Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Saturday, September 17, 2016

I Can’t Say I Feel Much Sadness About This. She Never Really Grasped Health IT In My View

This appeared late yesterday.
September 16 2016 - 5:28PM

Finance Department secretary Jane Halton quits

Finance Department boss Jane Halton has announced her resignation.
The department's staff were told on Friday morning of her pending departure after 33 years as a public servant and 14 as a departmental secretary.
Deputy secretary Rosemary Huxtable will act in Ms Halton's position from October 15 until a permanent replacement is found.
Ms Halton has been one of Australia's highest-profile bureaucrats since she chaired the Howard government's "people smuggling taskforce" in 2001 and was at the centre of the children overboard affair.
Despite the bitterness the affair engendered on the left of politics, Ms Halton worked effectively with subsequent Labor governments, most notably as secretary of the Health Department and her role in delivering Labor's plain packaging for cigarettes.
Here is the link:

As the person who headed the Health Department when we were given the PCEHR and referred to my good self as a ‘nuisance blogger’ at Senate Estimates – I feel little sorrow that she has gone!
Just to be clear – I am sure she is a lovely person – just not much good as a leader of National E-Health! My criticism is professional not personal.


Anonymous said...

Rumour has it that Jane Halton was the reason the Finance Department took back money from the Department of Health (budget changes). The department once had descretionary funds available for PHCRIS, FMRC and other uses.

Then suddenly those funds were no longer available for DoH to spend and the services were defunded.

Anonymous said...

Mmmm - Some people move mountains building monuments. They do things that others won't do. Farewell.




Bernard Robertson-Dunn said...

The problem with both Tony Abbott and Jane Halton was their perspective. They both looked at healthcare from a Federal and funding position.

As such, personal healthcare was not their objectives. These were:

a) how to collect data for policy, research and other purposes
b) how reduce healthcare costs.

So, when they created NEHTA, NEHTA's objectives were to collect as much healthcare data as possible to support the Federal Government's objectives. Which was why they built a rather dumb database of documents and facilitated access to "repositories", rather than work out how it could be used to support either patients or healthcare professionals.

They've never addressed the second point - reduced healthcare costs. They've never even tried to justify how they would do it, other than motherhood statements saying that sharing healthcare data is a good thing.

NEHTA disguised their database as eHealth infrastructure, but the real infrastructure components (NASH and secure messaging) have never been properly built.

What they have built is a big data sucking machine, but they can't set it working without GPs putting data into it. Hence the bribes. GPs have no interest in making their own lives harder without any gain - other than financial through the ePIP program.

They made a number of mistakes along the way, the most important one being to make it personally controlled. This immediately destroyed its usefulness as a clinical tool. It was done to aid in selling it to the populous but has IMHO, backfired spectacularly - neither patients nor GPs believed the story.

That means, in the end, NEHTA built the wrong solution to the wrong problem.

Then Royle review pointed out all sorts of things wrong with the PCEHR as a solution, without addressing the problem - who is it for and what is its value?

Most of the things wrong have still yet to be resolved but the two things the government did, in support of its objectives above, were

a) to try and make it opt-out.
b) create ADHA

The first point only makes sense in the context of the government's objectives. It won't address patient's and GP's concerns and issues, in fact it will make them worse.

The direction set by Abbott and Halton is still the guiding star for Health and ADHA.

Unfortunately, ADHA has been set up in the context of My Health Record and under the control of the Health Department. For all the talk about eHealth and Digital Health, the main game is collecting health data and sharing it within government, with research organisations and potentially with commercial operations.

Good luck to them after the census and the mess they've made with the trials, i.e. removing the legal requirement for consent to collect patient's health data. That makes it even harder to argue that patients who have consented to having their health data collected for personal health care have also consented to allowing it to be used for other purposes.

They've sorted the legal problems so now they can collect health data without consent. Hospitals are already automating uploading of discharge summaries but GPs are not putting much in. Getting it out and sharing is proving a bit harder.

IMHO. the real issue facing Mr Kelsey is not will he realise all this, but will he be allowed to to anything about it.

Of course, this is only my opinion, YMMV.

Anonymous said...

Excellent synopsis Bernard with which I agree 100%. .....in the end, "NEHTA built the wrong solution to the wrong problem." Kelsey won't be allowed to do anything about it even if he understood what needed to be done. The Department's CIO can't do anything about it because he is drowning in the political imperatives to survive regardless.

Anonymous said...

I am sure there will be a role on one of these for her, I am sure David you and/or some of your contributors will have a chance to work with Jane http://www.digitalhealth.gov.au/news-and-events/news/1154-will-you-play-a-part-in-driving-the-digital-transformation-of-australian-healthcare

Anonymous said...

September 17, 2016 2:28 PM - please bury the thought. Thanks.

Anonymous said...

What a lovely gesture by Jane Halton – resigning “to give somebody else a chance at the top job” – how very considerate and quite a sacrifice too. Very few people would be so magnanimous. Mathias Cormann will notice a big difference. Unfortunately in commenting on her departure "the Prime Minister conspicuously omitted to use the word “retirement” in his press release"!!.

Anonymous said...

Her ambition was to run PM&C. She failed. Something isn't being said.
Under her watch, health has built a huge data warehouse that they want to fill with personal health data and let any agency that wants to analyse it. That's the real reason behind opt-out. It may or may not be totally legal. Maybe a deal has been done.

Bernard Robertson-Dunn said...

I just came across the Nigerian Health ICT Strategic Framework 2015-2020

Some quotes/extracts

"Health ICT is more than electronic health records; it is applied across the health system and services to ensure continuity of patient care across time."

"There is a special focus on ensuring privacy and security of personal health information. To maintain and strengthen trust between consumers, the private sector and the health system, use of Health ICTs must support and improve the safe, effective, efficient, equitable and timely delivery of care."

"A Health Worker Registry (HWR) is the central authority for maintaining
the unique identities of health providers within the country – “By whom” "

"A Health Facility Registry (FR) serves as a central authority to uniquely
identify all places where health services are administered within the
country – “Where?” "

"A Shared Health Record (SHR) enables the collection and storage of electronic health information about individual patients in a centralized repository which is capable of being shared across different healthcare settings."

i.e. they want a shared health record based upon clinical records, not a secondary summary system, and it doesn't seem to be patient accessible/controllable via the internet. They will be able to identify individuals who access the shared health record, like the UK and unlike Australia.

And finally, this is the person who wrote the forward:
Professor Isaac Adewole. FAS FSPSP, DSC (Hons)
Honorable Minister of Health,
Federal Republic of Nigeria

This is from his bio

Hon. Minister of Health

Professor Isaac Adewole, has been a Professor of Obstetrics and Gynaecology at the College of Medicine, University of Ibadan, Nigeria since 1997.

He enrolled as a National Award Scholar at the prestigious University of Ibadan in 1973 and obtained his MB BS degree from the University of Ibadan in 1978 with the Glaxo Allenbury prize for the best performance in Paediatrics.

He joined the services of the Department of Obstetrics and Gynaecology as a Senior House Officer in 1981 and underwent further medical training to become a Senior Registrar in the Department in 1984.

He then traveled to the UK for a Research Fellowship in the Department of Medical Oncology at Charring Cross Hospital in London. Professor Adewole was appointed Lecturer I at the College of Medicine in the University of Ibadan in 1989. He was promoted Senior Lecturer in 1992 and Professor in 1997.

He was Acting Head of the Department of Obstetrics and Gynaecology at the University from 1999-2000 and Dean of the Faculty of Clinical Sciences and Dentistry (2000 - 2002), before becoming Provost of the College of Medicine from 2002 to 2006.

A fellow of the Academy of Science of Nigeria (FAS) since 2011, he was awarded a honorary doctorate of science from the University of Sunderland, United Kingdom in July 2015, for his outstanding academic achievement and worthy contribution to preventive medicine and cancer screening in Nigeria.

In case you were wondering, this is from Sussan Ley's bio

Sussan Ley was first elected as the Federal Member for Farrer in NSW in 2001.

Before entering Parliament, Minister Ley worked a variety of jobs which provided a range of ‘real life’ experiences. At age 19, she enrolled in flight school and gained her commercial pilot's licence, which she still holds. This led to roles as an air traffic controller and commercial pilot – she has also been a shearer’s cook, wool and beef farmer.

While raising three children, ten years of part time study led to a Bachelor of Economics, Master of Taxation Law and a Master of Accounting before she took up a senior position with the Australian Taxation Office.

Anonymous said...

As an insider - Halton never really cared about PCEHR. She barely had anything to do with it, it was deputised to her Dep Sec to deal with. She only really ever got involved when she needed to be briefed for Senate Estimates or to face the Minister. After all, a secretary can't be in touch with everything that's happening in their department now can they......

Bernard Robertson-Dunn said...

Are you seriously suggesting that Jane Halton had little or no interest in an initiative that is likely to cost well over $2billion, has enormous privacy implications, is roundly condemned as being useless, but if it had been done properly could have produced great benefits, and has set eHealth in Australia back decades?

Bernard Robertson-Dunn said...

Not to mention the data warehouse they got Accenture to build for them so that they can collect large amounts of personal health data and let other agencies access it.

The $111milion business case she approved must have been a wondrous document.

"Health Reform" is such a lovely concept.