David More wrote:
Up to you all to say what should happen next.
My own view is that the last 10 years of reports (starting with NHIMAC's
Health On Line, Electronic Health Records, Electronic Decision Support,
etc.) adequately laid out the grand plan of where we wanted to go.
It was also self evident, without needing "lessons" from expensive
Health Connect trials, that key building blocks were required to get
there, such as standard terminologies, national identifiers, etc. I have
no argument with NEHTA's agenda in this regard.
Like others, I believe our failure to progress with clinically relevant
innovation over the last few years is largely because there has been no
funds for practical clinical informatics projects that would work in
parallel with NEHTA to implement their building blocks in the real world.
One example will suffice; for years I and others have been arguing that
if we are to integrate Australian evidence-based information resources
such as Therapeutic Guidelines, RCPA Manual, etc. into clinical software
to provide best-practice decision support then we needed:
1. A National Health Information Plan to prioritise the required
resources and sort out copyright and funding models;
2. Project funds to:
2.1 Assist knowledge distillers to atomise their information and make it
machine, as well as human, readable;
2.2 Add standard terminologies (SNOMED-CT, Medicines terminology, etc.);
2.3 Devise a standard interface that would enable disparate knowledge
resources to plug and play with a variety of clinical software operating
in both hospital and general practice.
Funding applications were put to DoHA and AHIC and bounced back and
forth without any decision. Then NEHTA was created and I was told it's
now their responsibility. I went and discussed the above with Ian
Reinecke soon after he was appointed in 2004. He suggested I come back
in three years (which will be later this year)!
In my view there was absolutely no reason why the above work could not
have proceeded in parallel with NEHTA's activity to serve as a
practical, real world test-bed for their "standards" and also provide
some clinically useful products. All that was required was some
decisions and small start-up funding.
I suspect that when I knock on Ian Reinecke's door later this year
(after the three years are up) I'll be told to come back in another
three years when the medicines terminology and other building blocks are
ready! By then, I'll have completely retired and the postgraduate
students who were interested in such projects will all be overseas!
Cheers
Ken
--
Dr. Ken Harvey
Adjunct Senior Research Fellow
School of Public Health, La Trobe University
http://www.medreach.com.au
VOIP: +61 (03) 9029 0634; Mobile +61 (04) 1918 1910
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