Sunday, July 26, 2015

The Consumers eHealth Alliance (CeHA) Has Real Problems With The Order Things Are Being Done With The PCEHR.

The CeHA released their submission on the planned PCEHR and IHI legislation a day or so ago.
Here is the note on their web site.

CeHA submission on PCEHR & HI discussion paper

Jul 242015
The 2013 Royle Review into the PCEHR resulted in 38 recommendations. Several years and one Health Minister later, some of those recommendations are finally being pursued by the Australian Department of Health. The Consumers e-Health Alliance submitted comments on the Department of Health’s Electronic Health Records and Healthcare Identifiers: Legislation Discussion Paper released in late May 2015.
CeHA’s submission can be found here.
Here is the link:
They make some interesting points.
First they are not keen on having the Department and NEHTA planning the future rather than the new e-Health governance  entity - the ACeH taking the lead and responsibility - pointing out the old group have not got far in a decade or so.
As they say
“The Consumers eHealth Alliance considers it premature for the Australian Government to contemplate legislative changes and pilots to test an opt-out national electronic health record-sharing system.
Instead, the priority should be consultation on the formation, composition and operational aspects of the proposed Australian Commission on eHealth, as this new entity should rightfully be tasked with decision-making on future PCEHR/My Health Record (MyHR) developments.
We believe the Department should engage in very broad community consultation with stakeholders, with a view to identifying people with the necessary expertise and bringing them together as a foundation body. We do not believe the Department should try to pick participants, as this approach has failed to date as is evidenced in various related reports.”
Their concluding remarks are also quite clear and pointed.
The Real Issue:- Why is eHealth so Hard ?
This question has often been raised. The answer has long been known - but continues to be avoided !
WE suggest that the key factor has been lack of governance appropriate to the task.
The nature of the required governance was clearly spelt out in the principal recommendation in the Health Online final report to Parliament in 2001.
This report and most others since have recommended the involvement of all key stakeholders in a collaborative Governance/Management structure from day one. This would bring their operating needs to immediate attention and could be promptly reconciled within a teamwork environment.
The allied aim would be to avoid a repeat of a silo mentality that so often arises when the various interest groups are kept apart rather than developing a dedicated teamwork spirit actively engaging within an integrated framework.
The Department of Health and NEHTA have been struggling for almost 11 years now, yet have produced few practical results for the cost to date.
A string of consultants' reports have found issues and concerns, and scant evidence of worthwhile implementations and outcomes despite more than $1 billion in spending.
The Royle and Deloitte consultations have confirmed this, and in their reports they recommend significant changes in governance.
We should not carry on for an extended period without speedily acting on their advice, which involves creating a teamwork structure involving all key stakeholders.
----- End Conclusion.
All in all a useful contribution that makes some very powerful points. Well worth a download and read.
My only point of difference would be is that I think you need excellent leadership as well as dramatically improved governance.


Anonymous said...

As both a consumer and an advocate for what E-health has the potential to deliver now and into the future, I fully support the recommendations of CeHA. Sadly the signs are that what changes ACeH will bring will be a different label on the current tin. This is self evident in reliable reports some are without shame spouting a messiah complex of sort, one particular executive supposedly is more than happy to tell anyone that they are the next entity and the MyEHR design will be there’s alone, and is simply waiting for the CEO to depart.

What is does highlight IMHO is a need to remove NEHTA executives pronto and bring in a caretaker committee overseen by the company secretary, have the department just stop. This would allow as CeHA recommends a starting point (and unpolluted), for the formation of ACeH, they are not all incompetent, however; leaving any executives in place will most likely ignite omnipotence in some, resulting in a repeat of the past at best, or at worst, Australia will be taken down an even deeper and darker hole.

Anonymous said...

My only point of difference would be is that I think you need excellent leadership as well as dramatically improved governance.

Couldn't agree more, so long as leadership is provided across ALL disciplines required to research, develop and implement. If it is just a repeat of current practice then please don't bother.

Terry Hannan said...

This is a very good conversation. As a Moderator on I initiated a discussion (robust) with the topic "Why is eHealth so hard" using Enrioc Coiera's paper with that title and my own personal (non rewarding and distressing) experiences with attempts to use eHealth tools in the clinical environement.
The discussion can be found at

Anonymous said...

July 26, 2015 10:53 PM. I have little doubt you are correct, all I can add is 'what a joke' here again is evidence that we are being treated like fools.

Anonymous said...

A joke indeed, I have given up being interested in NEHTA antics, it is a shame that one or two have made such a mess and do nothing more than hack jobs, especially in areas of such importance. The real problem as I saw it was the weak spot surrounded himself with people that would embarrass even the most harden 'yes man'. I do hope that NEHTA wakes up! as the ACeH needs to break away from the past, a lot is changing and we need people who understand the challenges ahead and are able to lead a range of disciplines to embrace emerging standards, work openly with the community to evolve the foundations and governance that eHealth is crying out for.

Now is the time to remove the bad apples, and not let the few drag the rest down. Have the collective NEHTA leaders the spine? Time will time.