David More wrote: > Oliver and Tim > > "Reading between the lines of David's blog, I think that he wants *his* > strategy. He is > not alone. Every woman, man and her/his dog has their own take on the One > True Strategy." > > Please read my blog properly..I want a consultative, involved, inclusive > strategy to be > developed and I don't know what it should say..that's why I put all the > material up - so > all can think about it and form a view for the day when we all have our say.. > > Kindly don't put words in my mouth - and please just note what I say. > > From the March 11 Open Letter to Mr Abbott. > > "I believe this is a major policy failure of the present Government and will > have > electoral consequences unless addressed promptly with a coherent, inclusive > and properly > funded National Health IT Strategy in conjunction with an appropriate > Business Plan and > Implementation Strategy. Neither NEHTA nor the newly re-formed Australian > Health > Information Council appear to be cognisant of and focussed upon the excess > costs and > suffering inaction is causing. Action is required promptly."
Yes, OK. My take is different. I don't think that there is a lot wrong with NEHTA's *strategy*. It is NEHTA's *tactics* which suck. By that, I mean that after several years, they are failing to substantially increase the pace of progress. Yes, they are far less anodyne than the bunch of bureaucrats that preceded them, but that is not saying a lot. In each of the areas that NEHTA has identified as important in their strategy, ranging from secure communications and messaging to shared terminologies to unique identifiers, things are moving too slowly. The problem is that a) they are trying to do far too much themselves, instead of either outsourcing tasks to more highly skilled and better established technical groups and b) they are failing to enlist local talent, meaning the local software industry and local universities and so on, to help (um, OK, a and b are the same, but I am using repetition to hammer home my point, and old debating trick...). By "enlist" I don't just mean consult, although that is important, I also mean fund R&D and commission reference implementations (which should be open-sourced) in order to force industry to follow. Leaving it to the market will take forever, because there are only weak or absent business drivers, from software vendor's perspectives, for things like implementation of terminologies or of proper, detailed standards (especially interoperablity and data intercahge standards - there are actually negative business drivers there). And yesterday we have reports that the NEHTA CEO only wants to engage with the large software players (as if they give two hoots about the tiny Oz market...). NEHTA has been given, I've lost track, but I recall $150m at least by COAG (council of Australain govts). They need to start using that, instead of trying (and mostly failing) to recruit technical staff to fill up their little office in Brisbane. OK, they need technical staff, but only to commission technical work, not to do the actual work - else we'll be waiting forever. And they need to start leveraging matching or like funds from their constituent govt organisations. At the very least NEHTA needs a full-time liaison officer who sits in the CIO's office of each state health department, constantly promoting the NEHTA agenda to state health depts. And equivalents to work with the primary care sector and the local software industry and with local academia. That would be ten NEHTA staff who would more than earn their keep, instead of being bunkered in the Brisbane NEHTA enclave. There is plenty of talent in the private sector, in academia and at the coalface in Oz - harness it! NEHTA must not just rely on "the market" to implement its strategy - it needs to drive the strategy forward using its funds and other people's funds - spent with *Australian* companies and institutions. Don't rely on the same old group of professional volunteers working at a very leisurely pace with Standards Australia to develop the standards and codesets we desperately need - commission others to create them. And for goodness sake, don't let the perfect become the enemy of the good! Adopt the open-source mantra: release early and often. Which means release drafts and initial versions of guidelines, standards, prototypes, reference implementations etc as soon as they are good enough to be even marginally useful - don't wait until they are perfect. And then keep releasing updates, upgrades and improvements. Everyone would prefer Version 0.4 in 6 months followed by versions 0.6, 0.8, 1.0, 1.1, 1.2 etc every month or so thereafter, instead of Version 1.0 in 4 or 5 years time, which is what we are seeing with so many NEHTA initiatives. And keep the documents short, for goodness sake. Institute a policy in which staff member's pay is docked for every page they write over 30. And fund reference open-source implementations to kick-start industry into implementing your initiatives. NEHTA, your tactics are terrible! But your strategy is pretty good, I think. Tim C _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
