A modest e-health proposal to government

May 12, 2015 § 4 Comments

Dear [insert country name] Government,

E-health is hard. I think we can all agree on that by now. You have spent [insert currency] [insert number] billion on e-health programs of one form or another over the last decade, and no one knows better than you how hard it is to demonstrate that you are making a difference to the quality, safety or efficiency of health care.

You also know that so much of e-health needs to happen in the public domain that, irrespective of your desire to privatise the problem, you will end up holding the can for much of what happens. E-health is your responsibility, and your citizens will, rightly or wrongly, hold you accountable.

It is so hard to get good strategic advice on e-health. You recently commissioned [insert large international consultancy firm] to prepare a new national e-health strategy, and it didn’t come cheap at [insert currency] [insert number] million. In the end it told you nothing you didn’t really already know, but at least you can say you tried.

You also commissioned [insert large international consultancy firm] to prepare a business case to back up that strategy, and it didn’t come cheaply either at [insert currency] [insert number] million. The numbers they came up with were big enough to convince Treasury to fund the national strategy, but deep in your heart of hearts you know you’ll never see a fraction of the [insert currency] promised.

It’s also really hard to find organisations that can deliver nation-scale e-health to time, to budget and of a quality that the professions and the voters all agree it’s a good thing. You want the IT folks who build these systems to understand health care, its needs and challenges, deeply. Just because they can build a great payroll system or website does not qualify them to jump in and manage an e-health project. Do you remember how [insert large IT company] ended up crashing and burning when they took on the [insert now legendary e-health project disaster]? We can all agree that didn’t go as planned, and that you didn’t exactly enjoy the coverage in the press and social media.

What you really want firstly is impartial, cheap and informed expert advice because you are in the end driven to do the right thing. Given the heated and partisan nature of politics, that advice needs to come from safe and trusted individuals. That often means the advice comes from within the tent of government, or from paid consultancies where legal contracts and the promise of future work secure your trust. You also want the IT folks who build your systems to be deeply trained in the complexities of implementing systems for e-health. The health professions, and indeed the voters, also need to be sophisticated enough to understand how to use these systems, and their limitations. That’s going to maximise your chances of success, as well as blunt the uninformed chatter that so often derails otherwise good policy.

Our proposal is a simple one. We suggest you set aside 10% of the E-health budget to train the next generation of e-health designers, builders, and users. Use the funds to resource training programs at the Masters level for future e-health policy leaders, as well as system designers, builders and implementers. Let us provide incentives to include e-health in health profession training both at primary degree and for continuing education. Let us also invest in training the public in the safe and effective use of e-health. Investing in creating a critical mass of skilled people over 5 years will be your best insurance that, when you are again faced with e-health, you have a real chance of doing the right thing.

Given how little outcome you have had for your e-health investments over the last decade, and the harsh reality that little will change over the next, this is a chance to rewrite the script. Invest in people and skills, and you might find that with time e-health isn’t so hard after all.

[insert name of concerned citizen, NGO, or professional association]

[insert date]

Help us write the 3rd Edition of the Guide to Health Informatics

May 28, 2013 § 23 Comments

The Guide to Health Informatics 2nd Edition was published in 2003, and has endured surprisingly well over the following decade. One of the guiding principles for selecting material in that text was to focus on core ideas that had a long half-life. In other words, the was focus less on the ever changing “bleeding edge” of technology and its application, and more on foundational principles and topics.

Well, we are now beavering away at the third edition, and hope for the totally revised text to be completed by the end of 2013.

We would very much welcome feedback from the community about what you would like to see in the third edition. What new topics would you like to see covered (remembering that we are going to focus on long-half life ideas and topics). What new features would you like to see in the chapters? We currently have questions at the end of each chapter and further reading. We will use this web site as a place for online teaching materials (such as a PowerPoint deck with the figures used  in the text for teachers to download).

The table of contents for the 2nd edition is here if you want to look at it again. Some of the old topics will be substantially revised (for example all the material on the internet in health). All existing chapters are being updated with the latest material.

New chapters or topic sections are being prepared for:

  • The safety of e-health (what can go wrong, how do you minimize risks)
  • Nation-scale health IT systems – their designs, functions, risks and benefits (including HIEs).
  • Consumer Informatics
  • Social networks and media
  • Modeling and analyzing large scale data sets (big data).
  • Computational discovery systems

What else do you want? Now is your chance to help shape the text!

We will use this blog keep you up to date with progress on the new edition, and continue ask for feedback on the edition as it progresses.

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