e-Health in Australia – A Governance Farce that Will Hurt us All.

e-Health in Australia is a ‘rudderless ship’ in a very large storm and is way too close to the rocks!

Just a few short years ago everyone knew who was at least meant to be doing what in the e-Health Space.

We had the Australian Health Ministers Advisory Council (AHMAC) and the Council of Australian Government (COAG) who sorted out major policy directions and provided funds.

The Australian Health Information Council (AHIC) provided e-Health Strategy and Direction.

The Commonwealth Department of Health and Ageing (DoHA) set policy detail, sponsored national initiatives (such as HealthConnect) and tried to foster State co-operation and co-ordination.

Essentially, following the 2004 Boston Consulting Group (BCG) Review the HealthConnect Program was cancelled. It became a ‘change management strategy’ and a few annoying money-wasting remnant projects rolled on to use up the funds that had been committed.

By 2005 AHIC had been canned and the National E-Health Transition Authority (NEHTA) had begun operations. Virtually simultaneously most of the e-Health skills in DoHA left the public service and the place of e-Health was downgraded in the Commonwealth bureaucracy.

Come to 2007 and where are we?

First we have the BCG undertaking a review of the now 2.5 year old NEHTA. This review is a governance nightmare as we have senior health bureaucrats commissioning a report on their performance in managing NEHTA. Ever hear of a senior health bureaucrat criticising their own performance? Clearly the outcome will not say you have all done a poor job managing NEHTA as everyone knows they have. Talk about a conflict of interest!

Second we have the now resuscitated AHIC. It seemed to make some hopeful noises for a little while. The silence is now deafening and with an election due in a month or two we can be sure nothing will ever come of their work.

Last we now have a brand new E-Health Ministerial Advisory Council – established as an effort to blame shift away from the Minister and DoHA who have been negligent in their inactivity. Again we have a secret, non-communicating entity working away in a bureaucratic non-transparent vacuum.

Let’s not even consider the managerial qualities of the State Health IT bureaucrats. Most of them are still tied up in overly slow procurements (WA, SA etc) or are doing rigid state-wide system implementations that have the users more than a little grumpy.

IBA (our largest indigenous e-Health Company in which I have a few not so profitable shares) makes the point in its annual results, just released, that it has been forced overseas to survive as virtually no serious sales are likely until 2008/9 in Australia.

If ever there was a situation where an election offered hope for a re-start and a new plan this is it. What a humongous mess.

David.

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