tag:blogger.com,1999:blog-23447705.post4517064698399423402..comments2024-03-29T09:18:22.495+11:00Comments on Australian Health Information Technology: There Seem To Be A Lot Of Docs Not Happy With The Way E-Health Is Being Run.Dr David G More MB PhDhttp://www.blogger.com/profile/06902724829795199526noreply@blogger.comBlogger21125tag:blogger.com,1999:blog-23447705.post-78228244645213744232013-11-29T11:34:44.261+11:002013-11-29T11:34:44.261+11:00Implying the Decision makers exercising their deci...Implying the Decision makers exercising their decision making authority to deliver the PCEHR in its current guise with all its avoidable problems were:<br /><br />Neither <i>"highly intelligent"</i> nor <i>"well informed"</i> or both!<br /><br />But more appropriately, and to utilise the same Wicked Problem resource:<br /><br /><i>”The command and control paradigm of Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-33585180175246318482013-11-28T22:39:47.834+11:002013-11-28T22:39:47.834+11:00Or, as I quoted in my submission to the review tea...Or, as I quoted in my submission to the review team.<br /><br />“Some problems are so complex that you have to be highly intelligent and well informed just to be undecided about them.”<br /><br />Laurence J. PeterBernard Robertson-Dunnhttp://www.problemsfirst.com/blognoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-52022228757125784942013-11-28T20:00:43.182+11:002013-11-28T20:00:43.182+11:00Agreed!
Apart from any prior analysis that may or...Agreed!<br /><br />Apart from any prior analysis that may or may not have been conducted, which content we are most likely never to see, the biggest question revolves around what individual or group of individuals has actually "made this PCEHR decision", and how on earth they may be held "Accountable" for this Taxpayer funded eHealth travesty!<br /><br />It would be absolutelyAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-22842640900450821162013-11-28T15:56:09.338+11:002013-11-28T15:56:09.338+11:00An early, architectural decision.
Do you create a...An early, architectural decision.<br /><br />Do you create a large central repository of data that may or may not be complete and/or accurate in case it is needed?<br /><br />or<br /><br />Do you create an interchange mechanism such that all the current data is moved to where it is needed when and only when it is needed? You may still not know how accurate it is.<br /><br />Has that question everBernard Robertson-Dunnhttp://www.problemsfirst.com/blognoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-30023350945594584852013-11-28T13:52:36.761+11:002013-11-28T13:52:36.761+11:00Allowing point to point communication with a lot o...Allowing point to point communication with a lot of work improving the quality and detail of the content would allow us to build up quality data and easily transmit it to where it was needed.<br /><br />I don't think a shared repository is the holy grail at all - what we need is good quality data that can be moved at will. It not sexy and mostly invisible but its a much cheaper strategy. The Andrew McIntyrehttp://www.medical-objects.com.aunoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-71014700406610101352013-11-28T12:36:26.729+11:002013-11-28T12:36:26.729+11:00My real fear is the Review Committee will miss the...My real fear is the Review Committee will miss the point entirely and fail to understand that the foundations are NOT IN PLACE despite years of rhetoric.<br /><br />The CeHA sums it up precisely in their submission - as follows:<br /><br />....... The submission states that while even the AMA president is suggesting the foundations are in place and all the PCEHR needs now is improved usability Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-40622460249513645952013-11-28T10:56:11.341+11:002013-11-28T10:56:11.341+11:00Some are underway with no Government help. I would...Some are underway with no Government help. I would rather see that with a little supporting grant payments to get started and develop capabilities if needed. Make it competitive and have those who do a good job prosper.<br /><br />This is what the 2008 Deloittes Strategy suggested as I recall.<br /><br />DavidDr David G More MB PhDhttps://www.blogger.com/profile/06902724829795199526noreply@blogger.comtag:blogger.com,1999:blog-23447705.post-2839469215300990192013-11-28T10:48:18.214+11:002013-11-28T10:48:18.214+11:00David, I think most intelligent and experienced eh...David, I think most intelligent and experienced ehealth practitioners would agree with you. I do.<br /><br />However, the start-up development cost is not insignificant. It is also a high risk exercise. But that shouldn't deter the brave and courageous from going down that path.<br /><br />While you advocate getting big government out of it - are you in favour of big government providing someAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-58557179118078513972013-11-28T10:33:52.515+11:002013-11-28T10:33:52.515+11:00Nope.
Just let the private sector do it as they a...Nope.<br /><br />Just let the private sector do it as they are already doing in a number of locations and get big Government out of it. If health information exchange is of no use it won't happen - if it is useful it will!<br /><br />Done right I think it can be - again read the full set of ideas in my submission.<br /><br />David.<br />Dr David G More MB PhDhttps://www.blogger.com/profile/06902724829795199526noreply@blogger.comtag:blogger.com,1999:blog-23447705.post-62458390163916541202013-11-28T10:28:18.544+11:002013-11-28T10:28:18.544+11:00..... after putting in shared regional informatio........ after putting in shared regional information exchange hubs<br /><br />Sounds simple. And where are these RIEH going to come from? <br /><br />Who will establish them? Who will run them? Who will fund them? Will they be viable? Will they all be the same ie standardized? What software will they use? Who will develop the APIs? How will they be updated? Who in the eHealthIT industry will be Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-12854525942507439672013-11-28T09:59:17.165+11:002013-11-28T09:59:17.165+11:00Yes - close it down after putting in shared region...Yes - close it down after putting in shared regional information exchange hubs. See my submission a week or so back.<br /><br />David.<br /><br /><br />Dr David G More MB PhDhttps://www.blogger.com/profile/06902724829795199526noreply@blogger.comtag:blogger.com,1999:blog-23447705.post-21707183854385575502013-11-28T09:50:23.695+11:002013-11-28T09:50:23.695+11:00They need to cut their losses.
I presume you mean...They need to cut their losses.<br /><br />I presume you mean lose it down?<br /><br />I think you may be whistling in the wind on that one David if the AMA submission is anything to go by. <br /><br />The AMA makes some good points, however, careful scrutiny will reveal they too don't really (get it) understand what they are dealing with except at a very superficial level.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-79053771151311348352013-11-28T09:49:28.538+11:002013-11-28T09:49:28.538+11:00Projects are all about assumptions and decisions
...Projects are all about assumptions and decisions<br /><br />In my experience projects go wrong when an invalid assumption or bad decision is made. Once one of these occur, unless it is detected and corrected the project will fail. The earlier in a project this happens, the greater the impact and the harder it is to detect.<br /><br />In the case of the PCEHR, there seem to have been two Bernard Robertson-Dunnhttp://www.problemsfirst.com/blognoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-31127978011584215462013-11-28T09:15:32.923+11:002013-11-28T09:15:32.923+11:00"so are we off on another goose chase?
If so..."so are we off on another goose chase?<br /><br />If something is unfixable - does it not follow that it cannot be fixed?"<br /><br />Whatever, but I fear they are probably planning to try and fix it and yes that does mean another expensive wild goose chase I believe! <br /><br />They need to cut their losses.<br /><br />David.<br />Dr David G More MB PhDhttps://www.blogger.com/profile/06902724829795199526noreply@blogger.comtag:blogger.com,1999:blog-23447705.post-15883784417007489302013-11-28T09:09:06.040+11:002013-11-28T09:09:06.040+11:00..... fix the unfixable .... mmm - isn't that ........ fix the unfixable .... mmm - isn't that an oxymoron? Even so, it looks as though that is what the PCEHR review Team is focussed on - so are we off on another goose chase?<br /><br />If something is unfixable - does it not follow that it cannot be fixed?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-49025963148574862722013-11-28T08:22:24.692+11:002013-11-28T08:22:24.692+11:00I do agree that the overall outcome of the group&#...I do agree that the overall outcome of the group's contribution was very poor but equally I do think SOME of them were working to try and fix the unfixable.<br /><br />We all know they ultimately failed and took way too long to come out and say it was hopeless.<br /><br />David.<br />Dr David G More MB PhDhttps://www.blogger.com/profile/06902724829795199526noreply@blogger.comtag:blogger.com,1999:blog-23447705.post-54746441231307487022013-11-28T08:12:52.565+11:002013-11-28T08:12:52.565+11:00Sorry David, I don't often disagree with you b...Sorry David, I don't often disagree with you but on this occasion your commentator above is quite right. Spivs, salespeople, they were. <br /><br />If they had any semblance of the slightest understanding and experience in what is involved in developing ehealthIT systems, (design, development, project management, deployment, quality testing, phased implementation, etc.) they would NOT have Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-45118570950075237362013-11-28T08:06:46.066+11:002013-11-28T08:06:46.066+11:00"No matter what the outcome of the current re..."No matter what the outcome of the current review if the people who have been in charge remain absolutely nothing will change...... not even a single spot on a solitary leopard."<br /><br />Absolutely correct.<br /><br />David.<br />Dr David G More MB PhDhttps://www.blogger.com/profile/06902724829795199526noreply@blogger.comtag:blogger.com,1999:blog-23447705.post-82056555406839791152013-11-28T08:00:25.970+11:002013-11-28T08:00:25.970+11:00My experiences and first hand knowledge from the c...My experiences and first hand knowledge from the commencement of the PCEHR project and well before confirms that this article is a very close portrayal of the truth of the way things have been run. <br /><br />No matter what the outcome of the current review if the people who have been in charge remain absolutely nothing will change...... not even a single spot on a solitary leopard.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-23447705.post-68637582018174966272013-11-28T07:59:15.788+11:002013-11-28T07:59:15.788+11:00Hang on! I think that is a bit too sweeping. Some ...Hang on! I think that is a bit too sweeping. Some were experts and some not. I don't think that was really fair to the better or them.<br /><br />David.<br />Dr David G More MB PhDhttps://www.blogger.com/profile/06902724829795199526noreply@blogger.comtag:blogger.com,1999:blog-23447705.post-40018840461568929762013-11-28T06:59:01.493+11:002013-11-28T06:59:01.493+11:00These doctors were mostly spivs of the highest ord...These doctors were mostly spivs of the highest order, paid six figures sums by NEHTA to lend their "reputations" to the PCEHR. They had no health IT or informatics domain experience, let alone expertise, were more than happy to take the cash, but like so many associated with this project, delivered zero value. <br />When the election loomed, and it was clear beyond doubt that NEHTA Anonymousnoreply@blogger.com