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Wednesday, August 21, 2013

NEHTA Clinical Lead Resignations Round Up And Some Thoughts On Implications For The Future.

I had heard some rumours on this news Tuesday afternoon and these were confirmed when this came in early Wednesday  August 14, 2013:

Peter Fleming to NEHTA staff:

Dear Colleagues,
This announcement is to inform you that Dr Mukesh Haikerwal AO will soon be stepping aside from the role of National eHealth Clinical Lead and Head of Clinical Leadership and Stakeholder Management with NEHTA.
I would like to acknowledge the tremendous expertise that Dr Haikerwal has contributed to eHealth in Australia. For many years he has been a tireless advocate to turn the eHealth vision into reality, with the Personally Controlled Electronic Health Record system now being well established and moving into a new phase. Dr Haikerwal will no doubt continue to advocate for the transformative ability of technology to improve healthcare delivery and outcomes for all Australians, and indeed worldwide in his role as Chair of the World Medical Association.
Over the past months, Dr Haikerwal and I have been in discussions with the Department of Health and Ageing about the way NEHTA and governments engage with healthcare providers, peak bodies, consumers, vendors and other key stakeholders who are playing a role in transforming healthcare delivery through eHealth.
This discussion aligns with NEHTA’s shift in focus from designing and building national eHealth infrastructure to implementing and supporting adoption of eHealth. As we are reaching the conclusion of these discussions, Dr Haikerwal has advised me that he sees this as the right time for him to step aside from the leadership role with NEHTA he has held for the past six years.
Mukesh brought to NEHTA the advocacy for a clinically led national eHealth programme and built a strong network of clinical leads who are experts across the entire Australian clinical landscape. This network, together with the internal Clinical Unit Mukesh developed, were successful in embedding clinical perspectives and needs into the design of NEHTA specifications which directly support the uptake of eHealth systems which are being implemented today. It is this tireless effort in the years of design which has provided a solid foundation for years to come. Mukesh will officially finish at NEHTA on 22 August.
On behalf of NEHTA, I wish Mukesh the very best in his future endeavours and look forward to continuing our dialogue on eHealth in the future.
The Executive team are meeting next Wednesday to discuss changes to NEHTA’s structure that arise from Mukesh’s departure and other recent changes. I anticipate these changes will be finalised and communicated shortly thereafter.
The first press coverage was found here:

Mukesh Haikerwal leads NEHTA exodus

  • by: Fran Foo
  • From: Australian IT
  • August 14, 2013 4:39PM
THE National E-Health Transition Authority has been rocked by the departure of top clinical lead Mukesh Haikerwal alongside other senior executives working on the e-health records project.
Sources told The Australian that several clinical leads, including Nathan Pinskier and Chris Pearce, have also resigned.
Dr Haikerwal, a former Australian Medical Association president and NEHTA's head of clinical leadership and stakeholder management, will officially leave on August 22.
He has been instrumental in promoting the benefits of the $628 million personally controlled e-health record system, especially in trying to woo doctors to adopt the platform.
Lots more here:
Next we had a good few on the next day:

Shock mass departure of NEHTA leads

15th Aug 2013
FOUR of the most senior clinical leads of the National E-Health Transition Authority (NEHTA) have quit following a massive breakdown in relations between the authority and the Department of Health and Ageing, sources confirmed today.
The shock departure included the man widely regarded as the figurehead of the personally controlled e-health record (PCEHR) former AMA president Dr Mukesh Haikerwal and clinical leads, RACGP e-health standing committee members Dr John Bennett, Dr Nathan Pinskier, as well as Dr Jenny Bartlett.
All were understood to have had contracts which expired in August. A fifth clinical lead Melbourne GP Dr Chris Pearce told MO he had quit “not even remotely disgruntled”. Rather, he made the decision to concentrate on his research.
Lots more here:
Next we had this from the AMA.

Dr Haikerwal NEHTA resignation raises serious concerns about clinical input to PCEHR

AMA President, Dr Steve Hambleton, said today that the resignation of Dr Mukesh Haikerwal, head of clinical leadership and stakeholder management, from the National Electronic Health Transition Authority (NEHTA) raises serious concerns about clinical input to decision-making in the implementation of the Personally Controlled Electronic Health Record (PCEHR).
The resignations of Dr Haikerwal, a former AMA President and NHHRC Commissioner, and other clinical leads, including Dr Nathan Pinksier, come amid reports that the Department of Health and Ageing (DoHA) is taking over engagement with the medical profession and IT industry over the design of the PCEHR.
Dr Hambleton said that the AMA has long advocated that the success of the PCEHR depended on how it met clinical needs.
Lots more here:
Then we also see the News Limited view:

Angry doctors quit over e-health system

  • News Limited Network
  • August 15, 2013 10:14PM
THE government has been rocked by the mass resignation of doctors advising it on its troubled $1 billion e- health system.
The system barely functions a year after it was launched and this week former AMA president Dr Mukesh Haikerwal and Dr Nathan Pinksier and two other advisers quit in frustration.
Although 690,000 Australians have signed up for an e-health record the Department of Health has admitted only 5427 patient records have been provided by doctors.
"There is less than a 0.5 per cent chance that doctors or hospitals will find something of clinical relevance if they consult these records," Australian Medical Association chief Dr Steve Hambleton said.
"There are over 600,000 blank records which are of no use to anybody," he said.
Lots more here:
Last for the day here:

Dr Mukesh Haikerwal resigns from NEHTA Clinical Lead

Dr Mukesh Haikerwal has resigned his position as the national clinical lead for the National E-Health Transition Authority (NEHTA), and will finish the role on August 22, and NEHTA confirmed this morning that deputy clinical lead Dr Nathan Pinksier and Dr Chris Pearce have also quit.
However a spokesperson from the Department of Health and Ageing (DOHA) today confirmed that clinical engagement remains a top priority both for NEHTA and in other DOHA eHealth initiatives.
“We are continuing to work with NEHTA to revisit consultation and clinician arrangements to ensure that the Department takes a fresh look at the design of the PCEHR system and consults with those who will engage with it,” the spokesperson said today.
“The Department of Health and Ageing is taking the lead in the consultation with medical peak bodies and industry sectors, such as the new ICT Industry Consultative Forum bringing together more than 120 industry organisations next week and the PCEHR Peak Bodies Workshop next month,” the DOHA spokesperson said.  
More here:
Interestingly this was all not covered by the SMH or Age as far as I could find.
We then got official reaction from NEHTA.

Statement from Dr Mukesh Haikerwal AO

Created on Friday, 16 August 2013
On Tuesday 13 August 2013, I tendered my resignation from NEHTA effective Thursday 22 August 2013.
I have been with The National E-Health Transition Authority (NEHTA) as National Clinical Lead since the 2007 Boston Consulting Group report.
I am a passionate advocate for health and healthcare and maintain my fervent belief that eHealth will transform the way we receive care and practice medicine. My decision to move on from my role with NEHTA has not been made lightly, and of course there is never a ‘good time’ to take this step.
However, with the eHealth system now in its current place and moving into a different phase, this is the right time for me to step aside.
More here:
and some more in depth coverage here:

Doctors quit NEHTA en masse

16 August, 2013
The top team of clinical experts behind the billion dollar e-health record system have quit en masse, leaving the Federal Government's flagship program floundering with virtually no clinical oversight.
Among the first to go was NEHTA's head of clinical leadership Dr Mukesh Haikerwal (pictured), the former AMA president, who has been the medical face of the personally controlled e-health records (PCEHRs) for the last six years.
But other key players are also understood to have quit from the executive of NEHTA's so-called "clinical unit".
These include Melbourne GP Dr Nathan Pinskier, a member RACGP's national standing committee on e-health, and Dr John Bennett.
Australian Doctor also understands that Dr Jenny Bartlett, a former executive on the Australian Council for Safety and Quality in Health Care, has left along with Dr Chris Pearce - although the reasons behind their decision to stand down are unclear.
More here:
The comments on this post are fascinating and make it clear that there are many who are less than impressed with the whole program.
Also we have here:

Doctors ready to pull plug on eHealth

Published on Fri, 16/08/2013, 08:43:39
By Julian Bajkowski
Australia’s long and troubled efforts to create a functioning national system of electronic health and medical records system is once more close to collapse.
The Australian Medical Association has expressed serious concerns over clinician input into the project following the shock resignation of highly respected clinical representative Dr Mukesh Haikerwal from the National eHealth Transition Authority (NeHTA) this week.
Other crucial clinical advisors, including Dr Nathan Pinksier and other clinical leads are also understood to have quit signalling a severe breakdown in relations between doctors and Department of Health and Ageing.
A loss of confidence by doctors in either DoHA or or NeHTA would, in practical terms, shut-off political life support for the circa $1 billion Personally Controlled Electronic Health Record (PCEHR) project because the scheme cannot work unless doctors voluntarily agree to use it.
The urgent warning from the AMA in the wake of the clinicians’ walk out now puts substantial pressure on DoHA’s high profile secretary, Jane Halton, to personally intervene to get the project back on-track.
More here:
And here:

 ‘Souring relations’ spurred mass quit of NEHTA leads

16th Aug 2013
THE AMA has questioned the future medical viability of the personally controlled electronic health record (PCEHR) after the shock departure of five senior clinical advisers including the scheme’s most vocal proponent Dr Mukesh Haikerwal.
The mass resignation of National E-Health Transition Authority (NEHTA) clinical leads this week came amid reports of souring relations between the advisors and the Department of Health and reports that the department was taking an increasingly central role in the rollout.
The other resignations were RACGP e-health standing committee members Dr John Bennett and Dr Nathan Pinskier, as well as Dr Jenny Bartlett. Melbourne GP Dr Chris Pearce also quit but he told MO his decision was because of a desire to concentrate on research.
Lots more here:
Each of these articles provides a slightly different take on what has happened - and a worth reading in full - but the conclusion seems to be that this event is something of a watershed even in the life of the PCEHR.

For the last few months Dr Haikerwal and his colleagues (along with the AMA and the RaCGP) have been saying they are not happy with the way the PCEHR was evolving and the lack of clinical involvement in the overall process. NEHTA and DoHA did respond to this to some degree but apparently the response was either too little too late, not credible or not the right response and we have then seen what we seen.

There were also concerns about the fundamental design and its ultimate suitability for purpose.

What I also find very interesting is the degree of coverage these resignations have obtained. To me either this means that the journalists see an important statement being made here or it is recognised that we are in an election campaign and that this issue might just be important and get a run - especially with all the recent Government advertising on the topic.

There is another take on what is needed from Dr Edwin Kruys found here:
Very sensibly he has a major focus on Governance - a line I have pushed for years now!

Another point that has not been mentioned as far as I know is that the current Deloitte’s Refresh of the National E-Health Strategy now has a real opportunity to see if some worthwhile improvement can now be planned. If ever there was a time for a full review - along in my view with a full review of the PCEHR Program by the Auditor General - it is now. It seems to me that without major change the whole thing is doomed.
I am interested in knowing what others think will be the outcome going forward.

1 comment:

Anonymous said...

What's more to be said than execute the Advanced Directive and cease anymore life-support (funding) on this Dead-on-Arrival (DoA) PCEHR bureaucrats baby!

Biggest lesson to learn is never give this magnitude of Taxpayer funds to unaccountable bureaucrats (DOHA) and untethered QANGO sycophants (NEHTA) to fuel their deluded technocratic wet-dreams.

Despite the obvious debacle of the slow-moving PCEHR train-wreck, it must be a new record for wasted taxpayer funds spent and not a solitary political ribbon cutting ceremony reported anywhere!

A tragic unconscionable joke on the Australian polity.