The Strategic Disarray in E-Health in Australia Goes from Bad to Worse!

Last week DoHA and NEHTA conducted a briefing on the National E-Health Strategy.

A very new and very reliable correspondent provided the following points from the presentations and discussion.

Overall Impression.

Not much positive to report.

Key Attendees

Megan Morris (DoHA), Rob Cameron (DoHA) and Peter Fleming (CEO, NEHTA) were present.

Some of the points they made were:

1. Although the strategy has been endorsed by AHMC, and there has been a commitment to continue the NEHTA work program, there is no funding commitment to the strategy at this stage. Megan/Rob indicated they would not be addressing the strategy at this point in time as there are a number of key initiatives that are underway at present that need to be considered first (e.g. National Health and Hospitals Reform Commission work, National Primary Health Care Strategy, Regional Telecommunications Strategy)

This confirms what we already knew – we have been sold an unfunded pup.

More than that it is clear that the DoHA team are incapable of ‘walking and chewing gum’. If they were they would realise that the e-Health Strategy is an integral component of this other work and needs to be considered as a whole. Seems we have severe cognitive failure on the part of this lot.

2. In particular, nothing about the IEHR has been agreed to, i.e. the model of funding, development, implementation, ownership etc. Waiting on policy/funding decision from COAG.

This has to be ‘bureaucratic speak’ for ‘forget this for the foreseeable future’ (Subtext - blame the GFC). It is clearly so far off that by the time anyone actually gets round to it, it will have to be re-considered from the ground up. As regular readers will know I am more than happy with this outcome. Let’s get the basics – secure messaging, e-prescribing, e-referral and core operational systems in place- and then work out what record sharing would be ideal.

3. There is no further information about the strategy to be released. The summary is all that will be made available.

This is just utterly pathetic. We, the stakeholders and public, paid $1.3 million for this work. Just exactly why should be not see what was suggested? Even more amazing is that as recently as a presentation to the Telemedicine Summit on March 16 we have the NEHTA CEO suggesting the National E-Health Strategy is alive and well. Three days later we are told zilch is happening and we can’t see it! The story is getting very confusing here!

See here:

http://www.iir.com.au/conferences/healthcare/national-telemedicine-summit

and for presentation see here:

http://www.nehta.gov.au/component/docman/doc_download/673-telemedicine-conference-sydney-peter-fleming

A little piece of history is warranted here:

The following is found on the NEHTA web site:

New National Entity To Drive E-Health

28 January 2004

Australian Health Ministers, meeting today in Sydney, endorsed arrangements to establish a new national entity to drive forward critical e-health initiatives.

Joint Communique

Australian Health Ministers, meeting today in Sydney, endorsed arrangements to establish a new national entity to drive forward critical e-health initiatives.

Health Ministers noted the achievements to date of the National E-Health Transition Authority (NEHTA) in progressing national priorities on behalf of all jurisdictions, and agreed that collaborative arrangements would be formalised.

“E-health systems and processes offer very real opportunities to improve patient care and the efficiency of health services. It is important that all jurisdictions work together to set the foundations for a more connected system”, Chair of the Australian Health Ministers’ Council, Minister Peter Toyne said.

Ministers agreed to establish the new entity as a company limited by guarantee, governed by a board of directors made up of CEOs from Health Departments across Australia.

Ministers endorsed-in-principle the 3 year work program for the entity. In addition to funding of $9.5M already committed for 2004-05 priorities, Ministers agreed to provide $18.2M over 3 years from 2005-06 to fund the core activities of the entity. These activities include: the development of timelines for the urgent advancement of the e-health agenda; option assessment and business case development; standards development and implementation support; and provision of advice and resources to assist implementation of already agreed solutions.

Ministers noted the need for further cooperation on significant national projects over the coming years, including in the following key areas:

  • Clinical Data Standards and Terminologies;
  • Patient, Provider and Product/Services Standards and Directories / Indexes;
  • Consent Models;
  • Secure Messaging and Information Transfer;
  • User Authentication and Access Control;
  • Technical Integration Standards;
  • Supply Chain;
  • Electronic Health Record (EHR) Standards; and
  • Health Informatics Industry Reform.

The new entity will seek to leverage existing investments to progress these priorities.

The full release is found here:

http://www.nehta.gov.au/nehta-news/403-new-national-entity-to-drive-e-health

Note the date! This is now over five years ago. Tens of millions have been spend, hundreds more have been committed and which of that list of key areas is actually now making any difference in actual clinical practice?

Is there any sense of urgency – other than platitudes about 2009 being the “Year of Delivery”. Not that one can see. We have the IHI wandering off into 2010 and this release that appeared (rather slowly) via RSS today.

http://www.nehta.gov.au/nehta-news/484-pathology-leaders-working-together

Pathology Leaders Working Together

Thursday March 12, 2009. Pathology leaders will work together to promote the adoption of national e-health standards and specifications following the signing of a national consensus statement.

The Australian Association of Pathology Practices Inc (AAPP), National Coalition of Public Pathology (NCOPP), Royal College of Pathologists of Australasia (RCPA) and the National E-Health Transition Authority (NEHTA) have agreed to cooperate on implementation of e-health standards and specifications.

NEHTA CEO Peter Fleming said the consensus statement was a milestone achievement that would stimulate dialogue with the profession.

The adoption of national e-health standards in Pathology will improve the safety and quality of healthcare for all Australians”, Mr Fleming said. “Pathology leaders have agreed to work together to design and develop a roadmap for the adoption of national e-health standards and specifications,” he said.

“All parties will cooperate to implement these e-health standards and specifications so that they can be supported in the clinical, technical and organisational environment.

“Stimulating discussion and feedback will allow issues associated with their implementation in Australia and internationally to emerge.

Further initiatives by NEHTA would ensure the material developed would enable interoperability, promote Australian standards and support the various ways through which implementation may occur," he said.

Media enquiries: Gabrielle Lloyde Communications Manager 0408 170 001

----- End Release

Another one of those agreements to co-operate. Outcomes will clearly come very much later! Does this remind of you of the “Statement of Commitment” malarkey associated with ePIP?

For more evidence of being asleep at the switch we have the following

“The National E-Health Transition Authority have presence at the “Australian Pharmacy Professional Conference” being held Thursday 2nd – Sunday 5th April at the Gold Coast Convention and Exhibition Centre.

NEHTA are on stand number 141.

For more information, log onto: http://www.appconference.com/

NEHTA are apparently paying for exhibition space and not apparently giving a presentation explaining their expectations of the various actors who seem to be quite keen to ignore NEHTA approaches and directions as noted last week on the blog.

See the program here:

http://www.appconference.com/conference.htm

Just exactly what is the value for NEHTA to pay fares and staff to go to this conference when most of the e-health initiatives being discussed are not apparently adopting NEHTA standards? I must be missing something!

I believe we have seen the end of any hope of a proper implementation of the National E-Health Strategy and confirmation too that NEHTA is just wandering off into the briars in the absence of a real strategic plan. I also fear it will only get worse from here!

See if I am not right.

David.

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