The organizational chart which we discussed a day or so ago is very interesting with respect to Digital Health.
What is clear from this link is that the part of the org chart in the lower left that had Paul Madden and Bettina Konti has gone, with her moving to a purple box a half way across the new chart and he vanishing.
Here is the link:
http://health.gov.au/internet/main/publishing.nsf/Content/24BEDAF18381C86ACA257BF0001E0193/$File/Departmental%20Structure%20Chart%20-%2019%20Jan%2018.pdf
Here is a link from the NLA Wayback Machine for almost 6 months ago (August 1, 2017) when all was in place:
http://webarchive.nla.gov.au/gov/20170816053652/http://www.health.gov.au/internet/main/publishing.nsf/Content/health-struct.htm
So we seem to have a pretty major un-announced, as far as I know, change in Digital Health responsibility and coverage.
I think what we need to know is the fate of the senior officers and the projects that they were looking after. The ADHA does not publish a detailed org. chart but what is there has not changed. Has it been a merger, a takeover or outsourcing or are we just not understanding the new chart?
A thorough independent assessment of the before and after suggests:
- The loss of a Dep. Sec. Position and 2 actual individuals at this level.
- The loss of over 25% of the SES Staff in total heads
- The loss of the PIP Program as best I can tell.
I am sure some who read here will know he ins and outs of what has / is going on!
Always fun to start the new working year with a shakeup and a little mystery!
David.
This might help the confusion. Someone has been plotting things out. I would guess this is ADHA exec rather than a PS based on the use of the tool and not understanding Government guidelines.
ReplyDeletehttps://coggle.it/diagram/Wkc7UAQj9QAB2V2F/t/swot-analysis-30-12-2017
I am not sure there is anything new here. I am pretty sure the intent was that overtime DoHAS would focus on policy and ADHA would implement against policy and take over the running of health systems. I am guessing this is the start of that and all electronic health related services will fall under the digital health agency.
ReplyDeleteNow if digital health agency of the future looks and operates like the current ADHA, I can only hope it does not. They are not a Government organisation in structure, practice or mentality.
I also note the ADHA in Canberra has a new address, this might be another indication of the separation of concerns.
AnonymousJanuary 28, 2018 4:18 PM What a odd thing to leave laying about in the public domain. I trust whoever did this is not in a decision making role when it comes to the MyHR privacy and security designs.
ReplyDeletere: " I am pretty sure the intent was that overtime DoHAS would focus on policy and ADHA would implement against policy and take over the running of health systems. I am guessing this is the start of that and all electronic health related services will fall under the digital health agency."
ReplyDeleteSo who's setting ehealth policy? The Department doesn't seem to have the skills or resources. Or is ADHA empire building?
DoHA will make policy using the same stakeholders that make a fortune consulting on the design and implementation of those policies. If you boiled in down there are probably 20 people calling the shots and making good livelihoods for idea to almost implemented
ReplyDeletere "DoHA will make policy using the same stakeholders that make a fortune consulting on the design and implementation of those policies."
ReplyDeleteYou're probably correct. But it's no different from IT and other technologies.
myhr is just another technology project and will probably go the way of other government IT/Health projects.
The useful thing about using consultants is that they can't be held responsible for a project failure. The stupid thing is that the people who should be held responsible - the public servants - can hide behind the consultants. And it's not in the interest of public servants to hold other public servants to account - that would set a precedent.
I know for a fact that one health executive some years ago did something they could have been prosecuted for, but all that happened was a stern phone call from one of central agencies.
Bernard, for over a decade Government's the world over have spent billions of taxpayers money pushing the digital(e)health market with not much success. It does make one wonder whether waiting for market pull to take hold might not be a better option.
ReplyDeleteIf so, would market pull accelerate uptake of digital(e)health if the suffocating force of market push exponents was diminished.
@2:10PM I agree, Government's market push approaches haven't been very effective.
ReplyDeleteI think the reason is because instead of being a catalyst by setting policies and funding some private sector initiatives (which might succeed or fail) they get so involved they try to control and run projects and in doing so push small competent technology companies to the periphery thus blocking forces trying to create a market pull.
Free market forces must be encouraged not crushed.
@Ian "for over a decade Government's the world over have spent billions of taxpayers money pushing the digital(e)health market with not much success"
ReplyDeleteOver a decade????
The reality is that this has been going on since the 1960s. Have a read of this:
Hope And Hype: Predicting The Impact Of Electronic Medical Records
by David U. Himmelstein and Steffie Woolhandler
Health Affairs, September/October 2005. Vol 24. No 5.
https://www.healthaffairs.org/doi/full/10.1377/hlthaff.24.5.1121
"In the 1960s innovators such as Lawrence Weed implemented clinical computing systems that aimed to revolutionize practice. Soon after, the COSTAR system replaced paper records at a Boston health maintenance organization.
The enthusiasm of innovators was mirrored in the hopes of vendors. By the late 1960s
Lockheed Corporation was marketing its system, first installed at the Mayo Clinic and later at the El Camino Hospital, with much fanfare."
"The pattern of vendors capitalizing on great expectations was oft repeated. Many hospitals bought 'total hospital information systems that were at best partial and contained remarkably little information. When the dust settled, in part on expensive, unused computer terminals, hospitals…found that they had spent a great deal of money and received little in return.'”
If the Department of Health, NEHTA and ADHA were serious about "evidence" they would have uncovered a treasure trove of information and research that says the claims for health records is mostly hype, primarily driven by technologists - people pushing their "solutions".
They might also realise that implementing a secondary health record system on top of existing health record systems is a recipe for total disaster.
And the critics are not Luddite loonies, they include the USA's Congress Budget Office:
Health information technology May 20, 2008
Blog of the Congressional Budget Office, USA
https://www.cbo.gov/publication/24787
IMHO, the problem lies with the noise made by technology evangelists who understand everything about "their" solution but very little about the problem. The real problem has more to do with medical science and advanced engineering than technology. Governments would be better off funding basic science and engineering aimed at medicine and health care than trying to pick technology winners.
The free market is influenced by its buyers. Buyers need to be well informed so they can make intelligent choices. At the moment all they can hear is the noise coming from technology vendors.
Governments are some of the worst buyers - they like quick, simple solutions. When it comes to the practice of medicine and health care, there are no simple solutions - just repeated failures that, because of a lack of understanding of the root cause (their own ineptitude), they fail to learn from.
Here is where all that staff went maybe?
ReplyDeletehttp://www.afr.com/business/accounting/inquiry-could-kick-big-four-consultants-off-the-federal-government-gravy-train-20171211-h02wni
• Jan 30 2018 at 10:30 AM
Inquiry could kick big four consultants off the federal government gravy train
The entire professional services sector is splitting its activity in two.
by Edmund Tadros
An inquiry into the use of consultants by the federal government has set off alarm bells across an industry that has won management consulting-style contracts worth $39.4 billion from Canberra over the past five years.
The use of external advisers, driven in part by on-going caps on the size of the public service, that have helped Australia become the most attractive consulting market in the world for professional service firms.
A Joint Committee of Public Accounts and Audit has made it plain that there is a perception these firms have had it too good for too long in Canberra and they are going to have to seriously prove their worth if they want too avoid getting booted off the gravy train.
The committee called for the inquiry after seeing the findings of a first-of-its-kind analysis of government procurement contracts by the Australian National Audit Office which highlighted the big taxpayer dollars at stake and how little the government knows about how money is being spent across the departments.
----
David.
re "Anonymous said...
ReplyDeleteAnonymousJanuary 28, 2018 4:18 PM What a odd thing to leave laying about in the public domain. I trust whoever did this is not in a decision making role when it comes to the MyHR privacy and security designs.
January 29, 2018 8:16 AM"
- It appears the diagram tool's pricing plan has a free option with 'unlimited public diagrams' and 3 private diagrams. Probably explains it but it's no excuse!
An inquiry into the use of consultants by the federal government has set off alarm bells across an industry that has won management consulting-style contracts worth $39.4 billion from Canberra over the past five years
ReplyDeleteThe irony will be that each department and their Agencies will probably now engage these consultants to determine if they are spending to much on consultants and develop a business case to justify spending on consultants.
I have no issue with consultants, but are we outsourcing to much to these big firms at a cost of engaging smaller specialists local consultants?
@7:23 AM. Do not disagree. What would be good would be a report on how much of this ‘consultancy’ was acted on to a successful outcome and how much simply became a dust collector? In my experience a lot of work never gets acted on and gets forgotten only to be repeated at some later date. That is the real waste here.
ReplyDeleteI am sure the ADHA has thrown a lot of money down the drain in its first 2 years.
It would appear ADHA slashed out some $ 81 million on consultancy and another 9 million on contractors FY 2016-2017
ReplyDeletehttps://www.digitalhealth.gov.au/about-the-agency/publications/reports/annual-report/part-4-financial-statements/financial-statements-2016-17#cashflow