Friday, April 08, 2016
The Department of Health Releases A New Draft National Health IT Strategy. How Did They Do? Not Well I Fear.
This e-mail and an attachment were sent out on April,4, 2016.
Attached is a copy of the draft National Digital Health Strategy 2016-2019 (the Strategy) for your review and comment. This Strategy has been developed in order to replace the previous 2008 National eHealth Strategy. The Strategy, once fully developed will be presented to the Australian Health Ministers Advisory Committee (AHMAC) before being recommended to the COAG Health Council for endorsement. This version is an early draft which not yet been considered officially, and as such does not currently have any formal status. We also appreciate that there is still work to be undertaken on the presentation of the document. What is important, at this stage, is to gain your feedback in relation to the content of this document. We are sending you this draft as part of a closed consultation process, and ask that you limit distribution and discussions on it to a representative group of your members at this stage.
The Strategy aims to recognise the need for increased collaboration across governments, healthcare providers, healthcare consumers, the private sector and software vendors to deliver an integrated digital health eco-system that supports healthcare provision within Australia. While it articulates the government programmes to be delivered, it's intended to provide certainty for private sector technology and innovators to encourage and foster innovation by the non-government sector. It acknowledges the need for real, consistent and ongoing engagement with consumers and healthcare providers in the design of digital health solutions.
The Strategy acknowledges the health system is changing rapidly, with new models of healthcare being regularly developed in response to opportunities, challenges and demands on the health system. Many of these changes are being driven by improved use of data. Technology is also rapidly evolving, and consumer and healthcare provider expectations of digital health solutions are increasing as they are exposed to advanced innovative solutions in other sectors such as retail and banking.
We will update the Strategy based on the comments that we receive from you and others during the consultation period. Once the Strategy has been endorsed, the Australian Digital Health Agency will take responsibility for the ongoing development, coordination and implementation of the Strategy through the National Digital Health Work Programme.
Any questions, comments or feedback that you have on the Strategy should be forwarded to James Robertson at James.Robertson3@health.gov.au by 14 April 2016.
Deputy Secretary and Special Adviser
Strategic Health Systems and Information Management
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As you might expect I have had a number of copies forwarded to me as I was not on the original distribution list. (the full distribution list was provided to all recipients in what seems to be a minor security leak).
I have read the document through and have contributed my thoughts to one of the groups who were asked to respond. Sadly I can’t reproduce the document on the blog but I have made it available here for download:
I am making this file available to readers as I see them as part of a special group who have a major interest in the future of Digital Health and who need to have a say.
My thoughts are in 2 parts. My general response is that the present document has a very long way to go before it could be considered even vaguely satisfactory.
As far as specifics are concerned I would make the following points (in no particular order):
First I believe there are so many gaps in the work I believe the document is not really worthy of being described as a strategy - it is more just a really unconnected series of assertions and desires.
Second the document lacks any real insight into the current Health IT situation in Australia, especially it largely ignores the wide range of successful private sector initiatives.
Third, there is no clarity provided as to just who the intended audience for the strategy is and just who are to be assisted and supported by the plan. Is it for clinicians, consumers, the jurisdictions the Department of Health, the private sector or a mix/combination of all of the above or something else?
Fourth, as previously noted in this blog almost decade ago, a strategy without a funding plan and commitment is the emptiest of strategies / plans.
Fifth there does not appear to be anything that could be described as an implementation plan.
Sixth the current document totally fails to review the 2008 National E-Health Strategy to draw lessons on just what matters in actually delivery of a Strategy and fails to analyse where the successes and failures lay and why.
Seventh it is clear that the present document has been inadequately consulted on with many stakeholders largely ignored and no real consultative processes conducted, with an overwhelming predominance of Government staffers.
Eighth the document is excessively focused on the myHR and while recognising it is not fit for purpose - suggests the need to press on while trying to fix it. If ever you saw a chicken and egg problem - this is it!
Ninth the current document fails to grasp that Health IT needs to clearly recognise at least two customers - of which the health care providers are the most important - for the strategy (the other is the public/consumer). It is not clear the same solution can work for both classes of stakeholders.
Tenth the document is really weak on evidence, benefits analysis, overseas research and a realistic technology assessment and future analysis.
Eleventh there really is not a clear strategic situation assessment and a future vision.
Last it is not clear just how this document relates to the nascent Digital Health Authority - which is meant to be a strategic organisation.
Overall this document has a very long way to go I believe before being a half useful contribution to the state of play.
I would ask that those who are interested download the document and comment - I am sure DoH will have someone having a browse of the comments!
Posted by Dr David More MB PhD FACHI at Friday, April 08, 2016