After watching the failure of the Government Home Insulation Scheme and the Payroll issues with Queensland Health unfold its clear that the eHealth issues in Australia are part of a much bigger problem.
There is enormous potential for eHealth to cause damage and there is a duty of care to make sure the risks are minimised. Currently the push to roll out parts of the eHealth agenda is just as flawed as the home insulation scheme and the payroll system. We need to get some basic quality controls in place first or the consequences will be worse than what we have seen with these programs. Poor, missing or incorrect patient data can be just as deadly as Foil insulation in the hands of untrained installers.
Nehta, I am sure, has some great talent in its ranks, but I don’t see anyone with an overall understanding of the issues that face eHealth or how to fix them. They are unwilling to listen to the practical concerns of people with experience and now it seems they are under political pressure to deliver and just like these other rushed programs the risks are very high.
I have multiple levels of concern, but chief amongst them is to try and steamroll connectivity in a physical sense when in a practical sense it is badly broken. The quality of the data being moved is low and very non-compliant with standards and this is well known. There appears to be a block on the idea of a quality program for the messages, despite the machinery to do this at a basic level existing for over 5 years. Applications fall over importing good data and often fail to display it correctly and in many cases can’t support HL7 (Health Level 7) at all. Blindly sending data around, even with shiny New Health Care identifiers is a recipe for disaster.
We need to get some compliance programs going for existing health data and once that is done it is possible to try and move to the next level. No matter how much political pressure you apply computers are very stubborn when the bits and bytes are in the wrong place and will not budge. It seems that politicians NEHTA and the public service are yet to learn this. Failure to do this will expose us to the first big eHealth Train wreck, that is clear. Large applications are built from components and to make something big work you have to have confidence that the components work reliably, currently they do not. We don’t need radical change, we need an expectation of quality and a requirement for quality, backed with testing. I am sure the underlying intentions of the Home Insulation scheme and a New Payroll for Q Health were sound. They both failed because of a lack of compliance testing on the components. At the moment Nehta is heading down the same track and the bridge is out just around the bend.