Sunday, August 25, 2013
This Is A Really Excellent Article On The E-Health Machinations Going On In Canberra. A Careful Reading Is Warranted.
This appeared a day or so ago.
By Julian Bajkowski
The Australian Medical Association (AMA) has held crisis talks with the head of the federal Department of Health and Ageing, Professor Jane Halton, over the unprecedented walkout of clinical advisors from the nation’s decade long $1 billion effort to build a functional eHealth system.
Held on Tuesday, the meeting followed calls by AMA president Dr Steve Hambleton for Professor Halton to intervene and take a “personal focus” on why highly respected eHealth clinical advocate Dr Mukesh Haikerwal and several other medical advisors suddenly parted company with National eHealth Transition Authority (NeHTA) after a decade of attempting to make eHealth an everyday reality.
The situation that is emerging is that DoHA, assisted by contentious technology consulting and services firm Accenture, are poised to take on far more control and work to finally deliver software end-products to doctors and hospitals leaving an existential question mark over the future of NeHTA.
Dr Hambleton told Government News described the meeting with Prof. Halton as “extraordinary.”
“Clinical utility will drive this thing,” Dr Hambleton said. “If we can’t get it from NeHTA let’s get it from somewhere else. We have got a railway line … we just don’t have any trucks.”
“We can’t be driven by the techos,” he said.
The metaphor of rail lines, and the attendant headaches they have caused the Australian Federation, appears to be a highly prescient one.
It is understood that a major driver for greater federal involvement is that state governments, particularly those held by the Coalition in Victoria, New South Wales and Queensland are now far less willing and financially able to plough in the cash resources required to make a doctor-friendly front-end appear.
Ironically, the latest hiccup comes despite much of the back-end infrastructure for eHealth already being in place.
“It’s not a big jump. We just have to make it happen,” Dr Hambleton said.
Either way, the support of what some Canberra bureaucrats cheekily refer to as the “doctor’s union” is essential for any eHealth scheme to work because state and federal governments simply cannot, nor want to, compel clinicians to use it.
Relations between DoHA, NeHTA and the doctors have been strained now for some months over apparent difficulties in providing a usable system interface that provides what clinicians term “clinical utility” - or the ability for the system to be used for practical work by doctors.
A number of informed sources have suggested that reticence of the big states to keep ploughing long-term financial resources into NeHTA through the Council of Australian Governments has effectively left Prof. Halton and DoHA in control of the wider eHealth delivery agenda by default.
“It’s a pretty desperate lot that they are left with,” one government source said.
Much more here:
On the basis that Dr Hambleton is being accurately reported I have to say I am concerned he is being rather more optimistic regarding where we are in terms of the quality and utility of the present e-Health infrastructure than I am at present. However I really think he is spot on in the diagnosis that without ‘clinical utility’ the whole effort is doomed.
I also agree strongly with the comment that without real AMA support and commitment the e-Health Scheme is doomed to fail.
The sooner DoHA and NEHTA face up to this fact the better for all of us and the less money will be wasted.
As a general point I think that there are some really useful and sensible things happening in e-Health - some of which I plan to write about during the week - but I have to say the Federal Government interventions have been by far the least valuable and evidence based and have cost the most. Hardly a great recommendation for Government intervention in what is a complex health / technology space that requires a good deal more understanding than is presently apparent.
I note in passing that other e-Health interventions from DoHA in other areas such as the AMT are also going badly at present with the Government just ignoring the expert advice they are receiving and leaving patient safety under increasing risk.
Posted by Dr David More MB PhD FACHI at Sunday, August 25, 2013