Sunday, August 13, 2017

I Think It Is Fair To Say Reaction To The New National Digital Health Strategy Has Been Rather Mixed.

We have now had a week or so to thing about the new Strategy and have had a presentation from Tim Kelsey at HIC early last week.
Here is a link to the presentation:

Tim Kelsey - HIC17 Presentation 'Digital Health: A Human Imperative'

Tim Kelsey, CEO of the Australian Digital Health Agency, presented at the Health Informatics Conference (HIC) on 9 August 2017 about our work program, My Health Record and COAG's (Council of Australia's Governments) approval of Australia’s National Digital Health strategy.
Here is the relevant page:
Among the reactions to the Strategy have been the following:
First we had this:

Critics voice concerns about a national digital health strategy lacking details

Lynne Minion | 08 Aug 2017
Australia's new digital health strategy has been labelled “incomplete”, with critics claiming it is short on detail about how sensitive medical records will be secured.
Australia’s state and territory health ministers approved the Federal Government’s Safe, seamless, and secure: Evolving health and care to meet the needs of modern Australia at a COAG meeting on Friday, giving the green light to automatically sign up citizens to My Health Record by 2018, with an opt-out function. By 2022, all of the nation’s healthcare providers will be connected to the digital platform.
But some, including managing director of IT consultancy PivotNine, Justin Warren, have raised concerns about a lack of detail.
“The strategy document is heavy on breathless positivity, and light on concrete detail about how it will achieve its lofty goals. Indeed, it doesn't specify concrete goals in many places at all,” he said.
According to Warren, information security is difficult to achieve, particularly when numerous apps and platforms will be allowing healthcare providers such as GPs, hospitals, pathology services, specialists and pharmacies to access the same system.
“What I've seen so far doesn't inspire confidence that the very real security issues are being adequately addressed,” he said.
“For example, when your myHR is created, it defaults to an ‘allow all’ access so that all health providers who provide you with services can see all your information.
It's not clear how myHR knows if a provider is one you deal with, so it would seem that any provider who can look you up would be able to see your data.”
The opt-out mechanism also appears to be flawed, he said, as a person’s record isn't deleted if they opt out but instead simply locked.
For Warren, #CensusFail, #notmydebt, the ATO's ongoing woes, the publishing of identifiable medical data by data.gov.au and the recent discovery of Medicare numbers up for sale on the dark web show the government doesn't have a good track record with cybersecurity and the strategy doesn’t allay his concerns.
“They can't just sit back and expect us to trust them. They don't have the required track record of trustworthiness, so they need to work harder to prove they can be trusted, and they don't seem to be inclined to,” he said.
“The lack of detail concerns me a lot, because if privacy and security were really a priority, those parts would have been designed in already and we'd have a good understanding of how the processes would work. We don't.”
The Australian Medical Association, the Royal Australian College of General Practitioners, the Pharmacy Guild of Australia and the Pharmaceutical Society of Australia, as well as the Consumers Health Forum, Medical Software Industry Association and Health Informatics Society of Australia voiced their support for the strategy in the ADHA’s media release on Friday. But medical specialist and a spokesperson for technology thinktank Future Wise, Dr Trent Yarwood, who has opted out of My Health Record, claims the digital health strategy “completely fails” to address how the Federal Government will secure health information on the portal in light of recent IT breaches.
Lots more here – including some of my comments:
Second I found this:
8 August 2017

ADHA outlines digital future for doctors

Posted by Julie Lambert
The Australian Digital Health Agency says it will smooth a five-year transition to the digital future for doctors by having technology vendors adopt secure interoperable platforms across the health system.
The agency’s blueprint for change is spelled out in a five-year strategy, approved last week by all state and territories, that will begin in earnest with the creation of opt-out My Health Records for all Australians in 2018.
“By 2022 all healthcare providers will be able to contribute to and use health information in My Health Record on behalf of their patients…” the strategy says.
 This will provide “potentially lifesaving access to reports of their medications, allergies, laboratory tests and chronic conditions”, and support significant improvements in the safety, quality and efficiency of healthcare, it says.
“Every healthcare provider will have the ability to communicate with other professionals and their patients via secure digital channels by 2022. Patients will also be able to communicate with their healthcare providers using these digital channels.
“This will end dependence on paper-based correspondence and the fax machine or post.”
The transformation will require a standardisation of patient data so it can be shared in real time across the health system and be available whenever and where it is needed, the document says.
The strategy was adopted by the Council of Australian Governments health ministers in Brisbane last Friday.
Days earlier, the agency’s chief information security officer, Anthony Kitzelmann, offered an assurance that GP clinics would be spared much of the security burden accompanying the jump to digital.
Mr Kitzelmann said small, under-resourced general practices could never be completely secure.
So the agency was working to “incentivise the software developer community to build products that are more secure, demonstrate to us that they’re taking the risk away from the GP, so they can do their job and get on with healthcare without having these overheads”.
More here:
Third we have this commentary:

Australia's inside-out digital health strategy

If patients are to be 'put at the centre of their healthcare', they need to be put at the centre of their health data.
By Stilgherrian for The Full Tilt | August 7, 2017 -- 07:21 GMT (17:21 AEST) | Topic: Security
The thing to remember about strategy documents is that they're merely aspirational. They set out a proposed pathway to achieving a set of defined goals, but they're no guarantee that those goals will even be achieved.
Australia's digital health strategy, released on Monday, is no exception.
As the old BBC TV series Yes Minister taught us, when it comes to writing government reports, "the tricky bit should be disposed of in the title". This strategy [PDF] does exactly that: Safe, seamless, and secure.
That dealt with, let's look at some of the details that worry me.
"An economic analysis, undertaken as part of the development of this strategy, has estimated that the gross economic benefit of secure messaging could be around AU$2 billion over four years and more than AU$9 billion over 10 years," says the strategy.
That's the gross benefit, but what about the net economic benefit? Setting up the digital health record system during its trial phase had its budget topped up by a few hundred million a couple of times, putting it well into the billion-dollar project category.
As a submission from health insurer HCF put it: "Health does not lack innovation, the issue always is in scalability, and execution in a fragmented system."
This integrated national system will have to link up statewide systems, and as the strategy notes, there's "no overarching standard in place to govern the sharing of data". The potential for massive cost blowouts is obvious.
"There have been widespread calls from peak professional bodies and health services for immediate action to create a standardised, universally accepted, secure messaging capability," the strategy says.
So why implement secure messaging as part of a massive, complex data interoperability project, where delays in other parts of the project could well delay this "immediate action"?
You could just set up encrypted email as a separate project. Or use WhatsApp?
The strategy does list some "critical success factors", but there's no discussion of risk mitigation strategies, except to note that the risks exist.
Lots more here:
Fourth we have:

Australia's digital health strategy gets the nod without data interoperability controls

The Council of Australian Governments Health Council has given the federal government the green light to automatically sign citizens up to an electronic health record, with a public consultation on draft interoperability standards to come by the end of next year.
By Asha McLean | August 7, 2017 -- 01:26 GMT (11:26 AEST) | Topic: Security
My Health Record, the Australian government's e-health record system, has been officially given the green light from the Council of Australian Governments Health Council to automatically sign citizens up to the service, allowing them to opt-out if they choose.
By 2018, all Australians will have a My Health Record and by 2022, all healthcare providers will be able to contribute to and use health information in My Health Record on behalf of their patients. They will also be able to communicate with other healthcare providers on the clinical status of joint patients via the digital platform.
According to the strategy, Safe, seamless, and secure: Evolving health and care to meet the needs of modern Australia, the interoperability of clinical data is essential to high-quality, sustainable healthcare, with My Health Record allowing the collection of citizen's data to share in real-time between providers. However, there is currently no overarching standard in place to govern the sharing of data, with a public consultation on draft interoperability standards to determine an agreed vision and roadmap for implementation of interoperability slated to occur "by the end of 2018".
"Base-level requirements for using digital technology when providing care in Australia will be agreed, with improvements in data quality and interoperability delivered through adoption of clinical terminologies, unique identifiers, and data standards," the strategy explains.
"By 2022, the first regions in Australia will showcase comprehensive interoperability across health service provision."
In the strategy [PDF], the Australian Digital Health Agency (ADHA) said Australians want a health system that puts people first and offers more choice, control, and transparency. Most importantly, Australians want their health information to be confidential and secure, protected from cyber criminals and from any unauthorised access.
Healthcare providers have a similar desire, ADHA said, wanting secure digital services that provide instant access to a patient's information -- especially in an emergency.
Lots more here:
Last for now we have this:

How would you like all your medical and mental health records leaked online? You might find out soon.

Freelance JournalistThe government is planning to give every Australian a digital health record by the end of 2018. With that goal in mind, the Council of Australian Governments (COAG) Health Council has approved Australia’s National Digital Health Strategy, drafted by the Australian Digital Health Agency (ADHA.) So how much data will a digital health record — known officially as a My Health Record (MHR) — contain?
Lots.
The MHR was previously known as the Personally Controlled E-Health Record (PCEHR.) But after patients and healthcare providers avoided signing up to the PCEHR in droves, ADHA renamed the project and changed patients’ sign-up option from opt-in, to opt-out only. Yes, that’s right: you all get an MHR, whether you like it or not. Want to opt-out? Too bad.
The government won’t delete your e-health record: people who opt-out will still have a shadow-file — a shell account the ADHA will retain, void of healthcare data from the date patients opt-out. And how well do opt-outs work anyway? Well, before the UK scrapped its equivalent digital health data project — known as care.data — it was discovered the National Health Service was disregarding patient requests and still populating patient files with information, even after patients opted-out.
(Before people opt-out of MHR, they should consider setting up a pin to lock down their accounts, as MHR accounts are automatically set to universal-access. Without a pin, any health care provider can access MHR files, not just patients’ regular GPs.)
The National Digital Health Strategy claims the MHR will allow all Aussies to access their health info “at any time online and through mobile apps”. And what could go wrong, considering the Australian government has left a trail of failed data governance projects in its wake in recent years? “Early app developers are already taking advantage of new interfaces on top of the MHR system which allow people to see the medications they have taken, or to view clinical documents on their mobile devices,” according to the strategy.
Lots more here:
Overall there has been a pretty large amount of careful analysis of what the ADHA is proposing and most find themselves being like David Copperfield and wanting more, or seeing the Strategy and a privacy invasive and security disaster.
Overall I feel we need much less marketing and much more implementation planning and that we should wait and see the outcome of this process before deciding what our final view is, remembering that we need to also be convinced that the myHR is a useful and central vehicle for this implementation.
I am strongly of the view we need an impartial option analysis as part of the implementation plan that looks at all the forward possibilities for the myHR including solving problems in different ways to the present plan based on the myHR. It seems there are a few others who agree with me! Last week's poll rather confirms that view.
David.

46 comments:

Anonymous said...

If that is as it seems the coverage and level of coverage then the board might need a new communications and marketing strategy.

A couple of suggestions:

Digital health a human imperative - 95% of the audience just switch off.

Interoperability - you might want to ensure simple things like power point can be opened on common operating systems, it errors on IOS and seems to not be liked by power point from the App Store.

And Tim wants me to believe eHealth in Australia is in good hands, your having a giraffe looks more like a Jekyll and Hyde from a Saturday boot sale.

Anonymous said...

August 13, 2017 7:29 PM. You are correct you cannot open the ppt file over IOS. It is not an isolated issue. It really makes you wonder if this leadership team as they call themselves have any clue or talent in running a national organisation let alone tackle complex issues like open interoperability in healthcare.

Anonymous said...

"you cannot open the powerpoint file over IOS"

Perhaps this is a versioning issue.... just opened it with Office 2011 on iOS10.11.6 (old but works)... maybe more data are required before conclusions are drawn.

Anonymous said...

Whatever you say and do now will make not a jot of difference. Accept the fact that the horse has bolted and cannot be tethered. You and your readers and numerous other informed people and Agencies have repeatedly invested time and resources in making numerous submissions ad infinitum to NEHTA, the Department and now the ADHA, all to no avail.

Anonymous said...


Perhaps this is a versioning issue.... just opened it with Office 2011 on iOS10.11.6 (old but works)... maybe more data are required before conclusions are drawn.

Or maybe it should just work?

Anonymous said...

I presume when Mr Kitzelman says he is going to incentivise software developers to make their products more secure he is intending to provide the funs to underwrite the work! Or am I delusional?

Bernard Robertson-Dunn said...

The ATO has been in a bit of strife recently

How repeated IT outages saw the tax profession go sour on the ATO

http://www.smh.com.au/business/the-economy/how-repeated-it-outages-saw-the-tax-profession-go-sour-on-the-ato-20170808-gxrsyx.html

This is a service delivery agency that spends hundreds of millions of dollars on its information systems. It has a highly professional IT department that got somewhat gutted by the whole of government IT outsourcing initiative.

But it cannot keep its systems up and running:

"We continue to have reservations," Chapman says. "[ATO] outages negatively impact the ability of tax agents to service clients and cast a particularly poor light on the Commissioner's decision to give myTax another burst of free marketing in [the August 9] release."

Compare this performance with the Department of Health (a policy agency), NEHTA and ADHA.

Does anyone really think that this mottley crew can develop a system with far more users (most of the Australian population) that is available 24/7 with interfaces into every other health provider system and contains critical, essential, clinical information?

When the alternative is a resilient, distributed system capable of operating in times of emergency and where each part is sized and protected to meet local conditions?

PCEHR/MyHR took the wrong approach way back when some so called architects decided to cobble together a system that only reflected the owner's (i.e. the government's) requirements, not those of the rest of the health care community.

Going forward, words like lipstick and pig come to mind.

Dr Ian Colclough said...

Good points Bernard. The government had the funds and the power at its disposal. The health care community had the ability, commitment and goodwill to develop a system which would vastly improve health service delivery and facilitate collaboration between users.

HOWEVER, the government (the bureaucracy) did not really understand the health industry, what it needed or how it worked except very superficially. The health care community was beholden to the government and forced to bend to the bureaucracy’s wishes. Notwithstanding some huge consulting contracts being awarded this led to a no-win outcome all round which is where we find ourselves today.

Bernard Robertson-Dunn said...

Thanks Ian.

What I forgot to point out is that when the ATO's site goes down, it inconveniences accountants and citizens in a way that can be compensated for - i.e. money.

When a critical medical system goes down, people can be harmed or even die. Oh, wait a minute, healthcare professionals can revert to traditional methods and just ask the patient or look up/use their local systems (which they will still have, unless they are totally stupid).

By definition healthcare is a distributed profession. The clinical value of systems comes from the point of care (GPs, specialists and hospitals) or from data acquisition (e.g CT/MRI/fMRI scans, X-Rays, blood tests etc) where patients visit different locations, all interoperating with local systems.

Build hierarchies of information systems for management, research, administration etc on top of local systems.

IMHO, centralised point of care systems is an oxymoron in a country with the size and geographic distribution of Australia.

Andrew McIntyre said...

If the ADHA gets their wish then they will be getting the combined output of all the pathology companies 24hrs a day and all the event summaries and they have every health practitioner looking at them.

That sort of load at a level of reliability required would keep me awake at night and I doubt the budget is enough to even support it. Its may worse since a 2kb HL7 result becomes a pdf that would be orders of magnitude bigger.

Maybe as the census is over they can ask those people for some help. Its like running a census every hour, every day 24/7. Its a amazon.com scale problem at least.

Anonymous said...

Digital health a human imperative - 95% of the audience just switch off.

Yes I think that sums it up.

Anonymous said...

The volume of data the MyHR will need to receive, index, store and search through is a interesting issue Andrew, and yes the cost can't be cheap. Anyone know if these figures are available somewhere?

Bernard Robertson-Dunn said...

Having seen the original PCEHR RFT and various other technical documents, I'd say that the existing technology is nowhere near capable of hosting a high volume, high availability, mission critical, integrated piece of infrastructure or application.

Which strongly suggests that they will be contemplating a cloud solution.

Given the real and perceived problems associated with cloud solutions, they will be buying themselves a massive negative public reaction if they go down that track. IMHO.

Anonymous said...

A cloud solution sounds good - uncontrolled-cost-as-service, just what amazon and google would love.

Anonymous said...

All your health data in a cloud somewhere run by Amazon, Google, Microsoft, IBM etc. What could possibly go wrong?

Anonymous said...

Just as well the ADHA strategy doesn't mention cloud. We can safely assume that they have no intention of using cloud in the next five years. This might tempt them tho':

Microsoft to launch Azure in Canberra in push for sensitive govt data
Hyperscale data centres hoping for ASD approval.
By Steven Kiernan Aug 15 2017
https://www.itnews.com.au/news/microsoft-to-launch-azure-in-canberra-in-push-for-sensitive-govt-data-470794

Andrew McIntyre said...

The alternate strategy, which is no where near as flashy would be:

Legislate for all parties involved in receiving messages to reliably receive and render messages compliant with existing standards and generate an ACK. File based drop off and pickup. Sender can then be compliant and should be.

Make provider numbers freely accessible and issue them to all health care providers, public and private. Only some would be enabled for billing. Provider lookup service to find providers.

Have Medicare issue practice IDs for every physical practice in country, including public hospital departments.

Have one certificate for every practice, that can be used for everything with online renewals. Provide ID management for patients with trusted authentication service.

Get AMT integrated into SNOMED-CT and same coverage as MIMS

Provide some incentive payment to all providers that used software that had passed the standards tests.

Finance modelling of clinical data for various disciplines, with appropriate terminology bound. Make health departments accept electronic collection of all data from providers using these models.

Stand back and let the industry develop innovative solutions and ensure standards are in fact complied with by public, private and government departments.

Bernard Robertson-Dunn said...

How about just "Stand back and let the industry develop innovative solutions and ensure standards are in fact complied with by public, private and government departments."

What other industry does the Federal government get so involved in creating and running solutions?

Anonymous said...

@4:30 PM and 5:05 PM ..... But, but, but...... aren't HealthLinks, Medical Objects, Telstra Health, and a few others sorting it all out with the two new interoperability pilot projects Tim Kelsey has established?

Anonymous said...

The cloud is simply a delivery mechanism not a technology itself. That said it comes with some very real challenges if that is there target. Tim set the Google Deepmind ship sailing through the care.data fiasco so it is safe to say we are probably heading down the same path. It puzzles me why such a track record was put at the front of a 'trust me with your personal data' initiative.

Anonymous said...

Tim talks in technical or IT interoperability not clinical interoperability or even full interoperability in Tims context even this is in need of agreement as to what is meant. Open and interoperable are two words in the Information Technology world susceptible to misunderstanding at best, at worst to self-serving abuse. It is important to clarify their accepted meanings, because how they are understood in the market has direct practical consequences for consumers, vendors and regulatory authorities.

Under conditions of true technical interoperability, any two pieces of software a consumer selects are guaranteed to work together as well as any two others. One of the providers might well have a superior market position, but this reflects only consumer preference, not control over the conditions of connectivity.

To achieve full interoperability across legislative/policy/business/semantic/ data/ technology is achieved through a series of agreements and understood divergences by a number of participants within and interoperable community with a shared set of goals along manageable trajectories can move toward these shared objectives. Interoperability is a multi pronged outcome that does not equate to maximising connectivity. Thousands of independent messaging communities just creates a mess and opportunities for market manipulation. Eventually someone has to invest in shared meaning.
Calling SMD interoperability lessens the goals of each. How open is this SMD work? Can a new entrants into the market compete or is it a closed world now? What happens if in the future one or more vendors pull out? Are we now bound to specific technologies? If so does that not fly in the face of innovation and market competition?

Who really knows, this is all done behind closed doors, I wonder if anyone know what next, or is it another case of lets see if something, anything works and success can be claimed.

Anonymous said...

"Tim talks in technical or IT interoperability not clinical interoperability or even full interoperability". I'm none the wiser. What are the two interoperability pilots at 6:11 PM going to deliver and when? What will they prove? Will they be compatible from a technology, functional and clinical perspective?

Anonymous said...

Most likely they will deliver the current top vendors a secure market where it is a closed shop. The second deliverable will be two competing universes, secure messaging as dictated by the vendors, and the MyHR. Have a read of this mornings PulseIT seems NASH and HI are to be ditched. Looks like an almighty mess coming soon.

The trouble is Tim is neither Clinical or Technical, just desperate.

Anonymous said...

I read the PulseIt article this morning, thought it was a misprint or April fools day. The Board has made an almighty error in judgement. How this will pass government security or even uphold MyHR privacy is going to be interesting to watch. At lest they used FHIR to sound relevant and new. Poor HL7 Aus, now just a whipping boy for the ADHA to push through stuff. How a once trusted brand fell so far so quickly.

Anonymous said...

The irony is delicious. History will almost certainly repeat itself. The failure of care.data in the UK and the multiple failures in Australia will come back to haunt Tim, a historian by training.

Anonymous said...

So long as we see a reduction in the number of fax machines. Even by one that is a billion worth spending.

The digital revolution has largely bypassed the NHS, which, in 2017, still retains the dubious title of being the world's largest purchaser of fax machines.

http://www.telegraph.co.uk/news/2017/07/04/nhs-doctors-use-snapchatto-send-patients-scans-report-says/

Utimopia

Anonymous said...

10:42. That is an amusing testament.

Anonymous said...

10:07 AM You won't get a sensible answer from Tim. The vendors participating in the pilots probably don't know either.

Anonymous said...

Will look good on a power point scattered with slogans and moral, human social imperatives. The power point will have versioning issues so it will limit the audience.

Anonymous said...

I am interested in just how they intend to unwind the HI service, the real issue I thought was the relaxation stupidly given to the Jurisdictions, is the identifier not a key part of my personal privacy controls in the MyHR, if the SMD vendors are now also going to define content standards what impact/cost does that have to the rest of the universe. Seems we have simply created the original problem?

Anonymous said...

You are right to be interested, love to see some statement tabled from the ADHA architecture review board on this. I trust Martin Bowles will be explaining this to every citizen both current subscribed to the MyHR and those about to be forced on it.

Feom ADHA -

Operated by DHS Medicare, the Healthcare Identifiers Service is a national system for uniquely identifying healthcare providers and individuals. Healthcare identifiers help ensure individuals and providers deliver the right health information to the right individual at the point of care.

Healthcare Identifiers are necessary to ensure that only the right people have access to patient information and to ensure that newly acquired patient information is matched correctly with the existing patient records.

Use of the HI Service has grown steadily, driven by the Agency's implementation activities. There were more than 3.1 million IHIs downloaded into clinical systems during the year. There were 13,182,937 disclosures of IHIs from the HI Service via business-to-business (B2B) channels during the year due to downloading of IHIs into clinical systems, validation testing, and data quality activities undertaken on jurisdictional health data.

The HI Service was enhanced during 2012 in preparation for the launch of the My Health Record system.

Anonymous said...

Not convinced the messaging vendors careless about any impact to MyHR not their business model, and more than likely happy to push that cost into someone else. As for ADHA architecture review board, do they have one? I do not of anyone seasoned to talk to there anymore. Thankfully David if it was not for this blog and it open conversation mantra I would be in the dark as what the ADHA are stumbling along with.

Dr Ian Colclough said...

I find it quite bewildering that the National Digital Health Strategy made no mention of Health Identifiers and NASH which have previously been billed as foundation components of the national digital health project. If they are no longer relevant, for whatever reason, surely that should be mentioned as it will have a significant impact on the future directions of the MyHR.

Dr Ian Colclough said...

I find it quite bewildering that the National Digital Health Strategy made no mention of Health Identifiers and NASH which have previously been billed as foundation components of the national digital health project. If they are no longer relevant, for whatever reason, surely that should be mentioned as it will have a significant impact on the future directions of the MyHR.

Anonymous said...

Fully agree Ian, this you would think would be a rather large strategic change with far reaching consequences. The ink is not even dry and they are off working outside the boundaries of the strategy.

Anonymous said...

Maybe when the ADHA and its shadowy figures say the community was extensively consulted, perhaps the mean the public has been excessively conned and insulted

Anonymous said...

6:19 AM .. the community was extensively consulted, perhaps they mean the public has been excessively conned and insulted.

That's not fair and you know it. The ADHA said the community was extensively consulted. That is true - they were. To suggest otherwise is quite inappropriate.

These consultations involved asking 'people' what they wanted. From this approach the ADHA received simple answers which enabled it to justify its position in order to continue doing exactly what it wanted to do under the guise that it was responding to the communities wishes. Some people describe this as a confidence trick designed to elicit the answers the ADHA wanted to arrive at.

Of course, if the ADHA people didn't really understand the big picture and what was really needed, because they were incapable of analysing the complex components of a wicked problem, they would have been unable to present solution options to those being consulted because they had nothing to present.

Consequently, the only option open to the ADHA was to listen to what Harry, John and Jane thought they wanted without themselves really understanding the problem.

The end result is that neither of the two parties, ADHA and those being consulted, had any idea what was really needed so the ADHA adopted that as its basis for moving forward.

You can call that a con job if you want.
I would rather be less provocative and call it extreme stupidity.







Anonymous said...

3:30 that is a fair perperspective I suspect 6:19am was attempting humour as con-sulted is an old one, anyway it still leaves the question around where did to decommissioning and replacement of NASH and the HI service come from, it is certainly not in the strategy. Yes I am sure there are some challenges with it, but throwing your hands in the air because it is hard is not exactly leadership.

Anonymous said...

The ADHA consultation was a bit like the upcoming plebiscite on same sex marriage. It was non-binding and the ADHA only listened to people who said what they want them to say and ignored the others. In the research world it is known as cognitive bias, in politics it's ideology and party politics, in ADHA's case it's cargo culture thinking.

Anonymous said...

The cultural bit is funny, you should try working there, culture this culture that, no focus on running a business or making work predicatable, half sit around waiting, the other half are expected to much of, to many managers are out of there depth and there is no real technical smarts in the place. The one reliable thing is we get feed the same dribble as the rest of you about how brilliant someone is and how much he has made a positive difference towards since taking over

Anonymous said...

I am sure a few catering companies and airlines/hotel would disagree, I am sure they got great benefits

Anonymous said...

If you've got nothing better to do and want a good laugh, browse though these ADHA documents on Organisational Excellence:

Board Meeting 18 October 2016
Item 5.4 - Organisational Excellence PDF (345.8 kB)
https://www.digitalhealth.gov.au/about-the-agency/australian-digital-health-agency-board/board-papers/Item%205.4%20-%20Organisational%20excellence.pdf

PURPOSE: To brief the Board on the status of Organisational Excellence program that is positioning the Agency to be the best national digital health organisation it can be.

Item 5.4 Attachment A - Organisational Excellence PDF (194.14 kB)
https://www.digitalhealth.gov.au/about-the-agency/australian-digital-health-agency-board/board-papers/Item 5.4 Attachment A - Organisational Excellence.pdf

Board Meeting 16 November 2016
Item 7.6 Attachment A - Organisational Excellence PDF (47.23 kB)
https://www.digitalhealth.gov.au/about-the-agency/australian-digital-health-agency-board/board-papers/7.6%20-%20Organisational%20excellence-%20Attachment%20A.pdf

Board Meeting 15 December 2016
Item 8.1 - Organisational Excellence update PDF (78.77 kB)
https://www.digitalhealth.gov.au/about-the-agency/australian-digital-health-agency-board/board-papers/8.1%20-%20Organisational%20Excellence%20update%2020161205.pdf

Anonymous said...

6:47 PM describes a scenario which, if it is only partly true, reflects a dysfunctional organisation heading the same way as NEHTA. It raises the question some have been asking for far too long ... What can be done?

The politicians don't want to know nor do the most senior health bureaucrats in either Federal or State jurisdictions.

Is there any other option?

Anonymous said...

11:36 PM. The ADHA went to fast to early in to many directions with no real sense of why. By doing so eHealth has been drawn and quartered, scattered in a number of competing directions. Through this we have also lost a lost of knowledge, probably just wants some wanted so they could get there own agenda moving.

So now the ADHA will find it impossible to pull everything back into alignment. Desperate to please we are starting to see emerge some far reaching errors in judgement that will have far reaching consequences.

Anonymous said...

11:36, is there any other option? Yes hit the reset button, admit this is a very complex issue and throwing the baby out with the bath water is not leadership. The are very talented people in Australia and a lot of complex issues to work through. Rushing it on the back of a power point soap box and wishful thinking is taking us in the wrong direction.

By all means use the consultation feedback, reequipe with the right people and explore exactly what the stakeholders were really talking about.

Anonymous said...

10:28 PM....

Very entertaining. One of the streams of organisational excellence is to 'make the Agency hum'....is that because they don't know the words? Or maybe there is just a lot of static.
hmmmmmmm