Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Wednesday, August 24, 2011

Here Is The Reason That NEHTA is an Utterly Dysfunctional Organisation. They Are Off On A Total Frolic!

The following organisational chart dropped across my desk yesterday.

It covers the organisation of NEHTA’s Enterprise Architecture Office (EAO).

Click on image to enlarge and have the awful detail revealed!

As a respected management academic said to me regarding this chart - “the only way you get something like this is when you have no idea how to manage!”

To me this just shows an utterly out of control, overreaching and utterly absurd organisation that really needs to get back to doing what was expected - not build empires of this bizarre and irrelevant sort.

Just what is the justification for all this when the Health IT industry in this country is the provider of systems and services and not NEHTA?

This is just a travesty and a farce.



Anonymous said...

Did your respected management academic notice that this is actually an organisation chart in the sense of functions as opposed to positions?

B said...


Without defending that particular chart (which is a deliverables chart, not an organisation structure) the government owns the country's health problem, everyone else is part of the solution.

DoHA and NEHTA should understand the high level information and process problems such that the solutions that are implemented, a) address the problems and b) work together.

That said, my reading of what NEHTA is doing is far too much solution driven rather than problem oriented. And implementing the wrong solution is a common reason for project failure.

Dr David G More MB PhD said...

Yup, and wondered just why NEHTA was doing all this stuff when, as I pointed out, it doesn't actually deliver systems and services - as illustrated by having the PCEHR delivered from pre-built software components by and large.


Dr David G More MB PhD said...


I see this as a functional description and organisational approach for an office that I see does not need anywhere need this complexity or range of functions. More over why are they architecting away for something they won't be delivering?

It is not as if Accenture, Cerner, HCN or iSoft care much for, or take much notice of, any of this!


Anonymous said...

Perhaps, David, you could nominate which of these functions that aren't needed? And explain to the stakeholders who want them why their desires are to be ignored.

Dr David G More MB PhD said...

I struggle to know why NEHTA needs its OWN Enterprise Architecture (what customers is its IT actually serving except some small scale information products?) - so that is a middle 1/3 I am happy to do without.

The rest I have not heard any clamour for as well!

If there is I am sure I will hear!


B said...

NEHTA doesn't need its own architecture, however the problem that is eHealth does.

An enterprise architecture should describe the problem and solution requirements/constraints.

For eHealth to be a success, there should be an underlying analysis of the problem and the solution structure such that all the components work together to achieve the desired goal.

IMHO, as an architect I believe there is an essential need for architecture based technical leadership. Especially regards information issues.

Does this project have it? I'm not close enough to say, but the contents of the draft ConOp and the NIP SOR do not indicate that they do - there's a lot missing.

Dr David G More MB PhD said...


In a mixed private / public environment what is outlined here seems to not face up to the reality of what NEHTA is meant to be doing - i.e. facilitating and enabling e-Health infrastructure components and getting these adopted through consultation and not fiat as this page indicates to me.

Sure an overarching approach would be nice but I much prefer the pragmatic approach in the National e-Health Strategy to this.


Anonymous said...

Do you actually know what NEHTA does? It's not just a watchdog you know. They are charged with consulting all the stakeholders and then developing the requirements for this system! This all has to occur before the partner ie. IBM, Accenture etc can even get their hands on it.

Maybe you should give one of the friendly NEHTA guys a call and they could give you a little tour of their 'architecting'. (Good thing your blog isn't about being grammatically correct).

Dr David G More MB PhD said...


Yes and I like 'architecting'!

BTW NEHTA consultation is not seen by all as being real!


Anonymous said...

Nehta is a eHealth bubble that is waiting to burst. It full of hot air and well delivered PR, but there is no underlying deep understanding of the space or a cohesive plan. The bubble will burst soon enough but it will cover the industry in unpleasant smelling residum which will set us back quite a lot. At least then real working eHealth will be visible. At the moment anything that works is the enemy of these Hollow Men.

Anonymous said...

Ok we have a system we'd like to introduce to this country (it could be argued that we need to) and its not going to come without debate or without isses to be resolved. Your blog post today does not assist with this in any way. Be part of the solution not the problem.

I'd love to hear your suggestions for a better way. What we all need to do is contribute to solutions not just bring more problems.

The reason NEHTA has implemented an internal architecture is to put in place structure and proceedures to cut time wasting and get to its deliverables faster.

What business couldn't use more of that?

Dr David G More MB PhD said...

I would argue putting material that is not widely available does assist the process of getting it right rather than getting to what NEHTA wants. I believe the first is much more important.

See my post of 11:42 to know what I would prefer.


Anonymous said...

This looks like a tailoring of PRINCE2 product breakdown structure and a mere wall chart representation of a set of artefacts or workpackages that need to be delivered, looking at the colour coding it would seem that there is moving priorities and some sort of a coordinated overarching management in place.
I think David you are bagging an attempt and a good attempt at applying good project management governance around a more agile incremental development enviroment.
Are you disappointed in someone planning and controlling the work or simply bitter?
Personally whoever is behind bringing good project disciplines and blending the more fliud and agile needs of architecture development should be congradulated not publically whipped.

Shame on you

Dr David G More MB PhD said...

Methodology requires intelligent and insightful application. I see no evidence of this here!

I am not bitter at all, just sick of waste and mismanagement of a huge resource.

My point is that I don't think all this is needed when those delivering the work have their own methodologies and so on. Anyway we are 6+ years into the NEHTA experiment and so far where is the single clinical outcome improved or life saved?

NEHTA is hardly developing anything - they are managing implementation of others products - so how does all that effort fit in. There are better and simpler ways of doing all this in my view. If I am wrong so be it!


Anonymous said...

You do realise that chart is only for one part of NEHTA activity?

To get a more complete view try reading the 112 pages of the Strategic Plan Refresh 2011/2012 published on 11/7/2011.

That will make give you a much more complete view of how thick the mud actually is!


Bruce Farnell said...

I don't know about anyone else but I tend to judge people or organisations not by what they say but by what they do (or deliver). In the case of NEHTA the lack of delivery is the key issue.

Everything else from the quality of their project management to the colour of their coffee cups is meaningless unless that actually deliver the goods. If actual delivery of meaningful initiatives in a timely manner cannot be achieved then everything NEHTA does is just activity and waste - nothing more.

Anonymous said...

Bruce you seem to see project management as seperate from delivery? I take it you are an IT consultant. The major problem with NEHTA as with all Health and Governement initiatives is that you fail to understand programme/project management. Failure to correctly plan, monitor and control is what is wrong here. Leaving this to IT, Clinical or even executives is asking for trouble. If NEHTA is starting to wake up to delivery management then good for them. Before you reply stop and think - is your experience in complex programmes simply something you have googled. Those who pretent to understand this proffession do more damage than good

Anonymous said...

I would think that what the world should have learned like projects like this is not to do them at all as they are failure prone, and that is the optimistic view.

In fact health IT seemed to be progressing quite well until, sometime in the 1990's, governments decided to stick its nose into it and as a result we have had little progress since.

I think adding some governance around things that are working, and not trying to do anything themselves is the only role governments should play, and its very cheap to implement.

I might not understand big ticket project management, but I know its something to avoid at all costs, ideally by not doing big ticket development, but regulating when something has proven to achieve real use. Currently we have a failure to regulate what is working and billion $ waste on big ticket projects. Whats required is a government budget of a few million dollars a year to legislate for a compliance program for currently working standards that are in actual use now.

Its vital that the pin is pulled and industry is allowed to innovate free of the influence of the psychopathic eHealth "managers" that have painted themselves into a very desperate corner and are intent on shooting down anything that makes them look silly, which is anything that works.

Anonymous said...

Quote above: "the influence of the psychopathic eHealth "managers" that have painted themselves into a very desperate corner and are intent on shooting down anything that makes them look silly".

Pretty well sums this disaster up perfectly. Well said.