Honestly The NEHTA Spruikers Are Either Very Funny Or Very Deluded. Which Do You Think It Is?

This popped up yesterday.

Here is the link to the blog that has the comment.

http://aushealthit.blogspot.com.au/2014/12/aushealthit-poll-number-250-results.html

Anonymous said...

"This simply shows how blinded your readers are and how out of touch you lot are from what is really going on. NEHTA has probably the best technical leadership it could possibly hope for. This year will see SMD solved, PCEHR purring along and NASH and HI refactored to meet changing demands. The only downside is that this blog will no longer have a role

December 29, 2014 8:14 PM

When I first read this I wondered if it was serious - and felt it needed to be treated as a parody. Re-reading it came to me just how silly it actually is - and really confirms that someone is wandering somewhere in a very large swamp of confusion - or is a good comedian!

Look at the internal in-consistency?

The best technical leadership leads to NASH and HI still (after many years) wandering in the wilderness.

The best technical leadership leads to SMD still hardly being used compared with the private sector offerings of Healthlink, Argus, Medical Objects and so on.

The best technical leadership leads to a PCEHR ‘humming along’. Of course it is as there are no users to interfere with the virtual silence of the ‘humming’ made by all that money flowing out the door.

I would really like the blog to not need to exist but with commentators like the above, who just might believe what they write (although I very much doubt it!) I feel a need to shine a little light into some very dark, very useless and very expensive places.

Ï suspect it is fair to say the readership of this blog are rather better informed than our friend cited above....

Happy New Year to all who are holding onto their sanity!

David.

Note: Comment 3 from Bernard is also spot on!

D.

AusHealthIT Poll Number 250 – Results – 28th December, 2014.

Here are the results of the poll.

Holiday Poll: Will The Government Deliver A Working, Easy to Use, Safe, Clinically Useful And Widely Adopted PCEHR In 2015?

For Sure 3% (4)

Maybe 6% (10)

Neutral 1% (1)

Probably Not 29% (45)

No Way 60% (93)

I Have No Idea 1% (1)

Total votes: 154

A pretty clear response with the large majority believing there is little chance of a useful PCEHR being delivered in 2015.

Good to see a clear outcome.

Again, many, many thanks to all those that voted!

David.

A Challenge: What Are the Five Things Australia Needs To Do To Develop A Transformative, Cost-Effective e-Health System?

In welcoming the appointment of the new Federal Health Minister the Consumer Health Forum raised 5 key points it wanted to see actioned.

The second point was as follows:

“2. Commit to eHealth: The revolutionary changes (and cost savings) possible in health care through the introduction of a robust, consumer-centred eHealth system cannot be underestimated.  Funding commitments must be made beyond 2014-15 to realise the potential of this system.”

In a brief response to this point I suggested that I was keen to have some of what the authors were inhaling on the basis that I believed to imagine that such was possible, if the present directions and approaches were continued and funded, was rather unrealistic.

Here is the full link:

https://www.chf.org.au/pdfs/chf/20141222-Welcome-Health-Minister-Ley.pdf

Hardly surprisingly I was challenged to say what I would do in five points - so here goes.

Action One:

Recognise that there are two distinct clients for e-Health systems and services and that their needs are not by any means the same - meaning that different systems are required for each. The professional clients (doctors, nurses, allied health etc.) need systems that enhance their clinical capabilities, improve record keeping and facilitate their secure sharing of clinical information to improve patient care and safety.

The consumers need systems to allow them to record their own information while at the same time having access  to, ideally, the live clinical systems so they can better engage with and understand and contribute to their care.

It is obvious the present PCEHR does neither of these things well.

Action Two:

We need to recognise we don’t need a single monolithic System but that we need an e-Health ecosystem where health information flows efficiently, accurately, securely and privately between appropriately credentialed actors within the health system and to and from consumers.

Action Three:

We need an updated National E-Health Strategy that consults all stakeholders properly and provides the  governance, leadership, strategic technical, standards and managerial pathways to actually achieve the goals cited by the CHF for this domain. We then need the Strategy properly funded and led - as did not happen with the 2008 version.

Action Four:

Before anything more is done or spent actually undertake a proper in depth peer-reviewed evaluation of what e-Health in all its guises has achieved in Australia and what has been achieved in the rest of the world that might be applicable to Australia. This research should inform what comes next.

Action Five:

We need to understand that no-where in the world has a transition to e-Health been easy, uncomplicated, pain free or without missteps. As we increasingly realise, getting this right is a very considerable and some might suggest near impossible challenge that takes lots of time, lots of money and dedication - as well as quality leadership and governance for success. E-Health is not something for generalist bureaucrats and technicians to have repeated goes at and repeatedly fail at!

I could ramble on for ever on this - but it what is said above is taken seriously, actioned and funded there is hope. If not then the next 20 years will be the same as the past 20!
David.
 

I Would Award The Hon. Peter Dutton M.P. An F- For His Performance In E-Health!

The story:

He gets into office as Health Minister - kicks off a six week review of the PCEHR - releases it 6 months later and is yet to actually to provide a Government response 8 months later!

In passing leaves industry and Standards setting out in the cold and fails to properly evaluate what has been delivered for the $1.0 Billion or so!

F- is generous - but as low as the scale goes.

As for the co-payment debacle - his change of job says it all!

God help all those poor asylum seekers and refugees.

Here is a profile of the new Health Minister:

http://patricklion.files.wordpress.com/2014/05/leyfeat.pdf

David.

Has Anyone Else Noticed Just How Political The Political Leadership Of General Practice Is? The Good - They Have Now Actually Listened And Toughened Up Big Time!

This week we have seen the most amazing set of political turn-arounds I have seen in quite a while.

Let’s start with the AMA.

When the Medicare Co-Payment Plan B was announced the view was that the plan was a ‘mixed bag’. After a week and a few (the most ever) angry e-mails from those in the trenches we get:

“Last week I wrote to you outlining the details of the Government's latest co-payment proposal and asked for your feedback to help inform our ongoing advocacy.

Many members took the opportunity to respond, and I really value the constructive input you have provided.

As I said in my email, the AMA does not oppose co-payments for people with adequate means.

The AMA does not support measures that take billions of dollars out of general practice, undermine the viability of individual practices, and ultimately disadvantage our patients.

I write to make it clear to you that the AMA is strongly opposed to all three measures in the Government’s package that attack general practice, these being:

·         the $5 cut to Medicare patient rebates for general patients;

·         the non-indexation of rebates until July 2018; and

·         the introduction of time-based changes to level B consultations.

This is a triple blow that will hit general practice like a wrecking ball. The AMA will do all it can to stop these destructive changes.”

Full letter to Members here:

https://ama.com.au/letter-members-0

Suddenly the mixed bag is a wrecking ball!

The AMA in WA is even more contrite:

AMA WA president Michael Gannon agrees to oppose GP co-payment

• December 19, 2014 11:30PM
• Perth Now

THE WA president of the Australian Medical Association has changed his mind on the federal government’s modified GP co-payment scheme after speaking to members.

Michael Gannon last week called for MPs to support the policy to charge patients an optional $5 co-payment that would be determined by doctors — putting him at odds with the national office.

But after speaking to GPs this week, Dr Gannon said he now believed the policy would have a major negative effect on the provision of health services in Australia.

 Lots more here:

http://www.news.com.au/national/western-australia/ama-wa-president-michael-gannon-agrees-to-oppose-gp-co-payment/story-fnii5thn-1227162541925

With the RACGP we also saw a rather ‘limp wristed’ response. A week later we get:

General practice unfairly targeted in revised co-payment model: RACGP membership

18 December 2014

Following extensive consultation and dialogue with its membership, the Royal Australian College of General Practitioners (RACGP) has strengthened its position on the Government’s revised co-payment model announced last week and is calling for an immediate halt to any measure that jeopardises general practice services.

The RACGP is astounded and disappointed that the Government has targeted general practice in its pursuit to ‘save’ the health dollar by proposing a model that will equate to higher out-of-pocket costs for everyday Australians.

The RACGP is Australia’s peak body for general practice, representing over 28,500 GPs working in or towards a career in general practice.

Under the newly revised model, the Government has proposed a $5 cut in the GP patient rebate, a freeze to rebates until 2018 and an introduction of time-based changes to Level A consultations from 16 January 2015.

The RACGP labels these proposals as unacceptable.

Lots more is found here:

http://www.racgp.org.au/yourracgp/news/media-releases/strengthened-co-payment-position/

For more annoyance this has it all:

GP bodies defend co-pay policy response

16 December, 2014 Jo Hartley, Michael Woodhead and Kate Aubusson    103 comments

GP bodies have defended their muted reaction to the new co-payment plan that will strip $3.5 billion from general practice, as they prepare to meet with the Federal Health Minister. 

Grass-roots GPs have blasted the AMA, RACGP and ACCRM for failing to hit out at the government for the savage cuts it plans to impose on general practice.

The overhaul, announced by Prime Minister Tony Abbott last Tuesday, saw the planned $7 co-payment for all patients axed.

But instead GPs will see $5 cut from rebates for non-concessional patients over 16, a freeze on all GP items until 2018 and an extension to the consult time for a level B item to a minimum of 10 minutes.

In their initial responses to the news, all three organisations welcomed the revised plan saying it was a win for vulnerable patients - with the AMA and the RACGP adding that they were "disappointed" by the cuts to general practice. 

ACCRM President Dr Lucie Walters (pictured), however, went as far as to praise Mr Dutton for his "courage in taking a stand for quality and value for taxpayers’ money".

Later in the week the RACGP came out in support of the proposed changes to the level B rebate, saying in a statement it had "merit" because less than 10% of all consultations were six minutes long.

The college would "progress this initiative with government,  which will come into force in a months time, it added.

Hundreds of doctors responded angrily on the Australian Doctor website, accusing the organisations of lacking bite and letting the profession down.

"This is purely an attack on GPs. The AMA are a non-representative GP mouth-piece, historically aligned with the Coalition. Where is the RACGP voice?" Dr David Moss wrote.

"The RACGP and its president has sold us out and the PM has insulted us by calling us 'sausage factory' medical practitioners after years of hard work and sacrifice," wrote a commentator known as Athanasius.

"I think enough is enough! The talk is over. Action is needed like never before. Proposal: Mass resignation from the college, and let them know why."

Lots more here:

http://www.australiandoctor.com.au/news/latest-news/gp-bodies-defend-stance-on-new-co-pay

Note the huge number if comments….

The lesson in all this is that medical politicians are like other politicians and can become rather disconnected with the interests of their members.

What offers hope is that the grassroots were listened to and appropriate responses emerged.

Make no mistake this is an ideological attack on the core concept and intent of Medicare as well as an outrageous attack on General Practice - and needs to be named as such and resisted.

I hear the AMA are preparing a campaign to run in all the practices around the country. If that is true and I was the Government I would be very, very worried.

If only it was as obvious just what a crock of an idea the PCEHR is!

Back to holidays!

David.

Big Changes In Federal Ministry! Peter Dutton Gets His Reward and Is Sent To Immigration!

Sussan Ley has been moved into Health.

Peter Dutton was clearly out of his depth in Health!

I wonder what will happen next?

She must be thrilled to have been given the unresolved PCEHR problem to fix!

David.

All the major details are here:

Australian Defence Minister Dumped From Office As Tony Abbott Reshuffles Cabinet

Paul Colgan Dec 21, 2014, 3:27 PM

Prime Minister Tony Abbott. Photo: Getty / File

Tony Abbott has announced a cabinet reshuffle, promoting Scott Morrison and dropping defence minister David Johnston in changes the prime minister says will “refocus the government” on driving economic reform next year.
Abbott described it as a “ministry for jobs and families” and said the government would be putting the economy at the centre of its agenda.
Morrison has been promoted to minister for social services. Abbott said Morrison was a “master of difficult policy” and that his ministry was “essentially a ministry for economic participation” that would encourage people “to give a fair go”.
Morrison will be responsible for crafting a “wholistic families package” that will be at the centre of the economic reform agenda next year. The move gives Morrison carriage of changes to Abbott’s controversial paid parental leave policy, which has been losing support among Coalition MPs.
Peter Dutton moves from health to immigration and border protection.
Sussan Ley takes Dutton’s previous role as health minister, becoming the second woman in Cabinet along with foreign minister Julie Bishop.

Full article here:

http://www.businessinsider.com.au/tony-abbott-cabinet-reshuffle-2014-12

D.

Full list:



D.

AusHealthIT Poll Number 249 – Results – 21st December, 2014.

Here are the results of the poll.

Do You Think The Abbott Government is 'Strengthening Medicare' And Our Current Universal Healthcare System With The New Medicare Co-Payment Proposal?

For Sure 3% (2)

Maybe 4% (3)

Neutral 13% (9)

Probably Not 13% (9)

No Way 65% (44)

I Have No Idea 1% (1)

Total votes: 68

A pretty clear response with large majority seeing through the suggestion that the Government is going to actually aid our Universal Healthcare System.

Good to see a clear outcome.

Again, many, many thanks to all those that voted!

David.

Happy Christmas And A Great 2015!

Well, that is your lot for the year unless we have some important news emerge of the 'silly season', that I feel an urgent need to post on.

I plan to re-start posting in mid to late Junuary 2015.

Till then stay safe and have a great break!

David.