminologies, supply chain, pathology requests and reports, diagnostic imaging requests and reports, medication management, referrals and discharge summaries. The Blueprint is a living document and will be periodically updated as the NEHTA work program evolves.

This Blueprint is intended for an audience that is actively working in e-health. Potential readers include executives, policy officers, clinicians and technical staff.

If you have any comments or questions about the Blueprint, please direct your questions or feedback to: architecture@nehta.gov.au This e-mail address is being protected from spambots. You need JavaScript enabled to view it .


Download here: NEHTA Blueprint (20.87 MB)

Blueprint Sections

The Blueprint is a large document. Readers who wish to download the document in separate parts, a set of links have been provided

Frequently Asked Questions

A set of frequently asked questions can be found here: Blueprint FAQs (63.98 kB).

The announcement is here:


As you would expect the there has been an enthusiastic welcome from at least one quarter!

NEHTA Blueprint online

by Charles Wright on August 20, 2010

Not quite sure what’s happening with ehealth? NEHTA has just published its Blueprint - “a reference document intended to familiarise readers with major ehealth capabilities NEHTA is promoting for national adoption”.


Recommended for people writing in The Australian in particular!

More enthusiasm and excitement here!


Well where does this all get us?

First we need to be clear that this document is first a listing of the “major ehealth capabilities NEHTA is promoting for national adoption”. It is not a list of current outcomes it is what is being promoted!

Second there are some interesting comments in the draft Frequently Asked Questions (FAQ).

Examples are:

“Q: Who should read the Blueprint?

A: This document is intended for an audience that is actively working in the e-health area within Australia. It is designed to be a reference document used to promote understanding of all elements making up the current NEHTA e-health work program, and provide guidance to more detailed documentation. Potential readers include executives, policy officers, clinicians, reference group members and technical staff.”

It is a big stretch to imagine any executives digesting a 200+ page document – despite all the pictures

“Q: When will the e-health products in the Blueprint be rolled out?

A: NEHTA is currently collaborating with all States, Territories, the Federal government and the private sector to find opportunities for early adoption of ehealth capabilities that align both the national strategy and with local priorities and programs of work.

In these collaborations, ownership and priorities for implementation always remains in control of the local project sponsor(s). NEHTA’s role is to work with local project teams and facilitate access to specialist knowledge about NEHTA specifications and national infrastructure.

The majority of change and adoption activities will be undertaken and managed at local and regional levels across the Australian health system. There is a need, however, for national strategies to accelerate the adoption of e-health in Australia to a tipping point as quickly as possible. Once a tipping point level of participation has been successfully achieved, other mechanisms will be considered to sustain continued growth in participation by healthcare providers.”

Translation – we are looking around for local areas of activity we can help with but don’t actually have money etc to contribute.

Also we need national adoption strategies but we are not doing it ourselves and need to consider mechanisms to have this happen!

“Q: What about personally controlled electronic health records?

A: As part of the 2010/11 federal budget, in May 2010, the current government announced a $466.7 million investment over two years in to a Personally Controlled Electronic Health Record system to support the National Health and Hospitals Network. Personally Controlled Electronic Health Records (PCEHR) are discussed briefly in the Blueprint and the section will be updated once more information is available.”

We know little more than we read in the NHHRC Reports and the press about this. Amazing the most lavishly funded e-Health initiative ever seen in Australia and NEHTA is not really seriously engaged or involved months after the announcements. One might a hoped DoHA and NEHTA might be actually talking from the get-go on all this. Seems not!

I don’t plan to comment on the whole document – but this section really stood out (Page 8 of consolidated document)

“The implementation of this strategy (The NHHRC Strategy) will require:

Making sure the appropriate drivers are in place to support widespread adoption of e-health. This includes setting up a trusted approach to governance to deliver a shared vision based on a common strategy, thus ensuring that the benefits and outcomes are aligned with a mix of policy and regulatory drivers, such as claims and incentives and accreditation requirements;

Collaboration with a wide range of primary/community based care organisations, acute/post acute care organisations, and other bodies that promote better self managed care of individuals;

Development of national infrastructure services to support healthcare identifiers, security, location and other services (e.g. supply chain), as well as standards and solutions for key healthcare processes in care coordination, medications management and diagnostic services;

Collaboration with a range of IT vendors who support healthcare; and

Collaboration with government and privately operated online service providers, such as messaging solution providers, prescribing solution providers and imaging services.”

From where I sit and what I am told from all sides each of these points could do with a very substantial greater effort!

There also seem to be no clear dates for achievement of anything – just vague discussions of tipping points for adoption.

A classic example of this is the National Authentication Service for Health (NASH) Here we are told we are up to the design phase – and then, after a few pages – told no more information is available! What is going on here we can only wonder?

Overall, reading through I am left with two major impressions. First because of a lack of clear national leadership and governance of e-Health, NEHTA actually has no clear idea of how the get there (their future states) from here (the present states).

Second this document is much more a list of ‘gunna’s rather than actual blue-prints for steady progress. There is still so much in this document that is ‘will deliver.’ The classic is here (Page 15).

“Over the next three years, the National E-Health Transition Authority (NEHTA) will deliver key components of the National E-Health Strategy, endorsed by Australian Health Ministers in late 2008.”

Is it another 3 years we have to wait for delivery?

I do note in passing this is meant to be a ‘Draft for Consultation’ but that no date is given to get back to them. Additionally it surprising just how slow the development of the document was (took over a year – see page 7). Does NEHTA have no urgency for any of this?


Note many of the comments on this post – and the post itself also bear directly on this document.

See here:




Anonymous said...

I do not work for NEHTA, but do work in the eHealth arena.

David, you seem consitently suprised with the time frames of delivery. I see you have FACHI at the end of your title. As a medical informatician who MUST have experience in medical informatics, surely you understand the sheer complexity of what eHealth is trying to acheive? A similar set of documents for a state health department took a simlar time period to develop, so these time frames aren't suprising considering they're national.

I know NEHTA need a kick up the bum, but it would be good to know your own background and experience to see what your basing your comments on.

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

Compare NEHTA's effort with Deloittes taking about six months (or a bit less) to develop the National E-Health Strategy.

I have done equally complex consulting projects in the same time frame.

This is very slow to me.


Paul Zagoridis said...

Three years to "deliver key components" is not even a commitment to a solution. It's classic doublespeak.

I am suddenly interested in Personally Controlled Electronic Health Records. A relative is two years into a diagnostic process. The records are scattered between 3 GP's, 3 specialists, 3 outpatient clinics and 2 emergency departments. Despite asking for the primary care GP's details on every visit, it transpires that test results are not sent to that GP. Foolishly I assumed that information would end up at the primary health carer.

From today I will consolidate all my family's medical records.

What I want to know is what should individuals do today if we have a 3+ year wait for a national solution.

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


What I think you need to do is find a GP who makes sure your relative's information is properly tracked, collated, interpreted and acted upon and followed up - ideally using a quality, functional EHR from which a summary of all the important items can be printed out and handed to your relative on request.

The dedicated GP is always going to do a better job with tracking and actioning your health information than any shared record in my view - but then I would say that !


Anonymous said...

Of course the patient can always ask the doctor for a copy of the results of all investigations and maintain their own file. That's a start.