Richard Hosking wrote:
> The bureaucrats dont understand the process and can be easily
> bamboozled by slick sales talk. If govt would take control and
> ownership of the project they could outsource manageable bits of it as
> Horst says. But who has the expertise to manage such a project? Not an
> easy task.

Richard

Bureaucrats do understand this process at least when it comes to areas
where they have traditionally had expertise.

Australia was a world leader in creating markets for service delivery
but apparently the US and UK are further ahead in many areas (see
http://www.smh.com.au/text/articles/2006/09/08/1157222326103.html).
Thankfully everybody agrees that direct provision of services is
something that governments are not suited to and their role is in
creating the hoops for providers to jump through. At this they excel.

The problem is the Feds have yet to take on the responsibility for the
total health IT framework. No doubt this is due to a variety of factors
such as:-

    * it not being seen to be a need until relatively recently
    * the lack of maturity of the IT/IM market in this new area
    * the split of overarching control between the States and the Feds and
    * the quite considerable technical difficulties involved.

It seems likely that the recent UK IT experience will be cause for a
pause by the Feds but I suspect that the efficiencies obtained by
marketising the problem space will be a powerful driver that will
ultimately lead to a successful solution.

David


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