Tuesday, October 05, 2010

NEHTA’s Clinical Leads Recognise NEHTA is Not Enough! It is Time To Fix This!

The following editorial appeared in the Medical Journal of Australia yesterday.

E-health in Australia: time to plunge into the 21st century

Christopher Pearce and Mukesh C Haikerwal

MJA 2010; 193 (7): 397-398


  • E-health is the health care buzzword of the moment, with a person-controlled electronic health record funded in the 2010 federal Budget and legislation to introduce health identifiers recently passed by Parliament. E-health can ease the patient journey, improve quality of care and reduce costs.
  • Australia’s health care system lags behind all other sectors of our economy in the use of computerised systems. While general practice and community pharmacy are highly computerised, the hospital sector is not.
  • Adopting e-health is likely to result in higher quality practice, but general practice and hospitals need a mechanism for securely sharing patient data. Uncoordinated implementation of differing, incompatible systems within and between hospitals compounds a dire lack of national coordination of effort.
  • Multiple funding streams and jurisdictions and the lack of an implementation strategy have slowed e-health development. Government programs underestimate the costs of change management and the need for training and technology. Confusion reigns about responsibilities, but governments must ensure connectivity between health care providers and recognise that the benefits will accrue into the future.
  • The National E-Health Transition Authority has developed national open-access standards, and its foundation projects and the National Broadband Network are now coming into place.
  • To ensure the clinical relevance, utility, safety and acceptability of e-health systems, health professionals urgently need technical capacity and expert guidance.

The full article for those that can access it is here:


Now both the authors are Clinical Leads and important spokesmen for NEHTA.

This is acknowledged here:

Competing interests

“Christopher Pearce is Clinical Lead at NEHTA. Mukesh Haikerwal is Head of Clinical Unit and National Clinical Lead at NEHTA.”

Also in the article we find the following:

“To reap the benefits of e-health, the national role of NEHTA must be matched with a national implementation arm, with the ability to coordinate across the states and territories, and across the myriad private providers that administer the bulk of health care to Australians.”

If readers refer to my Australian Article from last week we see that I identified leadership and governance as key issues as well as pointing out that both the BCG and Deloittes had said NEHTA was not enough. The use of phrases like ‘confusion reigns’ says it all!

See here:


Here we have NEHTA’s own telling them essentially the same thing!

I wonder will they listen?

You can read coverage from the Australian here:

E-health needs implementation body: Haikerwal

NEHTA'S Mukesh Haikerwal has called for a new entity to co-ordinate activities across the states and with the private sector.

Dr Haikerwal, head of the National E-Health Transition Authority's clinical leads program, says a more integrated approach is needed if the community is to gain improved patient care and cost savings from e-health programs.

"To reap the benefits, the role of NEHTA must be matched with a national implementation arm with the ability to co-ordinate across the states, and across the myriad private providers that administer the bulk of healthcare to Australians," Dr Haikerwal said. "With the rubber now set to hit the health superhighway, health professionals urgently need technical capacity and expert guidance to ensure clinical relevance, utility, safety and acceptability of e-health systems."

NEHTA was established in January 2004 as a joint federal-state not-for-profit entity intended to deliver a nationwide health IT infrastructure.

Since it began operating in July 2005, NEHTA has made limited progress in achieving its goals, despite spending around $164,000 a day on its activities.

In the latest Medical Journal of Australia, Dr Haikerwal and Christopher Pearce, a GP and NEHTA clinical lead, say implementation of differing, incompatible systems within and between hospitals “compounds a dire lack of national co-ordination of effort”.

Lots more here:




Anonymous said...

While we need governance badly, I am not sure we need another government body to do actual "Implementations" as government implementations, or promised implementations are one of the big problems. It reminds me of this quote:

The nine most terrifying words in the English language are, 'I'm from the government and I'm here to help.'
Ronald Reagan
40th president of US

I think we need Government to set objectives and enforce them with a combination of carrots and sticks.

Anonymous said...

It's taken the medical profession thousands of years to realise they need to talk to each other to effectively deliver their services (MDTs).

Let's not leave semantic and systemic interoperability of medical systems to them, they don't have the skills. This is the job of the medical arhictect and informatician.

Tuly said...

The bar is actually set by the existing health care paradigm ... that paradigm is of itself the reason that the health care system is increasingly unable to meet the increasing demands of an ageing and chronically disease affected population. Health IT can do no more on its own than 'computerise' the paradigm and system that will be less relevant and ineffective as the century draws on.