Australian Health Information Council Resuscitated – What Should Be on the Agenda?

I am told that the Australian Health Information Council – the new and resuscitated version is to have its first meeting in February 2007.

I am also told the new chair is Professor James A Angus, BSc (Syd.) PhD (Syd.) FAA, Dean, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne. It seems Professor Angus is a very distinguished Australian pharmacologist with an interest in all sorts of receptor classes. His biography does not mention any clinical experience or health information technology background.

I am not sure whether congratulations or commiserations are appropriate for Professor Angus – time will tell I guess! (At present I have not seen an official announcement so this may be wrong in whole or in part.)

What would I want to see addressed at the first few meetings? The following, in priority order, are what I would (gratuitously) suggest.

1. The first meeting needs to work out how many seats should be around the table and who should occupy them. There is an embedded clique, I believe, of government committee attendees in this domain, many of whom have led the E-Health agenda for the last 15 years. As progress has been less than stellar it is not inappropriate to suggest that perhaps a transfusion with some new blood would be advisable. While some old blood should be maintained for corporate memory etc – at least half of the committee should have never been involved in the old AHIC or any of the committees that report to it. Perhaps it would be sensible if the Chair initially enrolled a foundation core of three or four independent experts to consider the issue of subsequent enrolments.

There should also be minimal, if any, crossover of membership between the NEHTA board and AHIC.

2. The reporting lines and governance of AHIC should be such that it is genuinely independent and is able to provide quality strategic advice to Ministers unfiltered by any external influences.

3. The new committee needs to make sure it has the resources and the independence to get things done – this means a real and tangible budget and a competent, dedicated, expert secretariat. There must no part-time bureaucrats who battle through. Ideally there should be a staff of three or four real experts to advise and assist. If it is not clear this will happen prospective committee members should just walk away in my view.

4. The new committee should closely review the terms of reference. These were watered down in November 2005 from the original 2003 version to read:

“Set up by Health Ministers in July 2003, AHIC works closely with the National Health Information Group to increase the effectiveness of IT investment in the health sector.

The revised operating arrangements for AHIC are based on an independent review of the Council commissioned by the Australian Government. These arrangements will enable AHIC to focus on providing strategic advice to Health Ministers about the more effective and efficient use of information management and information communications technology (IM&ICT) in the health sector.”

I would suggest the following terms of reference for the revamped AHIC.

A. To promptly review the progress and current status of E-Health in Australia (E-Health being broadly defined as the use of ICT in the health sector – and especially in Health Service Delivery) and benchmark and evaluate it against progress in the rest of the OECD.

This review should be of strategic and major operational systems only – not every isolated trial system in the first instance.

B. To develop a National E-Health Strategic Plan, Business Case and Implementation Plan, for presentation to and funding by Ministers within 12 months of the February 2007 meeting.

This plan needs to reflect the Health Service business drivers. These include efficiency and effectiveness of the health system, patient safety, quality of care, public health monitoring and reporting, clinician job satisfaction and retention and so on.

Issues of use and adoption of Health IT and aspects of security and privacy will also be critical to address.

Any plan must also be practically focussed and based on proven technology. It must embrace the use of standards which can be demonstrably implemented and which meet health system requirements. Benefits which flow from implementations should be focused on those who actually use the systems, not those who would like a free ride from the ‘uncompensated’ efforts of the ‘users’. This probably means introducing meaningful financial incentives for some stakeholders.

C. To advocate with all appropriate stakeholders the importance of planned, consultative action in the E-Health space.

D. To work with the Jurisdictions, the IT Industry and the Private Health Sector to obtain predefined optimal national E-Health outcomes.

E. To ensure NEHTA’s plans and directions are brought into alignment with the National E-Health Agenda and that NEHTA’s resources are focussed where the majority of CLINICAL and PATIENT benefits are to be found.

After this has been achieved I would be more than happy to let AHIC develop the rest of its agenda itself – but the members may want a long, well earned rest!

David.