The standards and foundations for nation-wide e-health solutions in Australia have now mainly been completed, according to National E-Health Transition Authority (NEHTA) CEO Peter Fleming, leaving implementation on the agenda for 2009.
"I've actually been pleasantly surprised at a lot of the work that's been done in the background around foundation standards. We're actually starting from a very good position," Fleming told ZDNet.com.au. in an interview last week.
"The reality is, though, that we have to move very quickly into a delivery mode and that means implementing. In my expectation, well, this is the year of delivery for NEHTA."
NEHTA had an "absolute mandate" from the Council of Australian Governments (COAG) to deliver in individual healthcare identifiers (which link electronic medical records together), Fleming said, which the authority has been working together with Medicare on. "Medicare is extraordinarily well positioned to do this because of its history and very keen to make this work," he said.
Although creating the individual healthcare identifier for Australians meant a "fairly substantial database", Fleming said the difficulties were created by non-technical issues. There were privacy issues, work flow issues and overarching consumer and government requirements, he said. Legislative changes would also have to be made.
This year would also see a number of pilots, according to Fleming. "I am expecting that as the year progresses we will move very quickly around some fairly reasonable scale pilots around medication management and discharge referrals, and we are talking to a number of groups about that at the moment," he said.
Those waiting for an all-at-once implementation would go home disappointed, however. NEHTA would move ahead incrementally, Fleming said, with the authority consulting states, peak bodies and vendors along the way.
NEHTA had been criticised in late 2007 in a Boston Consulting Group review for a lack of external stakeholder involvement. Fleming said that the recently formed stakeholder forum had borne fruit, with stakeholders feeling more involved.
It's not as though we're speaking to 1,000 suppliers.
Peter Fleming, NEHTA CEO
The stakeholder forum has met on a number of occasions, with the last time being late December, he said. Working groups of stakeholders have been created to take part in each of the major projects.
Fleming said that the authority has also been working closely with CIOs from state and territorial governments. The states had the "absolute intent" of following NEHTA standards with any projects they conducted, he said.
As for the disparate systems existing across the nation already, Fleming said it was unusual for any organisation of substance to find themselves in a greenfield scenario where they were starting from scratch, but that the number of different systems in health was actually relatively small.
"In the hospital environment there literally are a handful of systems," Fleming said. "It's not as though we're speaking to 1,000 suppliers."
Vendors had been helpful, he said, with an "absolute acceptance" that they needed to work together towards NEHTA's "wonderful world". Many of the vendors' systems were not competing, Fleming said, instead vying for different segments of the market.
As for available hardware in the hospitals, Fleming said that NEHTA knew there was a lot of equipment out there which wasn't going to be refreshed overnight. Yet he believed a workable backbone was there.
NEHTA itself has seen a recent refresh of top level employees. Fleming himself has only held the CEO position for a few months and is working with a relatively new chairman, a change of CFO and a new leader in the IT space — Dr Andy Bond as chief architect. The former chief architect Mark Gibson moved to GP Partners last September. Fleming was happy with his team, and looked to 2009 with anticipation.
"It's an extraordinarily exciting place. It's an exciting time," Fleming said. "We've got amazing support from the key stakeholders. I think everyone is saying this is something that needs to be done."