More front than Middlemore

You've got to admire the chutzpah of New Zealand's shadow assistant minister for health Shane Reti in taking new minister for health David Clark to task over his alleged mishandling of the National Oracle Solution program, what with him only having been in the job for less than six months and the project having limped along for close to six years.

Whether it's chuztpah or more front than Myers, Dr Reti is claiming that the project, which promises to streamline financial management, business intelligence and the supply chain for district health boards, including a single catalogue of medicines and medical devices, is alternatively “failing” and “going off the rails”.

Dr Reti seems particularly incensed that the Ministry of Health has called in Deloitte to review the NOS, as it also had a hand in designing the project in the first place through a subsidiary called Asparona, which specialises in Oracle ERP implementations.

Deloitte says the review is being done at arm's length from Asparona, although it does seem that the firm has its fingers in as many pies in New Zealand as it does in Australia. One of the big four consulting firms, Deloitte does pretty well out of health IT and out of government debacles in general: one former public servant described the sums the Australian government spends on outsourced management consulting and IT as “stupendous”.

Former health minister Jonathan Coleman also showed quite a lot of front recently when he hung up on an interviewer asking impertinent questions about a bad case of mould that seems to be infesting Auckland's Middlemore Hospital. Dr Coleman, who resigned from politics just the day before the interview having accepted a job as CEO of a private hospital group, probably didn't see the point of explaining himself when he no longer had the general public to answer to, so off he toddled, leaving behind a legacy that is becoming as murky as Middlemore's rotten buildings.

The unexpected change in government in New Zealand last October has shaken things up a little in the Shaky Isles. Radio NZ reported last month on the desperate state of some district health boards under the previous administration, where achieving a surplus seems to have been the only outcome expected. The once brilliant career of director-general of health Chai Chuah also came unstuck, first over a $16m blowout in the cost of refurbishing the ministry's head office and then a $38 million funding misallocation.

It was then revealed in February that Mr Chuah and his team had okayed the spending of $233,258 to bring out some digital disruption types from the US, including two from the nonsensically named Singularity University in California, where Mr Chuah had also spent $31,000 on a nine-day course.

According to Fairfax, that course was the executive program, which helps "future-oriented senior influencers" to "think exponentially". Well, Mr Chuah thunk himself exponentially out of the ministry. His replacement is yet to be announced.

All the while, one of the country's largest hospitals is full of fungus. It brings to mind another recently departed health chief, Waikato's Nigel Murray, who has not been much out of the news since his rather extravagant spending was first revealed last year. He was back in the news just last week, with the NZ Herald reporting on a submission by some Waikato DHB doctors to a review of the SmartHealth telehealth program, which amongst other things involved the use of the HealthTap app.

According to the Herald, those doctors are pretty scathing in their assessment of SmartHealth, although we've spoken to a couple of others and the underlying principles of the project seem sound. It may very well be that it is the app that is not.

One of the driving forces behind the telehealth program in the Waikato, Thames Hospital emergency doctor Ruth Large, told the HiNZ conference last year that there had been no clinical input into the choice of technology. She remains an advocate for telehealth, however, memorably telling the conference that healthcare providers in the region needed to “get their thumb out of their bum” and get on with providing virtual services where it made sense.

Perhaps what didn't make sense was importing new technology that was untested here. We remember first coming across the founder of HealthTap, Ron Gutman, at the Australian Telehealth Conference in Sydney in 2015, where he was quite impressive. He was less so at HIC the following year, when rather than tell the audience about what was happening with the Waikato project he instead decided to entertain us with a full-on sales spiel for his company.

He won't be at ATC 2018, which is on in Sydney next week, but the keynote international speaker is UK researcher Trish Greenhalgh. And the title of her presentation? 'Why do so many telehealth programmes fail.'

Speaking of which, our poll from last week asked: Will the My Health Record be a winner or a fizzer in its seventh year? The majority of readers who participate in our polls remain firmly of the view that the My Health Record is a fizzer, this time by a margin of 64 per cent to 36 per cent. And yet here we are, six years later.

That brings us to our poll for this week: Will high-profile failures slow the march of telehealth?

To vote in our weekly polls, sign up for our weekend edition or leave your comments below.

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