Towards eHealth Liberation Day: the recovery

In part two of her journey towards recovery from her injury and some of the most tumultuous years in eHealth in living memory, EpiSoft's Jenny O'Neill finds a silver lining in her other journey towards eHealth Liberation Day.

Hypothesis 6: PCEHR participation improves productivity.

It was a hot summer that year. My mother, my sister and an old friend took it in turns to come around and do stuff. They pottered while I went on with the eAdmissions system for my favourite hospital. You can get so much done when you are forced into the role of couch potato, migrating after a week or so to the role of office chair potato. The patient portal was taking great shape (and yes, congrats on spotting the slightly less subliminal than previous advertising).

By this time, it was my friend Prue’s turn to take up the baton from my sister as chief coffee acquirer and bottle washer. Prue was packing up her flat to move to Afghanistan and storing stuff in my garage. I lent encouragement and reams of advice from the couch.

Prue gave me some advice I’ll never forget. She said that if you have a day when there is no work on either side of that day, that day can deliver a special kind of mental liberation and foster creativity, and improve health and well-being. This was her very cogent argument for why every weekend should be a long weekend.

She was suggesting I forget about work for a while – for a minimum of three full days to be precise – which some business owners with a passion for what they do find really hard to do. But for once, I took her advice and took an eHealth Liberation Day some time in mid January 2011.

eHealth was completely and utterly off the mental agenda for the first time in maybe eight years. Nagging concerns about deadlines and grant applications were simply archived but in this new era of mental liberation, I was still immobile. A romance with the ED doctor was clearly out of the question. Trips to the beach, bike rides and other even more appealing summer attractions (namely pub beer gardens) were out too.

So, still couch bound, it was time to move onto some heavy duty creative – the historical fiction that had been gathering dust in the bottom of a Windows Explorer folder for something like 20 years. Maybe that old thing warranted a dust off and another attempt at completion.

It is another strange thing but as you grow older, the work deadlines, unopened mail, unread emails, unpaid bills and housework dam up the creative inclination like so many twigs strewn across the river. It’s impossible to get into the creative flow until that special day – that day of mental liberation – when there is no work either side.

But then, strangest of all, you realise that for the rest of the year, you’ve been beavering away on business problem solving, software design, process reengineering, marketing and business development so that compulsion to create hasn’t been dammed up at all – just channelled elsewhere. That elsewhere is not like a novel. In eHealth, you can only finish some chapters, never the whole work.

Conclusion: Hypothesis 6 was supported by the evidence.

Hypothesis 7: personal control is not always a good thing.

I went back to the hospital and first thing to do was check out the post-op ankle in the PACS. The amount of hardware in there was enough to make me wonder if some arch villain had done a Wolverine number on me, under general anaesthetic. I clenched the fists a few times but alas no six-inch titanium claws. But the ankle picture was another story – easily six inches of titanium in there.

It was time to seek an expert opinion. The expert was Damien, a former radiographer turned software developer who worked upstairs in the IT department. Who better? I hobbled up to his cubicle, brought up my images and asked him about the screws. Damien said it looked like a very neat job and I shouldn’t worry. After talking to Damien, radiographer-turned-software-developer, I didn’t worry another minute.

Conclusion: Hypothesis 7 was supported by the evidence and rather topical in light of discussions going on at present about ‘curated’ results. Thank goodness for Damien, curator on this occasion.

Hypothesis 8: Plus de change … you know the rest.

By late January, the priority meetings for MSIA were back in the diary. Other industry people, clinical leads, jurisdictional people, NEHTA people, DoHA people and DHS people were all back at the table trying to take the national eHealth agenda forward in leaps and bounds. I still couldn’t walk.

I sat near the door with an extra chair for my boot-encrusted ankle and realised how many of the same people had been at the table last year … and the year before that. Seemed to just bunny-lurch from one boot camp to another that summer.

We were on our way to Canberra in the MSIA's Geoff Sayer’s car for yet another meeting when the Wave 2 grants were announced. One of our industry colleagues called us. Some did well out of Wave 2, including some in the car that day, not some not so well. I was thrilled that some companies that had been working so hard for so many years were part of the Wave.

However, it was not such good news for us. I was disappointed after all that work and pain and inconvenience and expense (the physio didn’t count me as staff) to see it all come to nought for us, but that’s the nature of the competitive tendering process for you. Mostly it just leads to trauma and lost sleep and we seem to rub along pretty well without them much of the time.

I think that was the day we met Nicola Roxon and her senior advisor. I remember thinking if that was her senior advisor, her junior one was surely an embryo! I also remember that it was a very long walk to the car park in Parliament House for someone with a post-surgical ankle. Would love to tell you what the conversation was about but don’t remember; no doubt it was really important in influencing the government agenda. (In case you missed the sarcastic remark also mandatory in an article from a software vendor, that was it.)

The bad mood lasted a couple of days – but then one of my clients told me to look on the bright side: we could go back to working on our own priorities in eHealth instead of the government’s. That’s a new slant on eHealth liberation day. And so we, like many others, just knuckled down and got on with business as usual – the business of continuous improvement through eHealth, the business of selling solutions not widgets, the business of juggling numerous competing priorities in a complex environment and the business of designing and implementing useful technology.

At some level, it is hard to see that there ever was an eHealth Wave, much less two. Everyone now just seems to be back in business as usual mode as if it never were. On another level, to not recognise the extent of the achievements of those individuals who sat down at the table so often during the Wave era to get things agreed and get on with the daunting national agenda would be unconscionable.

It is largely due to this group that we now have a functioning national health identifier service, national framework for secure message delivery, a national framework for secure authentication, a PCEHR that healthcare providers can connect to, a technology framework for continuous improvement at a national level and a much greater focus on consumer engagement. I was proud to be a little part of that eHealth journey; collectively we wrote some mighty big chapters, albeit some of them are still in first draft.

It seems fitting at the time of my departure from the MSIA board to acknowledge those people who were most often at the table during the Wave era: from the MSIA Jon Hughes (SmartHealth), Geoff Sayer (Healthlink), Vince McCauley (McCauley Software), Emma Hossack, CEO Bridget Kirkham, John Green and Margaret Prichard.

From the wider industry, Michael Legg (Michael Legg & Associates), Caroline Lee (LeeCare Solutions) and past president of ACIVA, Russel Duncan (Emerging Systems) and a member of the AIIA's eHealth group; and NEHTA clinical leads Nathan Pinsker, Mukesh Haikerwal and Marina Fulcher.

From the state health departments, Ian Betheras, Peter Williams, Judy Redmond, Ian Bull, Rob Whitehead; from NEHTA Les Schumer, Bettina McMahon, Heather McDonald; from DoHA Paul Madden, Matt Corkhill and Liz Forman; from DHS Jo Hammersley, Monique Warren and Angela Morello; and from the healthcare consumer groups, the indefatigable eHealth stalwart, Peter Brown.

There were so many more but these people seemed to be at just about every meeting from 2010-2013 to work through the difficult problems and lay the foundations of our national eHealth infrastructure.

So I hope this group and everyone else in the eHealth sector takes a liberation day from eHealth and at least two days (though ideally several weeks) either side. Recharge the batteries for another year. Because some mighty big chapters have been written but we’re still a long way off the whole work.

So many lessons learned from one little transient imHealth event. And so adieu. I'm off to enjoy the therapeutic benefits of a long weekend.

Jenny O'Neill is the executive director of medical software company EpiSoft. During the tumultuous period between 2010 and 2013, she was vice-president and president of the Medical Software Industry Association (MSIA).

Posted in Australian eHealth

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