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


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Sunday, June 04, 2017

The ADHA Issues A Tender For Work It Should Be Doing Itself In My View. Also Some Very Odd Terms.

This appeared last week.

Strategic Interoperability Framework RFT

Vision for a connected Australian Health System

Australians and their clinicians want a seamless health system which delivers high quality, safe care through better sharing of information.
The Australian Digital Health Agency today has released a Request for Tender (RFT) to develop a Strategic Interoperability Framework for Australia.
Ms Bettina McMahon Executive General Manager, Government, Industry & Delivery will lead this important work, saying "Sharing patient information across the Australian healthcare system is a complex issue requiring the alignment of policy, workflow, patient information, even business models."
The Australian Digital Health Agency has a requirement for the provision of services to develop an interoperability strategy for the digital health ecosystem in Australia.
"Interoperability requires recognising the known concerns of patients and healthcare providers and working through useful approaches to manage the potential risks."
"Ultimately, an interoperable health system will provide a seamless service experience for a person using health services," said Ms McMahon.
The CEO of the Australian Commission on Safety and Quality in Health Care, Adjunct Professor Debora Picone AM, has welcomed the decision to tender for a national interoperability framework: "We know the key to a high-quality health care system is the secure, timely and accurate sharing of information between health providers and their patients."
"The Commission is looking forward to working with the Agency and Australian jurisdictions to support an interoperable health system," said Adjunct Professor Picone.
The Agency's recent consultation with the community, including more than 1,000 survey responses and written submissions, revealed that over 65% of respondents said the Australian healthcare system is difficult to navigate. People want to know the cost, quality, and availability of services, and experience a more integrated service experience.
The outcome of the RFT will shape the future design of an interoperable health system where the Australian Government continues to own, operate and deliver the infrastructure and work with industry to ensure that Australians can access the health information they need where and when they need it.
Responses to the RFT close at 11am local Sydney time on Monday 26th June 2017, with a procurement phase for the new system expected to commence in the middle of 2017.
Download the following RFT document:

Request for Tender Number 0329 - Strategic Interoperability Framework and Draft Contract

Here is the link:
The core of the Request for Tender (RFT) is the services required:
B.                                Services

B.1.                           Description of Services
There are two key deliverables to be provided by the successful Tenderer as part of the Services.
B.1.1.                     The first key deliverable is:
a.         to undertake a review of current state that documents successful interoperability efforts in other jurisdictions or industries where relevant to the Australian health system and the key success factors, not limited to technological factors (the measures of success should also be spelt out); and documents the current health interoperability directions and strategies that are being pursued in the jurisdictions within Australia. The review of the current state is required to include an international literature review to inform the Agency of what is working in other jurisdictions.  The successful Tenderer will be required to:
i.           provide a written report detailing its findings from its review of the current state;
ii.          present its findings to the Agency in the form of a powerpoint presentation.
The second key deliverable is:
to develop a ‘Strategic Interoperability Framework’ to support the Agency in the development, delivery and ongoing assurance of a digitally interoperable environment within the Australian healthcare sector. This Strategic Interoperability Framework will be required to include an overview of guiding interoperability principles and the component parts of an interoperable health eco-system that would deliver more connected services to people accessing health services in Australia. This Strategic Interoperability Framework will be required to establish a practical approach to deliver a digitally interoperable health system for Australia and deliver the Agency’s vision of interoperability. It will be used as the foundation for an implementation plan to address current disconnections and move Australia to a more interoperable environment within a 5 and 10 year timeframe.
b.        To support this second key deliverable, it is a requirement that the successful Tenderer develop a consultation plan for approval by the Agency.
B.1.2.                     During the provision of the Services and the development of the strategic interoperability framework, the successful Tenderer (if any) will be required to consider the following factors:
i.              provide a written report detailing its findings from its review of the current state;
i.ii.  clearly identify component parts of the current state of the system with respect to interoperability principles which are working effectively, and where there are gaps that require modifications, improvements and further developments in order to address these
ii.iii. present its findings to the Agency in the form of a powerpoint presentation.
a.         the broad range of digital health related interoperability standards, guidelines and policy which are required across different technical, professional and safety domains to enable an interoperable health care environment, their variable states (and drivers) of development and adoption, and their interconnections with each other, best practice and current industry and jurisdictional directions, as reviewed in the first deliverable, being the review of the current state;
b.        the ability to connect and empower care providers and to support people to have more control and choice;
c.         the Agency’s core principles including co-design and the engagement of health care consumers, clinicians, industry and research in the creation and ongoing development of all of its products and services;
d.        an evaluation process to determine the success of the development and application of the suggested interoperability strategic framework;
e.        the appropriate balance between cost, outcome, efficiencies and risk in the adoption of the suggested interoperability strategic framework, including funding considerations for the potential adoption and ongoing development and assurance with compliance of interoperability requirements for health services;
f.          the suggested Strategic Interoperability Framework should be developed and operate in harmony with our developing national digital health strategy and the Agency’s ongoing workplan priorities; and
g.         the suggested Strategic Interoperability Framework should support the principles of equity and access for all Australians to safe and high quality health care services.

B.1.5.                     The Strategic Interoperability Framework will be required to include the following audiences:
a.         the community; including healthcare consumers and their carers;
b.        software vendor organisations, including clinical software and secure messaging vendors; innovators new to the health sector; and the system operators (e.g. HI Service operator, NASH operator, My Health Record system operator) via the Australian Digital Health Agency;
c.         Australian Commission for Safety and Quality in Healthcare; and
d.        Standards Australia and its digital health subcommittee/s.
B.1.6.                     Prior to the commencement of this consultation, the successful Tenderer (if any) will provide a consultation plan to the Agency for approval.
B.1.7.                     The successful Tenderer (if any) will be required to provide weekly project status reports to the nominated Program Manager within the Agency. The format of these reports will be specified by the Agency.

----- End Extract.
Strangely there is the following just below the extract above:
Commencement of Services 17th of July 2017
The Services are required to be delivered in full by 30th of August 2017.
So it seems, as best I can tell, the whole of the work is to happen in about six weeks – obviously a really in-depth study. (At another point Sep 30th 2017 is mentioned – but not clear why.)
From my perspective I have simply no idea what can usefully achieved in the time available and why the skills to undertake this work are not in the ADHA. Surely this is very specialist work which general  IT consultants would need considerable time to become familiar with?
Also, the idea of developing a plan for the next 5-10 years in six weeks seems bizarre to say the least!
This is certainly an RFT I would let go through to the keeper.


Anonymous said...

It also comprises work that had already begun and to some extent progress to quite a good state. This work was well communicated internally and within constraints externally. Having been asked to contribute on some of it I will watch to see if the tax payer is being played. My money is this will go to EY or PwC.

It is sad how it has come to this but out of respect for those who fell victim to these scammers I will leave well alone, however they are being watched.

Anonymous said...

Happy for partners to be used, there are excellent Australians out there who work inderpendantly. why i agree with you let it go through to the keeper statement David, is without anyone of knowledge and experience providing steerage from the customer it will be near impossible. I also question if the work could be understood enough to be successfully implemented.

Anonymous said...

Agree the terms, expections actually the whole thing is confusing. To go to open tender indicates a large sum of money. Very suspicious. As someone else pointed out, the the national digital health strategy successful implemtation does not bring about interoperability then what is its purpose?

Had such hopes for the ADHA

Anonymous said...

This is quite a revealing price of work.

There is seemingly a need for a major legal firm to draft a standard RFT. Why? Why is a Federal Government RFT not used? And how much did the RFT cost? Why is it not used by the other initiatives released under the tenders page?

As it is drafted by a reputable legal firm you can guarantee no rephrasing of the deliverables was applied so this is an excellent insight. Are these the right people to be overseeing sure a complex and important undertaking?

Was this approved by the CEO? Was it even reviewed by the CEO? Was it known by the CEO to have been released?

What if any publication processes where followed to allow two revisions to be published and no traceability of the retracted Government documents available? Will the content be changed without notices going forward?

Why after only weeks of making the standards and interoperability team redundant we have this abvious standards and interoperability RFT released?

And ultimately it brings into question the CEO's ability to manage the Agency?

Why will this be yet another set of unanswered questions raised by concerned tax payers?

Anonymous said...

Be best if this is ignored so that hopefully it does not undermine other more productive , open and honest undertakings by parts of the ADHA who seem to be making progress

Andrew McIntyre said...

Its plain silly to be kind. Its like mapping out to progress of the internet over the next 5-10 years and choosing technologies that will be used. Not only does it potentially pick winners that will not actually work, it also effectively kills new innovations that might come along in the meantime.

I firmly believe that the governments role is to regulate the use of existing technologies via standards compliance requirements to try and ensure patient safety and encourage inter-operability. To try and map out a future is naive and potentially damaging. They need to encourage safe evolution and perhaps reward outcomes, but even rewarding outcomes is pretty dangerous if the PIP scheme is any guide to the ham fisted ways they try and do it. In reality the users are they ones that should pick winners, as long as the solutions comply with standards and don't try and create fiefdoms/data islands that block inter-operability. We have had many attempts at this type of plan and they have all failed, and so will this one.

Anonymous said...

Would seem a pretty loud and clear message from the Executive General Manager, Government, Industry & Delivery. The ADHA will dictate the market direction. If you do not fall inline what then? This does not read well for industry, I guess the principles of co-design are more codesign what you are told to codesign and when your opinion is required you will be given it.

Clearly the CEO has been fibbing to the Australian public or is not dealing in charge.

Anonymous said...

Executive General Manager, Government, Industry & Delivery, okay so definitely ticks the zgovernment box and ticks the Government attitude towards local industry, delivery, well not really of to much of a start, wonder what the actual scope of that is?

Looking forward to public comment, consultations, anyone know if there is to be an open webinar before responses can be lodged or will this be a classic case of , release dribnle, disappear for a month on 'holiday' come back and sacrifice a manager or two for it failure?

Anonymous said...

You only need to look at the Adani mine situation to get a sense that democracy, consensus, court rulings of the law in general or any regard to the broader wishes of the people are no longer a concern. You think a few little local businesses and the protection of our privacy is going to stop this lot advancing their careers and agendas.

If the PM is willing over turn land rights then no one is safe.

Bernard Robertson-Dunn said...

Open Systems, GOSIP, Clients First, Whole of Government Outsourcing.

Recognise any of these initiatives? I've lived through and participated in all of them and learned many a useful lesson, which is more than I can say for most if not all in ADHA.

The Federal Government, as the largest spender in Australia on IT, has tried multiple times to influence the market and failed miserably.

What's different these days?

A puny little, under-resourced and under skilled agency with no authority to impose anything on the healthcare market has no chance.

It's like watching children at play.

Anonymous said...

Totally agree Bernard, they seem to be struggling with their basic website. Heaven help them with something as trivial as the health system.

Peter said...

A standard Enterprise Architecture engagement will tend to be between 6-12 weeks depending on the depth of analysis required. The approach is usually involves a current state description, gap analysis, future state proposal and a high level roadmap of projects to get there.
There is an assumption is that key information is available but might need some work to extract. Otherwise the steps are fairly well defined and process well established.

There are complications in the RFT (e.g. review of nationally and international jurisdictions) but nothing insurmountable. We recently carried out something similar for a state government agency which took 2 people for about 60 days each over a duration of 25 weeks (so part time). That engagement was broader than the one described here in that it included operating model etc. as well - but probably not as deep. It was not in health of course, but that would not be particularly relevant at the level described.

In short, it is quite do-able, but I am not sure if the timelines are practical.
And I am completely avoiding the original question of whether ADHA should be out-sourcing the activity, or would be able to do anything with the result anyway.

Bernard Robertson-Dunn said...

A standard Enterprise Architecture approach is totally unsuitable for this problem.

Enterprise Architecture is fine if you already understand the problem of the enterprise reasonably well, the environment in which it operates is stable, and you have the authority to implement any solutions identified.

The healthcare ecosystem is both far more complex and is comprised of multiple wicked problems than any enterprise. There many are independent stakeholders with diametrically opposing objectives - many vendors and even some health care professionals (think pathology labs) don't want to reduce the spend on healthcare.

Not only are the problems difficult to deal with, but the available and enabling solutions keep changing. The Internet of Medical Things, as well as advances in genome medicine is going to have an enormous impact on healthcare; you can be sure it will not be stable.

The one thing that healthcare is going to have to be is flexible and adaptable; characteristics that cannot be applied to MyHR.

IMHO, ADHA should just get out of the way and let the healthcare industry get on with trying to cope with change, take risks (although not with the health of patients) and develop innovative solutions. If there is consensus to develop some useful infrastructure then government may have a role, but only a reactive one, not a leadership one.

Dr David G More MB PhD said...

Having read all the comments it seems to me I might have missed a key question.

Namely just what is actually required out of this engagement that will actually make a positive difference. As Bernard suggests there are a lot of tigers hiding in this ecosystem that are not easily resolved and made coherent.

Getting something useful and practical out of all this, that is acceptable to all stakeholders is going to be quite an ask.

Do others think this is a doable project with all its complexities in some reasonable time and for some sensible cost?


Anonymous said...

Something might be doable, they might define points of integration at a technical level, but the EGM calls out business processes and policy, in 6 weeks to define the changing business processes and policies to enable open interoperability in our healthcare setting sounds challenging. It would only stand half a chance with a smart insightful customer, with the greatest respect I do not see either person attached to this as a smart customer in this subject.

Hands up all clinical folk that want their clinical processes redesigned? Same for business owners, fancy government dictating your operational processes? The art is in coaxing different systems into working together, not stamping them out so there is only a vanilla flavour

Dr Ian Colclough said...

No-one with a reasonable amount of practical experience would deny the complexity of the health system's clinical and business processes. Contemplating redesign of business processes at the grass roots level, if that is what is intended as you seem to be suggesting, is impracticable and unacceptable.

As Andrew McIntyre (10.32 PM) politely said "It's plain silly to be kind".

For far too many years the Australian eHealth scene has been lacking in two fundamental elements at both the political and department levels - Leadership and Strategy, underpinned by extensive practical experience across both industries and a huge amount of nous.

Anonymous said...

Having pondered this confused RFT I am wondering the problem resides in a mishmash of terms, it seems to be overshadowed by a collective of latest buzz words and an obvious limited understanding of Interoperability. This to me devalues the document and what the intent may have been. I also agree with other commentators that if the Digital Health Strategy is not a pathway to interoperability then what is it?
I am guessing we will be unlighted in the fact that when viewed from the perspective of ‘connected care’, the Australian healthcare sector is severely fragmented, something that stems from a series of historical decisions that have left the market with numerous disconnects and incompatible problem constructed through a overly complex and politically driven mix of: Private and public health services. Different levels of (non-integrated) primary, secondary, in-hospital, ancillary and allied healthcare. Multiple sources of funding and payment from public and private sources and consumers themselves.
Multiple legislative and contractual frameworks across the jurisdictions and funding/payer environments. Numerous policy, administrative and compliance bodies and agencies operating at state, territory and Commonwealth government levels. Multiple reporting regimes and data collection requirements. Frustrated possibility of data sharing that is essential for fully informed healthcare and wellbeing

If the intent is to expose and document the multiplicity of historical decisions which have resulted in a health market that is acutely fragmented, as a result of political and greed/power driven organisations both private and public as well as the ever present political meddlers like NSW labour. Is it that what this work really intends is not interoperability nivarna but really to expose the fragmentation across policy, regulatory and health management settings, and through this provide the Federal Government a means to strip away the influence and control of the States and territories, provide a hammer to bring vendors and insurance companies to their knees and control them. Is the hidden agenda to expose and assign responsibility for the fragmentation across Commonwealth and state/ territory legislation and regulation that directly or indirectly governs health data. Expose and implement a tyrant regime to devour those responsible as identities by the ADHA for the fragmentation across many funding regimes. Expose and shame those the ADHA see as root causes for the fragmentation at the level of who provides care and in what setting, and which party or parties pay for this. If as I suspect this is to expose for nothing less than control by the Federal minions the many pieces of this fragmented universe, then the document will need to expose and document the historical decisions that have largely determined what data is collected, what identifiers are applied, what health diagnoses and treatment coding schemes are used, who collects and uses the data, who ‘owns’ this data, who it has to be shared with or reported to and in what circumstances, and how long it has to be held.
Then and perhaps then we can negotiate a new social contract with healthcare works and consumers.
However, I believe the RFT title is misleading, it uses terms like interoperability in a dishonest manner intended to manipulate and separate the community yet again.

Apologies for the rant, I feel we have been let down as a community by the ADHA, who I turn is a tool of others in the shadows. The Jurisdications are weak and the vendor and clinical communities are not being best served by their associations, peak bodies and colleges, the consumer, well we are as the English say, arrow fodder.

John Scott said...

We have a mixed public/private health system which was once explained to a visiting US delegation of IT people as the strength of the system because it eliminated the two extremes--fully public and fully private.

Certainly other countries with different health system architectures are struggling to make the connection to digital pathways and supporting electronic health records work.

I suggest the real challenge is how we engender a revolution in the quality of cooperation and collaboration.

I suggest further that at the heart will be a purposeful separation of health from IT in order to facilitate progress. Health needs to work out how to make progress, progress which is more organic and generative.

And, finally, IMHO it will take a new narrative--one not tied to electronic health records or the transformative impact of digital technology.

Peter said...

Every industry has complications which are specific to its own idiosyncracies. I have worked in Telecommunications, Retail, Banking, Education, Logistics, Government and Entertainment - there are far more similarities than there are differences. I would suggest one of the biggest issues specific to Health is the fact that the management/admin layer (whoever that is) does not have the power to impose change, but must try to cajole a group of highly individual and conservative players to work together. Note that this is the same problem that exists with the IT systems, and the similarity is not a coincidence.
I don't think the issue of defining an interoperability framework is particularly difficult. There is very little involved which is specific to health and the problem has already been solved in multiple other industries. Indeed, if the framework IS getting into industry specific detail then it is probably not at the right level of abstraction. [as a side note - defining the enterprise is usually part of an EA gig since few organisations have a clear view of what they actually do. It is not particularly difficult since the approach is mostly formulaic, but it can get very complicated (as well as complex)].
The real problem, as mentioned by others, is the "mishmash" of processes and widely variable approaches across every possible sub-set of the industry. To automate anything requires some standardisation and hence process definition. With every individual clinician having their own way of doing things, and both the desire and power to insist that they shouldn't have to change, this goal seems a long way off.
The solution (IMHO) is a common theme on this page - communications and change management, with clinician engagement way up on top of the priority list. No change is going to be successful until that happens. Although I think I disagree with the group when I say get it is still worthwhile putting together a (straw-man) framework so something is available as a centrepiece of that conversation.

Dr Ian Colclough said...

John Scott @9.57 AM said "I suggest the real challenge is how we engender a revolution in the quality of cooperation and collaboration." and "... it will take a new narrative".

Absolutely spot-on John. New ways of thinking about an age-old problem marks the beginning of the new narrative and challenges conventional wisdom. But that is unlikely to ever happen when bureaucracy remains constrained by old habits and processes and an inflexible culture.

Anonymous said...

Peter, there is an Australian Standard Interoperability Framework. This RFT is asking for more than a framework as confused as it is. All it exposes IMHO is that the ADHA is not equiped to understand interoperability so how they can facilitate that conversation is an interesting question

Architect extrude is a powerful tool when in the hands of those who understand it and are collaborative and insightful by nature.

Anonymous said...

10:19 AM --- the conversation, change in thinking, action and call to arms has to occur outside of the bureaucracy.

Bernard Robertson-Dunn said...


Re: "With every individual clinician having their own way of doing things..."

Can I suggest that the real difficulty is not with the clinician but with the patient.

All patients are different, it's the nature of human beings. This is also why trying to adapt solutions from other "industries" is not a good idea. Healthcare is not an "industry", although many people view it that way and, to be fair, parts of it are: pharmaceutics, pathology labs, diagnostic instruments etc.

As has been said before, healthcare is a social art, not predisposed to the highly repetitive and standardised practices of other industries.

If you look at the RFT:

"A.2.2 Strategic Interoperability Framework Program Scope

A digitally interoperable environment for the Australian health and care system is a key enabler needed to support the delivery of the core requirements for raising Australia's standards of health and well-being. In order to achieve this, the major domains to consider when developing interoperability principles include the prediction and prevention of illness; improvements in health and care outcomes; higher quality, safer and more effective health and care systems; and achieving financial sustainability in Australia's health system whilst demonstrating value for money"

In management consultancy speak, they are trying to boil the ocean. IMHO, they need to be far more realistic. But that requires a degree of judgement I haven't seen demonstrated so far.

And being realistic may mean just letting the people who actually deliver healthcare - the states, GPs and specialists, etc - get on with it. The money the Federal government is spending on ADHA and MyHR could, and should have been, spent at the point of care.

Anonymous said...

The bureaucrats have spent a huge amount of money building barriers to block vendors from demonstrating innovative approaches and finding ways to prevent free market forces from prevailing whilst persist in trying to "boil the ocean (10.59 am)".

Anonymous said...

@10.19 am Why don't consumers and their doctors find another way?

Anonymous said...

4:06 PM, find another way? Of what? Getting sick and treating the sick? Or do you mean applying technology as an information tool?

Anonymous said...

5.06 pm ... applying technology as an information tool.

Anonymous said...

8:15. Then that is a fair question. How is this then best facilitated, how do we reach these social contracts, negotiate custodianship and curation of that information and enable sharing of information as care groups expand and contract, how to allow a consumer to provide information for research purposes. All under the adoption, adaption and conformance to community agreements contains within standards and legislations.

You raise a great conversation starter. A lot has evelved in ten years in technology and the understanding and familiratiin of its use across multiple devices and we regularly access data from numerious sources with little effort.

The question is why does health need a central database when so much of our lives online draws and compiles information seamlessly from multiple sources?

Andrew McIntyre said...

I do find it amusing that anyone thinks a 6 week review can come up with a viable plan when virtually since computers were invented there application to healthcare has been touted as a revolution and yet only modest advances have been made and the advances that are working are over 20 years old. This is evolution in action, but this project comes from die hard creationists who keep wanting to start again. Every iteration of Healthconnect/NEHTA1/NEHTA2/ADHA wanted to do this. The odds of success are $2Billion:$1 against success. Time for a different strategy, perhaps some light touch governance worth a try? Its cheap and we have a big government deficit and lots of people happy to risk their own capital on their own ideas. Encouraging experimental solutions that have patient safety safeguards might be a strategy.

Anonymous said...

Andrew, is it not the intension of the ADOHA to deploy and operate a developer environment where innovators and the like can access resources, build and test software have access to reusable patterns of clinical workflows etc. The CEO was talking about something like that not to long ago, seemed like a hub of health interoperability innovation and digital transformation where vendors would open source everything and myhr was accessible to explore and engineer a future against. A national always open connectathon sounds a great idea, open July1 from memory

Trevor3130 said...

AndrewM's "light touch governance" is worth another look, but perhaps by aiming that governance at the tenderest parts with a laser-like focus and accuracy. If that approach is to be successful, it would have to be protected with severe penalties for attempts to subjugate and for negligent applications.
For instance http://www.apo.org.au/node/92016 (24 May 2017) from Victorian Auditor-General claims DHHS "is requesting state funding for a statewide digital health identifier — a system for uniquely identifying healthcare providers, healthcare organisations and individuals receiving healthcare."
What is that all about?

Bernard Robertson-Dunn said...


I think you are referencing this document:

Which says:

"Although data is collected, the use of paper -based rather than electronic record systems and the absence of a unique patient identifier make it difficult to analyse patient information to support clinical decision-making, monitor clinicians’ and hospitals’ performance and identify opportunities for improvement."

Somebody either doesn't know about IHI or doesn't trust it. Or maybe the audit office is confused and has misunderstood this project "Develop business case and implement pilot for a statewide master patient index, using national health identifiers".

This document is also interesting:

Which repeats the mantra: "In order to provide relevant patient information at the point of care, electronic patient records need to be legible, accurate, up to date, and easy to access."

Will someone please explain to me how any patient record, managed by one or more healthcare professionals can ever be relied on to be "accurate, up to date"?

If a patient hasn't seen a GP or been to hospital for six months their health status may well have changed dramatically.

Maybe ADHA realises that "accurate, up to date" isn't possible and is why it isn't one of their priorities.

Anonymous said...

7:01am. The ADHA is going to do what? If it is what I think you mean I would question if the ADHA has anyone left who has seen let alone know how to build operate and maintain such a software developer community. Seems a big overhead for a rather small market. Is there anything on open and transparent websites outlining what this is? Or is it still in the dreaming department?

Dr Ian Colclough said...

10.56 AM Bernard wrote - "Develop business case and implement pilot for a statewide master patient index, using national health identifiers". !!!

The Audit Office usually doesn’t get things like this wrong – their practice is to quote verbatim from source (Department) documents.

A statewide patient index, surely, is just a subset of a national patient index!!! Or is there something so different that one needs a separate patient index for the state and presumably a separate one for ‘each of the other jurisdictions’!!! No, that can’t be what they are thinking; can it?

If a national patient index contains address field(s) (for the patient and the hospital(s) attended) then surely the statewide patient index will (presumably) already exist.

What does the ADHA and the Federal Health Department have to say about this?

Anonymous said...

The ADHA is not funded to care, it is funded to fill the GovHR up with stuff. The Feds won't mind I wonder if this will be a useful tool in why citizen cannot rest their privacy setting to a useful granular level. Citizens it was always our intention to allow you full control over who can and cannot access your records but the Jurisdictions won't adopt the HI scheme which we require to support Australians in protecting their personal information, in the meantime thanks for all that data, has been most helpful is victimising you all and cutting essential public services to pay for our increasing IT operating cost.

Anonymous said...

Not convinced the ADHA is actually worth bothering about. There is far more interesting things going on than them, perhaps if we focus on other parts of the healthcare where progress and indeed transformation is taking shape they will disappear. I like many question the value or what they really do?

Anonymous said...

7:52PM. If the FAQ to this RFT is anything to go by you might be right. I don't get a warm and co-designy feeling. I am not sure if they don't want anyone to do the work or if this has already been awarded to someone and they are simply wasting everyone's time to tick a compliance box.

It still leaves the CEO a big question - what does the national digital health strategy not address that this is needed for? Not a good look, maybe the senate could bring an expert in to ask some questions? I think the authors behind the previous interoperability framework might be a good set of representatives for the tax payer

Anonymous said...

If you compare to the other proposals under Tenders page it is clear there is more than a slight gap in knowledge, skill and natural talent within the Agency. The Interoperability is a disgrace as a body of thinking coming out of Government Agency. One wonders if the Team that was reportedly included in the CEO brain drain efficiency drive, where victims simply because they may have pointed this folly out to stubborn mindless amateurs.

I agree with previous commentators, perhaps the CEO can explain this at the upcoming HIMMs where he is reportedly present the half a national Digital Health Strategy?

Anonymous said...

I can smell promotions, eHealth in the national bodies is littered with rewarding of incompetence and bullying of anyone that may question and definitely have alternative views.

Maybe the Senate could ask how well the CEO manages redundancy processes and how well the organisation is humming? I hear 9 months on it is still Umming and is likened to a shambles where even the basics of business are not in place.

Anonymous said...

This was always a questionable appointment, I have no doubt that the need to make people feel all warm and engaged has to a reasonable level been met, dampening down any misgivings about the Governemnets HR systems seems to have been a reasonable output, that does not make a CEO though, against the CEO's of the States this is a poor score card indeed, they have done all that and run their respective organisations.

There is always the possibility the ADHA CEO does not wear the pants and is simply there to head up the sales and marketing stage and will soon be relegated to running Comms for the Cop-out.

Time will tell but from where I sit I do not see a CEO of any caliber. Nice enough chap and bear no I'll will it's just business and as an investor I am not getting a good return.

Anonymous said...

Maybe 8:29am you have exposed a business driver behind the RFT, going back on a speaking circuit will get one out of the office where one does not need to deal with the day to day grind of running an organisation, there is plenty of room for blue sky dreaming, lots of open big data and little to measure results on the ground other than picking up on others success, sounds like another Twitter in Chief.

Anonymous said...

"I hear 9 months on it is still Umming and is likened to a shambles where even the basics of business are not in place."

Affirmative. Beam me back down, Scottie.

Anonymous said...

The state of ADHA is like the RFT in this post simply a reflection of an incompetence of parts of Government as well as the inability to attract the right talent. Yes the CEO is accountable for this poor use of public funds, but some of the blame must be shared with the transition task force and the former CEO's of ADHA and NEHTA during the transition period. A Strategic mistake IMHO. The GM of Operations at the ADHA might be wise to take a bow and move on, it certainly sounds like organising an event in a brewery is beyond that person imagination.

The ADHA needs to simply collapse into just a system operator, a new highly skilled entity needs to be formed that is solely forcused on the standards and specification and conformance to those so we can avoid costly mistakes like the Cancer Registries and Inam sure many more national initiatives dreamed up and agreed over a set of power points and poorly informed decision makers.

Can this be done? Not without Strong leadership from a good many Health Ministers at Federal and State level, who at the end of the day get left holding the bag when these things fail so spectacularly.

Anonymous said...

why would you put someone in charge of an important federal government agency who has had no experience working in, never mind running, an Australian public sector organisation?

maybe its just not that important

and while we are at it, why would you put someone with no experience in health or healthcare or in developing large scale information systems in change of ehealth at the department of health? all he had ever done is project manage a trivial reporting system at treasury

you can't really blame these poor unqualified individuals for doing such cr*p jobs, they just aren't suitable for them. I blame the senior public servants and ministers who should have known better

Anonymous said...

The consultant houses have some responsibility for placing people who would not even get to first interview, but that processes does not accuse for very expensive placements.

Anonymous said...

if the wrong people have been employed by ADHA what are the chances of them getting ehealth right?

Anonymous said...

June 09, 2017 9:12 AM said .... "Why would you put someone with no experience in health or healthcare or in developing large scale information systems in change of ehealth at the department of health?"

... and who put him there? Professor Jane Halton PSM of course.

Anonymous said...

It's hard to get eHealth right. It's even hard when the wrong people are in charge and have no idea.

Anonymous said...

It's now delivery date plus 1. Be interesting to see this Interoperability Framework. It is the first true deliverable from the ADHA let's see if Tim can deliver or it's just all talk.

Anonymous said...

It is just talk, do not expect much out of ADHA except the press hanging of people into the MyHR with no transparency of the total cost or plans for where data might end up. I am a supporter of the adoption of eHealth and agree it needs to be a topic of discussion across the full spectrum of society, my issue is with the conversation itself and the avoidance of topics. The current narrative is not engaging consumers or broader health care workers. Outside a closed set of stakeholders the MyHR is not known about and people care even less, so on that front the first year is a failure.
Time will tell I guess, one indicator will be if Tim reverts to past endeavours to bolster his perceived need to make MyHR a success, a bit like a mid-career crisis.

Anonymous said...

September 02 2017 9:16 AM. Try end of next year. http://www.healthcareit.com.au/article/tim-kelsey-my-health-whisperer

Seems we should be greatful Tim reached out to save us, I thought he left Telstra high and dry, ditching them to take on the CEO role, seems the Telstra gig may have been simply a waiting room role.

Don't worry about this weeks poll, Tim will fix it.

Anonymous said...

End of next year? So something planned to take two months has now planned to overrun by fourteen months, that is some failure even for Federally Government. I think an explaination is required, I am not convinced the CEO has a record of delivery and this certainly is not a good indicator.

Anonymous said...

ANON September 02, 406 PM. I am sure the ADHA has sent them a note from their legal team informing the authors of the factual errors and they will amend appropriately.

Anonymous said...

Anyone heard if this Interoperability Strategy will be released by Christmas, I need to decide if I by the fax plugin for our online clinical systems.

Anonymous said...

A knee jerk strategy by the CEO to make ADHA appear relevant in a short-sighted ill-conceived attempt to try to solve a problem they have never understood.

Anonymous said...

A strategy is a plan. This lot are good at making plans. Where they fall down is making a good plan and making that good plan work. So far, it's all been failures. Expecting anything different is risky. Just buy your fax plugin - it's safer.

Anonymous said...

Given what I have observed of the ADHA, they will just repaint the existing stack of stuff and call it Interoperability, of coarse lacking any understanding or ability they will avoid the cultural, policy and funding aspects. My guess is the themes will be

Some level of lip service to a need to move from a document paradigm but will falter in what an alternative might be, probably rely on the limitation of API’s

They will have to at least a knowledge a more universal uptake especially mandating the jurisdiction to use IHI

Some mention of standards but probably lean towards taking over the governance (manipulation)

Obvious hooks to ensure the MyHR becomes some sort of delusional trust broker for Interoperability but with my first point that is impossible
More universal use of IHIs to identify patients

Of coarse discharge summaries will get a good mention, have to get them plebs out of my cost centre as quick as possible

And a good sprinkling of adoption and implementation because being a funding funnel is important

As SMD is somehow important they old directory service will be a human imperative to ensure information exchange (exchange meaning you have to send as I don’t trust you to share).

See you in 2019 when $4 million has been spent on the obvious less the hard. Unless they choose not to as they realise it’s a bit more complex they it looks