Politicians as bad as each other on e-health

Round table event hears there is too much focus on the technology, and not enough on healthcare

The e-health capabilities of the major political parties are “as bad as each other” according to the former chief of the South Australian department of health.

The comments were made at the health informatics conference on Tuesday, when ABC's Tony Jones moderated a roundtable of industry veterans, who discussed a number of issues about e-health including the qualities required to lead a successful project implementation.

The panel comprised of the head of the National eHealth Transition Authority (NeHTA), Peter Fleming, Ernst & Young health and human services lead (former CEO South Australia Department of Health), Jim Birch, author of the independent evaluation report of the NHS summary care record, UK professor Trish Greenhalgh, Health Informatics Society of Australia (HISA) president professor, Michael Legg, and technology vendor Intersystems's CEO, Professor Stan Capp.

Former public servant Birch said politicians don't understand e-health because the “narrative” is too focused on the technology as opposed to the healthcare benefits.

“I think it doesn't really matter which government gets in relation to e-health I think they're both as bad as each other in that regard,” Birch said.

“I think we need to have a different narrative around e-health… It needs to be about how we integrate care better, how we provide better care, how we provide greater accountability of care, so what's the purpose of e-health.

“I think too much we talk about, they think of it as IT, computing, electronic, think of it as technology rather than about healthcare.”

Birch said during his tenure at South Australia health, many e-health initiatives did not receive approval despite having strong business cases.

“If you look at recent e-health performances, the level of business case work done, the level of justification done on e-health investments, it's very much stronger than many the other health reforms and yet it didn't get the level of investment that I think it deserves.”

HISA president Legg referred to the HIC conference in 2007, when Tony Abbott (then health minister) committed to rolling out an e-health identifier across Australia, a project which the now opposition leader failed to deliver.

“[Mr Abbott] felt it was very difficult to move the bureaucracy, and he felt he gave the money and direction but it didn't happen,” Legg said.

Professor Greenhalgh closely watched the UK's attempts to introduce an electronic health identifier, and said one of the greatest difficulties is defining the role of the project leader.

The key quality required is the ability to regularly reconcile the interests of all the stakeholders, she said.

“Whoever is put in charge, or thinks they're in charge, thinks what they need to do is nail down the different corners of the cloth and say 'we're definitely going in that direction, I don't want any wavering from it',” Greenhalgh said.

“In my book leadership is much more about capturing the different narratives of what's going, the different perspectives of all the different stakeholders in the program, and saying 'this is the extent to which we agree and this is the extent to which we don't agree'.

“And then to keep bringing people back around the table every few months regroup, we were going in that direction, let's reflect now where we've gone to and where we're going next.”

NEHTA is in charge of the rollout of the electronic health identifier across Australia and CEO Peter Fleming said the first priority is to roll out the foundations, and then collaborate with clinical and consumer groups.

“Firstly, we need to roll out the foundations... so get the roll out happening, let the implementation work,” Fleming said.

“However, collaboration is always important in this process and that needs to be done with clinical groups and consumer groups, if it's going to be successful.”

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