Sunday, August 24, 2014

Some Interesting Reactions To NEHTA’s Legal Letter And NEHTA’ s Overall Position.

First I had this e-mail.  Quoted with permission but not attributed .
The e-mail is referring to the poll that is running on the blog from 24 August, 2014.
“With respect to your latest Poll, the BCG Papers and EHealth Strategy (2004) unfortunately midwifed NEHTA into existence.  Based on their constituted 2yr review, it doesn't take too much super sleuthing to localise where the Governance issues are to the appalling lack of ehealth progress tragically observed to be missing over the past decade.
The past 10-year direct cost to the Taxpayer consumed by NEHTA is distasteful enough let alone the unfathomable "opportunity cost" their unabated incompetence has been on the healthcare system and ehealth sector of Australia.
And They Don't Care!
Deloitte in 2008 and now the PCEHR Review (2013) both recommended dissolving/winding down NEHTA and yet somehow miraculously they still keep on trucking and consuming Tax Dollars.  If you look at the names on NEHTA's Board and its surrounding alphabet soup of committees, advisory bodies and panels pretending to "Govern" eHealth in Australia, you will find over the past 10 years a common cast of characters that has gladly taken plenty and given nothing as far as positive contributions to Australia's eHealth, with this fish very much stinking and rotting from its very mindless head!
If at minimum nothing else changed but the ceasing of wasted taxpayer dollars thrown at NEHTA and its surrounding constellation of parasitic panels, sycophants and free riders, that alone would make Australia better off in returning these funds back to the taxpayer just as a responsible corporation would return unused or underused funds back to its shareholders for potentially better use and hopefully greater investment returns elsewhere.”
If you want to read these various reports supporting this view go here:
(There is a good collection of strategy files found here. If you have others that would be of interest to others please e-mail them to me and I will put them up. We probably needs a State Strategy page and an evaluation of e-Health Page)

It is always good have such a well-articulated view highlighting just what I also happen to believe has gone wrong. To me, NEHTA has a lot of competent staff who are being badly betrayed by the leadership and the Governance framework NEHTA exists under. We all know change is desperately needed but for some reason it doesn’t. Theories welcome!
This point has been emphasised to me by a number of people who know NEHTA very well indeed.
From a legal aspect the advice has been pretty consistent and helpful (nice to have partners in major firms help pro-bono - there are still some good guys around.)
1. NEHTA seems to have rather over-reacted - an e-mail would have worked!
2. It is sensible to remove the posts.
3. Treat the letter as confidential.
4. Keep an eye out and do not allow posting person specific comments that are negative.
Thanks to all for the supportive comments and do vote on the current poll!


Anonymous said...

Deloitte in 2008 and now the PCEHR Review (2013) both recommended dissolving/winding down NEHTA.

The problem, as I have often predicted, is that the various stakeholder governments were led by the nose into establishing such a complex entity that they now do not know how to unwind it without all of them having to bear considerable pain and backlash from the nation's taxpayers. They have tied themselves up into one humongous Gaudian knot.

Anonymous said...

I think that people have misunderstood the "dissolved" word. The report says:

"It is recommended that NEHTA’s current overarching role be dissolved and replaced by an Australian
Commission for Electronic Health (ACeH)"

But it also quotes from the Deloitte's review:

"Key to strengthening the current governance arrangements will be the establishment of an eHealth entity (created
through the transformation of NEHTA) that is focused on coordinating execution of the national strategy and the
nationally funded eHealth work program"

The key word here is "transformation". People seem to have appended "and washed down the drain" in their head when reading the word "dissolved", instead of hearing the apparent intent from the Deloitte's report of "and will become part of something bigger and better" (which retains all of the thing dissolved).

And since one of the authors is now chair of the board, shouldn't we expect this "dissolving" upwards to start happening soon?

Anonymous said...

Got to love the nehta wishful thinking/spin merchant post. Let's redefine the meaning of dissolved now! I mean it will be so much better if we just take what we have now and throw more public money at it because that's all that's wrong.

Suprised we don't have nehta lawyers at the blog again now over the interpretation of 'nehta dissolved'.

Anonymous said...

Oxford English Dictionary:

Dissolve [verb]

2 [with object] Close down or dismiss (an assembly or official body): the National Assembly was dissolved after a coup

PCEHR Review Report Recommendation: (p.15 2013)

2. Restructure the approach to governance, dissolve NEHTA and replace with the Australian Commission for Electronic Health (ACeH) reporting directly to the Standing Council on Health (SCoH).

Deloitte National E-Health Strategy (p.67, 2008)

Specific Actions
Given the strong national consensus for action and the amount of E-Health activity occurring at a national, State and Territory, regional and local level around the country, there is the need to move quickly to establish an appropriate long term E-Health governance regime. A pragmatic option is to leverage the existing NEHTA organisation and legal structure as the basis for creating the new E-Health Entity. In NEHTA, Australia has created and invested in a vehicle for the progression of the national E-Health agenda and, whilst the journey to date has at times been problematic, it represents the best foundation upon which to build momentum behind a national E-Health work program.

This recommendation will require changes to NEHTA’s constitutional basis to extend the range of organisational responsibilities and to end the transitional nature of the authority. It should also involve changes to the organisation’s brand, culture and operating model and the creation of a revised operating structure supported by appropriately qualified leadership and specialist resources.

In order to ensure there is a clear distinction between the new entity and NEHTA, there is a need for a formal transition process which should be completed over an estimated six to nine month time period.

Impact on National Governance Boards and Committees
Establishment of the recommended E-Health governing board will impact existing E-Health national governance committees, in particular the National E-Health and Information
Principal Committee (NEHIPC) and the NEHTA board. It is recommended that the NEHTA board be dissolved and, as appropriate, members of this group be inducted into the new EHealth governing board. NEHIPC will need to work closely with this new governing board (possibly cross-membership) to inform and manage policy issues, and facilitate the alignment of national E-Health and information management priorities and initiatives. Clarification of the roles, communication and reporting relationships between the NEHIPC and E-Health governing board should be addressed once the charter of the new governing entity has been defined.

Yep, pretty easy to see how this PCEHR recommendation (2013) and Deloitte’s recommendation (2008) may easily be misinterpreted and overblown as some pedant readers here suggest.

These verbatim extracts from the referenced documents by no means suggest any agreement and/or endorsement of their recommendations!