NEHTA's future in the hands of COAG: Hambleton

Former AMA president Steve Hambleton intends to play an active role in improving clinical input into eHealth and in influencing the direction of the National E-Health Transition Authority (NEHTA) despite the recommendation of the Royle review, of which he was a member, that the organisation be dissolved.

Dr Hambleton, who was appointed chairman of NEHTA late last month, said he stood by the recommendations of the review but that the final decision on NEHTA was in the hands of the federal and state health ministers. NEHTA is owned and funded through the Council of Australian Governments (COAG).

“COAG together with the federal health minister need to decide about future directions, the strategic direction of eHealth in this country,” Dr Hambleton said. “I think there is an enormous opportunity for us to do something. How and what body that is done in is the governments' decision.”

He said he took on the role of chairman to be in a position to help implement future plans for eHealth.

“I think there's a huge amount of investment that has gone into IT in this country, and I think there is a real opportunity to make sure we leverage off the investment we've made so far and get outcomes that are meaningful,” he said. “There is an opportunity for structural reform in the health system supported by good communications.”

While former chairman David Gonski played a low-key role at NEHTA, Dr Hambleton said the chairman's position and the board itself, which is made up of the state directors-general of health or their appointees, had a great deal of influence over the direction of the company.

“Obviously the governance body is the one that interprets the direction that the company should go in and the management needs to deliver on that, but you do have an enormous amount of influence together with the other board members, and that's the exciting part,” Dr Hambleton said.

“We have very intelligent, motivated and engaged people but as we said at the AMA, as we said in the review, we need to make sure that we engage and deliver what the profession needs.”

It is no secret that NEHTA has come in for a great deal of criticism, particularly from the medical software industry over its management and technical capabilities. Clinicians have also been critical of its lack of engagement with healthcare professionals in the implementation of the PCEHR, starkly illustrated last year when the entire clinical leads team resigned, including another former AMA president, Mukesh Haikerwal.

Dr Hambleton said he accepted there had been criticism of NEHTA's past performance but that he was confident it could be changed.

“The answer is absolutely we can change it,” he said. “There is no doubt that there has been criticism levelled, governments have been concerned, software groups have been concerned, the profession has been concerned, but if you don't get in and do something you can't change it.

“If you get in there and do something, and recognise there are issues, you can. I'm very confident that we can take up the challenge.”

He also said he was confident that he could improve clinical input and governance and that NEHTA was already moving to engage clinicians more in product development.

“My role early on is to find out where the clinical engagement in that sits and to make sure that we have sufficient to progress what NEHTA's tasks are,” he said.

He clarified a statement quoted in another publication last week that “NEHTA would continue indefinitely”, stating that he actually meant “eHealth would continue indefinitely”. He said a number of foundational products had been delivered, such as Individual Health Identifiers, secure messaging, the Australian Medicines Terminology and SNOMED-CT AU, which in effect had created a national rail gauge on which to build.

“We've got that, we've just got to start using it,” he said. “Having been to places like Canada where there is no standard rail gauge, at least NEHTA has decided what the gauge is.

“Part of the challenge is how NEHTA participates in the future, but much of the rest of the challenge is how we engage with what we've already got. There are some really good things about the PCEHR, the basics are there, and we've just got to start using them. It is not all because of NEHTA, but NEHTA has played a significant role in setting up the frameworks.”

Posted in Australian eHealth

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