Finally, An Communiqué from the Australian Health Information Council - Almost!

The Australian Health Information Council (AHIC) has finally released the communiqué you release when you don’t want to release a communiqué! To cover two meetings, of a still unknown number of members held over the last two and a half months, we get a single page notification that the meetings have been held.



What else do we learn?

1. The AHIC has a one year work program.

2. The Chairman is Professor James Angus, Dean of the Faculty of Medicine, Dentistry and Health Sciences at the University of Melbourne.

3. There are two executive committee members 1. Professor Enrico Coiera, Director of the Centre for Health Informatics, and Ms Yvonne Allinson, Executive Director of the Society of Hospital Pharmacists of Australia. The rest of the membership is not disclosed.

4. The role of AHIC is now that “The AHIC gives independent policy advice to Australian health ministers through the Australian Health Ministers’ Advisory Council (AHMAC). It provides the end users’ perspective on long-term directions and national strategic reform in health information management and information communication technology.”

5. A generalist Health, and non Health IT, consultant has been engaged to develop a yet to be finalised and possibly disclosed work plan for the next 12 months – after which time who knows what will happen.

6. There will be, at some future point, an e-Health Future Directions Summit, with members of the National Health Information Management Principal Committee being invited to attend.

7. The summit will examine the elements that will need to be in place in the next five to ten years to increase the provision of high-quality, timely information that will help consumers, clinicians and the health system to make the best decisions.

8. The new committee likes workshops rather than business meetings.

What have we not been told?

1. Just what the terms of reference of AHIC now are, who are the members and their affiliations, what were the criteria for selection and what proven track record do the members have in national health IT strategic planning.

2. Why AHIC just vanished and stopped meeting for approximately two years and has suddenly been resurrected.

3. What has happened to the AHIC web-site at www.ahic.org.au

4. Now we have resumed the a full work program – what were the outcomes of the old work program. (Does this remind anyone of the evaluation reports for the HealthConnect Trials?).

5. How end-users doing a future plan is going to influence the evolution of the supporting technology.

6. What is the relationship between AHIC and NEHTA? How are the work plans co-ordinated etc?

7. What are AHIC’s actual powers or is it just an advisory toothless tiger. The transmittal e-mail strongly suggests the latter.

“Subject: The Australian Health Information Council Communique - April 2007 [SEC=UNCLASSIFIED]

Dear eHealth Industry Member

Please find enclosed the April 2007 Australian Health Information Council Communique for your information.

The Australian Health Information Council (AHIC) is a multidisciplinary expert group that provides advice to the Australian Health Ministers via the Australian Health Ministers Advisory Council (AHMAC) on information management and communications technology development in the health sector from the end user perspective.

AHIC is an advisory rather than a decision making body and works in conjunction with industry, the public and private health sectors and professional bodies to formulate strategic advice.

The Council is chaired by Professor James Angus, Dean of the Faculty of Medicine, Dentistry and Health Sciences at the University of Melbourne, who also represents AHIC on the NHIMPC.

The AHIC has agreed that a Communique outlining their activities will be forwarded to eHealth industry members following each meeting.

The AHIC Secretariat is provided by the Department of Health and Ageing. Should you wish to contact the Secretariat please email ahic.secretariat – at- health.gov.au”

8. Other than one page communiqués are there going to be any substantive documents and reports produced by AHIC.

9. Is AHIC going to at any time publish minutes of meetings etc so those interested can be informed as to the directions considerations are taking.

10. What is to happen after the one year resurrection is over in April 2008.

11. What accountability will the AHIC members have for the outcomes in the e-Health domain.

12. What budget has been allocated to support the AHIC Strategic Planning Process?

The important point I see is that AHIC's role seems to be fundamentally different from the past. Rather than being concerned with e-health strategy and its implementation it is now an end user committee based on the assumption that it will all magically come technically together under NEHTA's skilful strategic guidance.

This is really nonsense - we need to get the user needs and the technology aligned and managed as part of a coherent forward plan. I don’t see AHIC being tasked or enabled to really undertake this. The complexity and subtlety of the plan that is required would severely test the Booze Allen’s and McKinsey’s of this world - The clinician engagement strategy of itself will need to be a masterpiece!

Some colleagues are suggesting I wait and see what happens over the next few months. From what I have seen so far I do not hold out much hope for real improvement unless the complexity of developing such a plan is fully recognised and addressed – and time allowed to consult very widely and get to some sensible answers.

I see it as vital there is a push pushing for openness and for doing this plan properly - rather than the planned approach of develop a briefing paper and having one day a meeting with 30 people around the table try to solve some really hard problems on a limited (very limited) information base of where everyone is up to (govt private sector, vendors etc), where the big gaps are and having no clear developed view of what is possible and doable and what the strategic choices really are.

I really feel that unless a really expert in-depth piece of work is done it won't go anywhere and another opportunity will be wasted.

Australia has done the lacking real depth type of planning exercise that is proposed couple of times in the last decade, and we find ourselves where we are.

I also don't think this can be done in chunks or parts - I really believe a proper job needs to be done - looking at current state of e-Health, e-Health governance, technology futures, clinician engagement approaches, costs, benefits, risk management, sector participation and so on.

Surely the lesson of the last decade is that if you do it by half you wind up with very little!

I believe it is time to give it one really good shot and get it right!.

David.

Are You Tired of Being Treated Like a Mushroom – Kept in the Dark and Fed Manure?

This posting will be short and to the point. I was wondering, over the weekend, how many others in the e-Health community feel that all the confidentiality and secrecy surrounding e-Health planning and progress has got a little out of hand. I suspect it may be part of the present electoral cycle but recently I have been seeing two main things happening.

First we have seen all sorts of documents from NEHTA which even by their own admission were just a preview rather than something that could actually be implemented for testing etc. Among the documents I put into this category are:

1. The various technical documents incorporated in the e-Procurement Hub Tender released a month or two ago.

2. The so-called Release 1.0 of the Australian Medicines Terminology (AMT) which was much more like a Release 0.01

3. The Pathology Terminology Reference List v1.0 - Release Note and associated documents

4. The still unreleased document explaining the Selection of HL7 for Australia and what the reasons for the decision were and what the implications for the e-Health Community are. (This document also is one of the secret ones that has been reviewed by consultants – but not been made public for comment by others who might be interested.)

The big question here is why all the haste and why release work that is half finished. Another secret I suppose but I can guess. Maybe a performance review is due?

Second we have news that the Department of Health and Aging (DoHA) and the Australian Health Information Council (AHIC) are working to develop a new e-Health Agenda for the country through a process that is distinctly reminiscent of the work undertaken by the Boston Consulting Group in 2004 and which has led to the present rather unsatisfactory situation in e-Health overall.

Last week a colleague mentioned, in passing, that this directional study was being commissioned and that it was intended that the outcome would be available for consideration by July / August 2007.

Having considered the prospect of such a strategic study, I responded as follows, outlining three points I found concerning about an apparently time, depth and transparency limited approach to the planning.

“First an assumption I have always had regarding any new national strategy is that we should work hard so we don't repeat the mistakes of previous work. These mistakes have certainly included a lack of inclusiveness and a lack of proper consultation with the actual health system and health system providers rather than bureaucrats, peak body representatives and medical politicians as to needs priorities and problems to be addressed. I am not sure what is now asked for is very much the same or not but I think it needs to be raised as a possible risk.

Second, even with a very clever approach, there is a risk of having “lots of time to do it again but not enough time to do it properly”. I also see that as a risk as this is very much a 'last shot in the locker' for 5 years at least. I also fear the political cycle may put time pressures on the project that may make the outcomes less than useful.

My last comment is that, with the way this is all unfolding, the standard operations procedures of DoHA and NEHTA, with almost paranoid confidentiality etc will dominate. This is a worry as it will be a block to getting a real diversity of view and choices to consider. Being 'inside the beltway' can give a very false view of the world.”

I hope my colleague can feed back some of these concerns to the powers that be!

I have no idea how all this will work out ultimately. Given that AHIC has already met twice and there is no public outcome one cannot be all that optimistic. When checked today the AHIC URL was still inactive and I discovered we have a new peak Health Information Management Committee – called the National Health Information Management Principle Committee . There are only two references on the web to this committee and its membership seems pretty obscure. Their functions etc can be found at the following non-DoHA site. More secrecy and very odd I must say!

http://www.e-health.standards.org.au/cat.asp?catid=11

It is amusing that the page lists all the key standing committees but does not mention AHIC!

I really despair of all this – but must continue to hope I guess.

David.

Useful and Interesting Health IT Links from the Last Week – 29/04/2007

Again, in the last week I have come across a few reports and news items which are worth passing on. These include first:

http://www.fiercehealthit.com/innovators/2007

Top Healthcare IT innovators

Hello, and welcome to the first edition of our Top Health IT Innovators list. We’re excited to be showcasing what are regarded as some of the most interesting—and disruptive—companies we know of in the healthcare IT industry, including some we can
more or less guarantee you’ve never heard of (yet).

Consumer Health IT?

Wondering why you see so many companies working on consumer-type problems on the list, rather than the back-end gear touched by CIOs and network admins? That’s because this may be the year when consumers have more contact with enterprise health IT than they ever have had before. Many of the intriguing technologies we’re highlighting are designed to guide consumers in their care electronically, using smart interactivity and content. Why? Because while doctors are already good at working with standard internal records, they currently don’t have a smooth way to interact with patients online, link the patients into their own decision-making process or collect patients’ self-reported impressions of how they’re doing. We’re not talking about a big boost in the use of PHRs, though that may indeed happen; we’re talking about a two-way flow of clinical and personal information that the industry has never seen before.

If some of the vendors below get their way, though, patients, clinicians and health organizations will have an online data-sharing dialogue, improving outcomes and saving time and money in the process. It’s an interesting shift in the business, and one, that we think is long overdue. We also think it’s going to hit big and take root quickly, so look for some major changes in patient-doctor interactivity this year.

…..

This is a fascinating collection of ideas for Health IT Innovation. Visiting the site provides access to 10 different start-up Health IT entities all of whom have interesting ideas that may make a difference either in how health care is delivered or managed. Well worth a browse.

Second we have:

http://www.kablenet.com/kd.nsf/Frontpage/F3416139CA164565802572C9005A59E3?OpenDocument

MPs warned about e-health records

27 April 2007

The government has been accused of ignoring concerns about the privacy of the NHS e-care record

Contributors to a hearing of Parliament's Health Select Committee on 26 April 2007 claimed the government is pressuring patients for their information to be included on the Care Record Service.

One claimed that the Department of Health has adopted an attitude of "suppressed hostility" towards patients who choose not to be included in the electronic care record system, NHS patient Andrew Hawker told MPs.

Andrew Hawker, an academic who has written about information systems and described himself as "an NHS patient", warned that the implementation of e-care records should be deferred until core IT systems are fully installed and it has been "thoroughly tested for privacy".

"I feel like a passenger on board a plane," Hawker said. "The plane has not had many test flights, and some of those have crashed. Meanwhile flight attendants are handing out brochures saying how safe it all is."

Further warnings were made by Paul Cundy, chair of the General Practitioners' Joint IT Committee. Cundy said that the summary care record, even in early adopter sites, shows signs of becoming far more than just a "summary" care record.

…..

This is another piece of evidence for three of the major contentions I have put in this blog. First that major technology initiatives have to be managed in a way they fully involves those at the coal-face. High level consultation during planning and implementation (with executives and managers) that does not reach the grass roots can pose a great risk to overall project success. Second developing an approach to managing privacy that clinicians and patient are happy with is vital. Third it seems increasingly likely that the best way to approach national e-health projects is to develop ‘bottom up’ implementation approaches and not ‘top down’ methodology.

On the same topic the following is also well worth a careful read – written by the developer of the 1998 Connecting for Health Program.

http://www.publications.parliament.uk/pa/cm200607/cmselect/cmhealth/422/422we54.htm

Evidence submitted by Mr Frank G Burns (EPR 60)

INTRODUCTION

It is, frankly, astonishing that a Committee of the House of Commons should, at the beginning of the 21st century feel compelled to undertake an inquiry into the value and mechanics of managing health care records in electronic form.
…..

The last important item regards SNOMED CT.

SNOMED sold to international organization

The College of American Pathologists has agreed to sell the intellectual property rights to its Systematized Nomenclature of Medicine Clinical Terms, or SNOMED CT, to the newly formed International Health Terminology Standards Development Organization, based in Denmark, for $7.8 million. CAP's decision to hand off SNOMED to an international organization was announced in January. To provide a smooth transition, CAP will continue to support standards-development operations with the new entity under an initial three-year contract and will continue to provide SNOMED-related products and services as a licensee of the terminology, according to an announcement today by the 16,000-member, Northfield, Ill.-based medical specialty society.

Charter members of the successor organization to the CAP and its SNOMED International division are organizations representing Australia, Canada, Denmark, Lithuania, the Netherlands, New Zealand, Sweden, the U.K. and the U.S.

"As the international adoption and use of SNOMED CT has grown, it has become apparent that an international governance structure that is open to the entire global healthcare community would be to everyone's benefit," said CAP President Thomas Sodeman, in a news release. "The college is proud to have assisted in this important milestone." -- by Joseph Conn / HITS staff writer

Details of what is happening in Australia can be found here:

http://www.nehta.gov.au/index.php?option=com_content&task=view&id=187&Itemid=144

A Canadian announcement of similar news can be found here:

http://www.infoway-inforoute.ca/en/News-Events/InTheNews_long.aspx?UID=267

The next step, for us in Australia, will be for NEHTA to announce the license conditions that will now operate and what the going forward arrangements for maintenance of the Australian version – including extensions for medicines etc.

http://www.healthdatamanagement.com/html/news/NewsStory.cfm?articleId=15057

Standard for ER Systems in Works

(April 25, 2007) A new “registered profile,” or a subset of an existing standard, could ease the creation of criteria to certify the functionality, interoperability and security/reliability of emergency department information systems.

Standards development organization Health Level Seven has adopted the Emergency Care Functional Profile as the first registered profile based on HL7’s EHR System Functional Model standard that was adopted in February. The functional model contains about 1,000 criteria covering more than 150 functions in such areas as medication history, problem lists, orders, clinical decision support, and privacy and security. The functional model is designed to provide guidance to electronic health records software developers and purchasers.

The new Emergency Care Functional Profile is a subset of the functional model, containing criteria specific to emergency department information systems.

…..

This profile is a useful step forward and will be of interest to all involved in emergency and ambulatory care system development. More information at the site.

All in all quite an interesting week.

David.

Something You Might Be Missing – The Comments.

As the blog has gradually acquired more readers there has gradually been an increase in the number of Comments posted after each article is published.

Neither the RSS Feed or the e-mail Alert lets readers know that new comments have been posted.

Since the beginning of 2007 there have been a range of really insightful and useful comments posted. (Thanks to all who have done so!) Can I suggest that readers occasionally scroll down the last few articles and check for new comments when visiting as I can find no obvious way to ensure these gems are not missed.

It is of note that many users often carefully consider their comments for two or three days before commenting so it is worth checking out at least the last week when visiting the site.

Oh! and before I go - yesterday it was a month since I have the note from DoHA regarding my letter to Mr Abbott. No response as yet.

David.

It Really is Very Hard to Make Shared EHRs Work.

Sobering news for all the proponents of Shared EHRs came in overnight.

The original article from E-Health Insider can be found at the following URL:

http://www.ehiprimarycare.com/news/item.cfm?ID=2635

iHealthBeat (http://www.ihealthbeat.org/) summarises the key findings well.

“Majority of British Physicians Oppose IT Project, Survey Finds

Sixty-six percent of British general practitioners said they will not allow their own health records to be shared through the National Health Service's Summary Care Record program, according to a survey of general practitioners by Pulse magazine, E-Health Insider reports. Only one-third of respondents said they plan to advise their patients on sharing their health information.
The survey also found that:

• About one-third of physicians said they will allow full sharing of their patient records;
• Four out of 10 physicians say they will opt out completely from the program and allow none of their records to be shared;
• 80% of physicians surveyed still think that sharing electronic health records can threaten patients' confidentiality, despite a government marketing campaign to promote the IT program; and
• 67% of general practitioners oppose the implied consent "opt out" model, which has formed the basis for the program to be rolled out, E-Health Insider reports.

Lord Warner, the former head of the NHS IT program, said that physicians have become "over-protective" of their existing health record system, according to E-Health Insider (E-Health Insider, 4/24).”

The lessons here are clear. The first lesson is that the implementation of a Shared EHR is a project which must be undertaken with continuing and ongoing consultations with clinicians and patients to ensure the directions being adopted are acceptable and will foster adoption and use.

The second lesson it seems to me is that in 2007 the Shared EHR is not a technical problem but a cultural change problem where is the trust of the users of the system is not developed and maintained the risk of failure of the overall project failure is greatly increased.

The third important lesson is that if the approach adopted minimises compulsion, maximises patient control of their information and maximises voluntary choice as to whether to use the technology or not, assuming good technical design, while slower to reach, genuine adoption and use is much more likely.

Separate from this report, the interested reader is referred to my article of March 15, 2007 which is found at the following URL:

http://aushealthit.blogspot.com/2007/03/shared-ehr-can-it-be-done-simply-and.html

Without going over old ground it seems to me a simple Shared EHR can be very useful, but only if it is developed in the context of using the information from advanced clinical systems to provide information to and retrieve information from the shared record. Clearly the shared record also needs to be properly standardised and securely transmitted, received and stored.

All this is easily done, using standard and well tried technology. Making use of the record voluntary for both doctor and patient is the way to go. With a voluntary record, I am sure what will happen is that those for who having their record available is important the service will be used, and those who are unsure or uninterested simply won’t. It should really be as simple as that.

I suspect that among those with chronic and complex disease, in the scenario I suggest above, there would soon emerge pressure on clinicians from their patient’s to upload records as “information insurance” for the chronically ill as well as assisting in the overall co-ordination and delivery of their care.

We must make sure any Australian initiative to develop and deploy a Shared EHR has these lessons from the UK firmly in mind and approaches the project in a genuinely voluntary way!

David.

It’s the Season for Silly Health IT Benefits Claims!

No sooner have we had NEHTA tell us how much we can save from e-Health but now we have a second entrant to tell us something different and even more incredible.

The Australian Centre for Health Research has just published (April 2007) a 19 page document entitled “E-Health and the Transformation of Healthcare”.

For those interested in reading the full document it can currently be found at the following URL:

http://www.achr.com.au/pdfs/ehealth%20and%20the%20transofrmation%20of%20healthcare.pdf


The headline claims from the executive summary are as follows:

“The impact on the individual can be imagined; the cost to the nation is immense. In Australia, it’s estimated that improved knowledge sharing and care plan management for patients with chronic disease would generate direct savings to the health care system of more than $1.5 billion per annum. Savings to the community from associated non-health care costs are of the same order. And increased workforce participation and productivity could add a further $4 billion per annum to the economy.

For the patients, home monitoring could reduce emergency room visits by up to 40%, hospital admissions by 30-60% and length of hospital stays by up to 60%.”

All I can say is “Here we go again!

”The argument made in the paper is:

• Disease Management (DM) and similar process improvement processes work
• Technology and ICT is an important enabler of DM
• If we approach Chronic Disease with technology there is a huge benefit possible.

This is all true as far as it goes. There is also no doubt – from a huge range of studies mentioned in other reports not cited here - that Health IT can make a difference. However the evidence as I read it does not support the proposed approach.

The paper does however get one point exactly right in the following:

“The Paper raises one final, important point - that of incentives. There is a cost to building this connectivity and information sharing but there is a mis-alignment between those who pay and those who receive the benefit.”

And rightly suggests who should pay

“Another important component is for the major beneficiaries of more efficient and effective health care (that is, governments, private insurers, and employers) to provide incentives for the use of electronic services, broadband health networks, and best practice processes.”

Of course we have yet to see any offers from Government etc to really ante up what is needed!

In summary the suggested approach is:

“ We should focus on three important areas:

1. get healthcare providers connected to one another
2. track health events across the continuum of care
3. create a broadband network of health services

In business, most high priority and high volume communications are handled electronically. But in health care, high-importance communications – e.g. referrals and hospital discharge summaries – are created using paper and pen and delivered via fax, letter and even by hand.

This is the point where we should begin – simply, aim to get referrals and discharge summaries to be delivered electronically in a convenient and secure form.”

To be polite this is a spectacular over-simplification of what is needed to achieve substantial benefit. Sure, - I have always been very keen on aiding the flow of key clinical documents electronically – but for a lot of good reasons this should be done in a secure, standardised, managed fashion and not as seems to be suggested here by provision of simple connectivity.

Likewise the second and third focus areas are dramatically more complex than identified in the paper.

The document has a ready, fire, aim feel to it. It is of note that the only Health IT benefits study that seems to be cited is this one while there are many other much deeper and much more recent studies readily available:

DMR Consulting, “HealthConnect Indicative Benefits Report”, Final Version, February, 2004 (extrapolated to latest chronic disease data). This can be found here:

http://www.health.gov.au/internet/hconnect/publishing.nsf/Content/C50C3B807441ADBACA257128007B7EC4/$File/hcibrv1.pdf

This document was so unpersuasive as to the available benefits of HealthConnect that the Commonwealth commissioned a review by the Boston Consulting Group (April 2004) and this review resulted in the change of HealthConnect from a funded strategic program to nothing more than a “change management strategy”.

Let me be clear about the problem I have with all this. Realistic estimation of the value of benefits from Health IT requires a clear exposition of what technology is to be implemented and how it will then provide benefit. To not have a Strategy for what is to be done, an Implementation Plan that describes how it will be done and a realistic Business Case that identifies both costs and benefits no one is going to care to take notice of, or action, unsupported claims of benefits.

We have seen two claims for major benefits that can be derived from Health IT (This present one and the study mentioned in NEHTA’s recent presentations). It seems passing strange that the two studies identify largely different sources of benefits and seem to come up with wildly different estimates of what is achievable.

The flaw in both studies is that they don’t proceed from a deep understanding of the business of Health Services Delivery and are not informed by what is needed at the clinical coal face. Only once the requirements and problems of the sector are clearly identified can a strategy to deploy technology to assist be developed and have a chance of success. Implicit in the strategy will be the benefit opportunities that will need to be firmed up. This is what then needs to be refined through the development of the implementation plan and business case which will reveal where investment makes sense and can make a difference. The last step (not the first) is to estimate the quantum of benefits and develop the approach to be used to capture them as implementation proceeds.

As I have said before the work required to convince the hard heads in Treasury to invest is substantial and needs to be a comprehensive package (Strategy, Implementation Plan, Business Case and Benefits Realisation Plan).

Without this work being done to a high quality I predict just nothing will happen.

These half baked studies do more harm than good I believe.

David.

Useful and Interesting Health IT Links from the Last Week

Again, in the last week I have come across a few reports and news items which are worth passing on. These include first:

http://www.govhealthit.com/article98187-04-16-07-Print

Finding Foreman

George Foreman named his five sons George. Will the National Health Information Network be able to pinpoint his health records? Maybe. Maybe not.

BY Nancy Ferris

Published on April 16, 2007

George Foreman — boxer, clergyman and entrepreneur — named his five sons after himself. So when the Nationwide Health Information Network (NHIN) is up and running, how will a doctor find the records for the right George Foreman?

Accurately matching patients with their electronic records is at the heart of the proposed network. But what if doctors search NHIN and find no records for anyone named George Foreman? If few matches are found, users will soon pronounce the network a waste of time and money, and they’ll abandon it.

However, if too many George Foreman records are found, the network could seem equally useless. Just imagine the number of records created over the years for the boxer’s sons and others with the same name who are not related to the more famous Foremans.

In that case, a doctor might be unable to determine which of the many records relate to his or her patient. If the doctor guesses wrong, the patient could end up with treatment that’s ineffective or even harmful. What’s worse in the eyes of many people is that the doctor’s employees could see the records of someone else’s patients.

Alternatively, someone from the doctor’s office could call the patient and ask questions such as, Did you ever live on Maple Street? Did you seek treatment for a broken leg in Grand Rapids? What was your maiden name? But that approach is labor-intensive and hardly seems to fit with the notion of a 21st-century information network. It also isn’t likely to provide enough value in return for the billions of dollars it will cost to create the network.

…..

As always see the sites for the full article. This is a useful listing of the problems you can face without really robust unique identifier approaches and is an especially large problem for Shared EHRs which do not have such technology at their core.

http://www.e-health-insider.com/news/item.cfm?ID=2618

IT and e-health is 'every nurse's business'

17 Apr 2007

IT and e-health is every nurse’s business because it has to be integrated into practice, nursing leader, June Clark, said on the eve of a major discussion at the Royal College of Nursing’s annual congress this week.

The discussion on the theme “Computerised records – what can they offer?” will be available online at the College website. Professor Clark, a former president of the college and chair of the RCN Information in Nursing Forum, told E-Health Insider she hoped as many people as possible in the e-health community would get involved.

She hopes the session will raise awareness on several fronts: “The first is awareness among nurses that e-health and IT and the introduction of IT into the NHS is every nurses’ business because it has to be integrated into nursing practice,” she said.
“The other awareness that I want to get across to this audience and more generally that electronic patient records must have appropriate nursing content, not just medical content.”

…..

Another useful point is being made here – the reason we prefer the term “Health Informatics” rather than “Medical Informatics” - it the Health IT needs to be used by all health professionals if the full benefit is to be achieved.

http://news.zdnet.co.uk/itmanagement/0,1000000308,39286714,00.htm

Parliamentary report urges action on NPfIT

17 Apr 2007 09:26

Public Accounts Committee has published a report that calls for urgent action to reduce the risks of the NHS National Programme for IT.

The success of the NHS National Programme for IT is precarious, with key projects running late and suppliers struggling to deliver, according to a long-awaited report from Parliament's influential Public Accounts Committee.

"There is a question mark hanging over the National Programme for IT (NPfIT), the most far-reaching and expensive health information technology project in history," said committee chair Edward Leigh on 17 April.
…..

The full report can be found here:

http://www.publications.parliament.uk/pa/cm200607/cmselect/cmpubacc/390/390.pdf

There seems little doubt that the huge UK programme has a large number of both good and bad bits. Despite the differences in Health Systems there is always a lot to learn from such reports. Careful reading recommended for those involved in major Health IT projects.

Further perspective can be found in a recent editorial in the MJA entitles "Lessons from the NHS National Programme for IT" written by Professor Enrico Coiera of UNSW. See the following URL:

http://www.mja.com.au/public/issues/186_01_010107/coi11007_fm.html

http://www.smh.com.au/news/National/Report-backs-electronic-health-records/2007/04/19/1176696992965.html

Report backs electronic health records

April 19, 2007 - 5:39PM

Up to $7 billion could be saved each year if Australia's health providers shared patient data electronically, says a new report.

Commissioned by the Australian Centre for Health Research, the report argues a broadband network of health services should be created to allow patients to be tracked no matter where they go for medical services.

Monash University e-health research unit director Michael Georgeff said about one-quarter of all Australians suffered from a chronic illness and many had complex health needs.

"Chronic illness requires close monitoring and, often, intensive management by a team of health professionals," Professor Georgeff said.

"But because of the way our health system currently operates, one doctor will often not know what tests or medications have been prescribed by another doctor even when they are members of the same team."

…..

The full report can be found at the following URL:

http://www.achr.com.au

I have deep concerns about this report and it claims which will be the subject of a future article. Download it and consider the claims it makes for yourself. (It’s only 19 pages)

David.

Policy Relating to Comments on the Blog.

The purpose of this blog is to provide a forum for discussion of the issues surrounding Health IT in Australia.

In that purpose there is the desire, from me, for accuracy, honesty and openness from all contributors.

Lately there have been a number of anonymous / whistle-blower comments on specific topics.

My view is that I will publish these – as long as they are free of direct personal attack and other objectionable comment on the basis that sunlight is a very good thing in the public policy arena – which is where this blog engages.

I am also more than prepared to publish any contrary views – both anonymously and as named contributions. Such contributions are both welcome and encouraged. Objectivity and truth is what is sought here!

I am also not planning to censor discussion – but I will protect any party from gratuitous personal abuse where possible - , including deleting posts I am informed or see are defamatory, obscene or deeply personally offensive. I will, of course, be the arbiter of that.

I believe in an open and transparent society and that the organs of government that support society should be equally open and transparent.

Would it were so!

David.

ps - I know that this is obvious - but it needed to be said. D.