Wednesday, October 27, 2010

I Think NEHTA Needs To Do Some Serious Fence Mending and Industry Consultation!

The following popped up late yesterday.

NEHTA lead attacks e-health contracts

By Josh Taylor, on October 26th, 2010

No vendor with half a brain would sign a developer contract with Medicare to work on software as part of the government's e-health agenda, National E-Health Transition Authority (NEHTA) national clinical lead Dr Mukesh Haikerwal said this morning.

When asked at an Australian Information Industry Association e-health forum in Sydney this morning why just 14 out of the 80 software developers who had a developer's kit had signed a developer's agreement with Medicare, Haikerwal said he wouldn't hide from the problem.

"I think the contracts — and this is on the public record and I've said this to the people responsible — the contracts the vendors have been asked to sign are not the sort ... that anyone with half a brain would want to sign," he said.

"If you're going to be fair dinkum about getting the vendor involved in this space you've got to make a contract that they can adhere to. [A contract] that is reasonable and is deliverable and you can't put belts and braces on them and hold them back and tie both hands behind their back and then say, now you've got to play in this space," he added.

"So I wholeheartedly agree there are problems with the contracts. And we've got to make it better. My job is to make it better. If they don't like me saying it, they can sack me that's fine. I'm very happy to go somewhere else."

Despite teething problems with getting developers onboard, the benefits e-health offered would be immediate for clinicians, Haikerwal said. In his own clinic he identified that secure messaging offered by e-health could potentially save up to $30,000 a year in the cost of scanning and sending patient documents manually.

Haikerwal admitted that delivering personally controlled e-health records in just two years was a big ask, and said that NEHTA needed help from the IT industry to meet its goals.

More worrying material here from a thorough coverage.

I really don’t think there is much to add here. We have the NEHTA sponsored blogger spinning away saying how good all this is - but, as quoted, I find it very hard to see there is much good news for NEHTA and Medicare here.

My view, if their Clinical Lead finds it necessary to speak out like this there is ‘trouble at mill’!



Anonymous said...

For the last few years dear old Dr Mukesh has been beating his NEHTA drum all to no avail. Numerous attempts to tell him and his employer and his clinical leads that their approach to getting the professions and industry to follow Dr Haikerwal and his band of over paid merry men called clinical leads would never work have consistently been met with blank looks and stony silence as though they only had half a brain and couldn't understand what we were trying to tell them.

Now in absolute frustration, hopefully recognizing the futility of the Clinical Leads as an exercise in going no-where, the good Dr has spat the dummy.

"Oh, we want to listen to you the industry. Oh, we think you might have some better ideas. Oh, maybe you can help us – ooops, maybe you can tell us how to get results. We are bereft of ideas, so now we have tried and failed we want to listen to you."

"Oh and we're going to make Medicare listen too, because we see them as contributing to the problem".

The problem, dear Dr, is you and your colleagues don’t know anything about us. You don’t know how we work. You haven’t had any experience in the health IT industry. You are by your own admission a GP and a good one no doubt. But what do you know about us, software developers, our problems, what makes us tick, how we survive in the face of the last decade of unbelievable arrogance and stupidity and hundreds of millions of dollars so blatantly and incompetently wasted through the combination of ineptitude and arrogance of an army of PhDs and naive politicians to which we as an industry have been exposed. Zilch. Zero. Nil.

And now you think a little empathy and listening will resolve the problems. You don’t need a meeting with us, or even a PhD, to be told that the first thing to do is “to change the leadership and the governance of eHealth and NeHTA”. You can read that here. All you need is nous ie. common sense. When that has been done, then invite us to the roundtable.

Rest assured, those of us with half a brain will then come to your round table.

In the interim e will continue to survive in the best way we know how - doing what we do best. And when all the monkeys being paid $200,000++ per annum in NeHTA, Medicare and doHA finally come to accept that we just might see some progress in ehealth.

Anonymous said...

For a real insight into MEDICARE (previously Health Insurance Commission – HIC) the introductory comments in the ICS Global Annual Report 2008 says it all:

There was a steady stream of new customers right across the board - health funds, hospitals, day surgeries, medical practices, diagnostic groups and medical software vendors. The re-signing in August of nib health funds limited, a Thelma customer for almost six years and the nation’s first private health insurer to list on the Australian Securities Exchange, was a solid endorsement of our products and services.
The Thelma business in Australia has been impacted by Medicare Australia’s participation in the private ehealth market over the past five years to try to block the private sector’s involvement in eHealth.
Consequently, on 11 August 2008, Thelma Pty Ltd, a wholly owned subsidiary of ICSGlobal, filed an application in the Federal Court of Australia alleging that Medicare Australia has unlawfully used its market power in providing electronic private health transaction services into the private health sector, free of charge, in direct competition to Thelma, for the purpose or effect of eliminating or substantially damaging Thelma; and/or to deter or prevent Thelma from engaging in competitive conduct. The Board of ICSGlobal is confident in the merits of the company’s claim against Medicare Australia.

Anonymous said...

If this represents the true state of the relationship between the top-level Government agencies involved in E-Health, I doubt if Australia will be seeing personally controlled e-health records by the end of this decade. Perhaps it's time for the private sector software vendors to work together, because the top-down approach clearly isn't working.

Jason Smart said...

Actually I find Haikerwal's comments encouraging, not 'worrying', for several reasons.
- He's acknowledging the problems and describing them and putting his neck out in doing so. He's not playing a game of denial.
- His comments in the linked article about going 'wide and thin' shows he understands that scope needs to be reigned in tightly to even be anywhere close to cost and time targets. Unfortunately there are plenty of ignorant people who will complain about the cost and time of such a 'thin' result, and to me that is more the problem.
Buckling to the pressure to unrealistically produce more (ie 'thicker' scope) at lower cost is historically the true recipe for disaster in IT projects; scope control being key, particularly on massive projects. Another is managerial unawareness and ignorance of IT project problems. These conclusions are borne out by IT research literature.
The constant barrage of demands I see here, to produce more results at lower cost, does not show understanding of these issues.

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


Nice to hear from you.

"The constant barrage of demands I see here, to produce more results at lower cost, does not show understanding of these issues."

I have not been saying this - can you be specific as to who has for us?

On your broader point - Dr Haikerwal has been making these points internally for a good while - and seems to not be being taken any notice of. That is the worry.

To previous remarks in ICSGlobal - I had a few shares in them ages ago and lost all the money due in part to Medicare. It was outrageous behaviour on their part in my view!