With Dr Fernando’s permission I reprint a note sent via the Australian College of Health Informatics E-Mail List.
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I was really surprised by Peter Fleming's Plenary session at HIC 2009.
I was horrified when he guaranteed that eHealth security and privacy frameworks posed *NO RISK* with regard to information privacy. All informaticians and IT experts understand no such guarantee currently exists and none is in development. Adding insult to injury, I recently met a series of experts from NEHTA and DOHA in Canberra about the proposed IHI (names, details and a contemporaneous record of meeting can be supplied on request) where expert staff agreed that my view of risk management and eHealth security accorded with their professional views. Mr Fleming's address greatly exacerbated the serious concern of the many in the audience who were already sceptical about the security claims made by Australian Health authorities.
Mr Fleming also spoke about the 13 % of Australians who (on the basis of research conducted on behalf of government health authorities) he said are opposed to the introduction of an IHI. It is vital that this research be published, together with detail about the research framework applied to this study. In the absence of published information, the study, and hence the claims, have no credibility.
One speaker at the conference, from a hospital in Northern Queensland, explained the circumstances under which his hospital works. Plagues of termites interfere with microwave signals and hence with the communications that enable eHealth systems. Power failures frequently cut off electricity at the hospital for more than 12 hours at a time, while their generator only functions for 10 hours. Moreover, the hospital will be excluded from the planned national broadband roll-out (because the town has a population of several hundred below the declared threshold of 1000), despite the hospital being the primary health care service for many hundreds more people living within many hundreds of kilometres of country.
Mr Fleming failed to even address the issues confronting rural Australians. This failure was exacerbated by his response to a question from the audience with regard to plans to measure the health and well-being of the population as a consequence of the eHealth implementations. His response referred to a small task group that may be established to examine and measure the outcome in the future – but the task does not yet appear on their worklist.
Mr Fleming also suggested that 6 or more private companies may manage the SIEHR (or PHR perhaps?) process and that while a SIEHR implementation is possible, the implementation is not definite. Finally, he spoke of national eHealth roll-out from 2010. How is this possible given the vast amount of work required on the legal frameworks, the security and privacy protocols, and the widespread training required for clinicians across the country?
The session accomplished one thing. It consolidated scepticism among the conference audience. Were I a member of the Australian government, I'd be perturbed by the electoral fallout from this session.
As is constantly reiterated, trust is the key foundation of successful eHealth implementations. Transparent and publicly available, evidence-based best practice is fundamental to advancement in eHealth in Australia. I think Mr Fleming's address has instead deepened stakeholder mistrust and scepticism of eHealth plans.
Juanita
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Dr. Juanita Fernando
Academic Convenor BMedSc (Hons), Faculty of Medicine, Nursing and Health Sciences
Chair, Health Sub-Committee, Australian Privacy Foundation
Foundation Committee Member, Australian Health Informatics Education Council
Mobile Health Research Group,Faculty of Information Technology
Monash University Vic 3800
I have had a look at the presentation that is found here:
http://www.hisa.org.au/system/files/u2233/hic09-2_MrPeterFleming.pdf
The presentation title was:
A strategic roadmap for e-health in Australia
This 13 page presentation is really a little sad. It actually just reflects just how Australia lacks any entity that is actually capable of serious strategic thinking and leadership and then the subsequent planning, funding and implementation.
Also very sad is the profile e-Health has in Australia.
Modern Medicine in the US has just published its list of the 100 Most Powerful People in Health in the USA.
Here are the first six.
100 Most Powerful People in Healthcare (text list)
Posted: August 24, 2009 - 5:59 am EDT
Modern Healthcare's 100 Most Powerful People in Healthcare in 2009:
1. Barack Obama, President of the United States, Washington
2. Kathleen Sebelius, Secretary, HHS, Washington
3. Nancy-Ann DeParle, Director, White House Office of Health Reform, Washington
4. Max Baucus, U.S. senator (D-Mont.) chairman, Senate Finance Committee, Washington
5. Chuck Grassley, U.S. senator (R-Iowa), ranking member, Senate Finance Committee, Washington
6. David Blumenthal, National coordinator for health Information technology, Washington
The full list is here (free registration required) :
http://www.modernhealthcare.com/article/20090824/REG/908219994
Health IT leadership at this level, might give us a chance! Getting e-Health happening in Australia will be a serious complex multiyear project and we should not even begin until we have the leadership, team and skills that can operate at this sort of level!
The other issues raised in the e-mail are also important and need a serious airing. Comments welcome.
David.
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