Thursday, November 27, 2008

Turkey for Thanksgiving

The Health IT Nerd has spies all over the world, and one of them sent me this from Australia.

Ahh, Australia. You know, I could stop right at this point, but I doubt anyone outside New Zealand would get the joke.

Anyhow, back to the article:

SPECIAL commissioner Peter Garling has prescribed a massive dose of IT to fix NSW's troubled public hospitals, and recommended a watchdog oversee e-health.

I found myself at a loss trying to figure out what parts of the article to quote. Only the crazed funny bits, I said to myself. Well, that didn’t eliminate any of it. So put down anything that you might spill, drop or snort, and read the article in full.

Peter Garling is a turkey, and he’s the main course for the Health IT Nerd’s Thanksgiving special. Like I said, any fool can figure out that Healthcare is completely screwed. And this fool did. And just like I said happens, he’s proposed a whole lot of IT programs that will fix healthcare up. I hope you like your turkey flavoured with stupid.

Let’s start with his proposed programs.

He says that NSW should have “critical infrastructure, hospital and community information systems and a statewide e-health record system”. Before I go on, I’ve heard about NSW. In a country full of blow-hard states with ever more obnoxious politicians, NSW tops the lot in venal corruption and plain buffoonery. In fact, the NSW politicians are now almost qualified to graduate to US Congress. But I digress.

So this Peter Garling fellow says that NSW should provide all these things – which probably comes as a surprise to their existing critical infrastructure and hospital systems – and it should do that in a timeline of four years, not the eight to fifteen (actually thirty) year timeframe. Because, you know, if you just wish for things and strike a pose, that’ll make it come true. I’ve heard this is called “Creating Your Own Reality”, and we've all see how well that works out.

So not only has our Thanksgiving Turkey already decided that it can just happen in a four year time frame, he’s already priced it out: $705 million – accurate to the third significant place. Unbelievable.

If that wasn’t funny enough, there’s this: “Mr Garling has called for an independent Bureau of Health Information -- separate from NSW Health -- to be established to access, interpret and report on all data relating to safety and quality of patient care”. Ahh. So, this is where the 4 years and $705 million comes from – creating a new government department. And since government departments don’t have non-negotiable contractual goals, you can fix the budget before hand, with total assurance that the money will be spent, exactly as planned. You can even tell right now that there won’t be any actual money for patient services here.

What goals does our Turkey have for his little stack of gold?

There will be no feel-good moment which comes from cutting the ribbon to open a new facility. However, it will surely save many lives, and protect many, many more from harm.

I’m at a loss for words. As I’m sure you’ve figured out, this is not something that happens to me very often. Even in the land of Nod Healthcare IT, you don’t often see someone proposing to spend that much money for no measurable outcome.

Ahh, Australia.

Anyone who had the misfortune to attend international Health IT conferences about 10 years ago will probably remember various chief high lord this and that from Australian governments giving serious presentations about how Australia was going to the lead the world in the use of IT to reduce the costs of healthcare while improving services.

So they should. Australians are tough, pragmatic people, and it’s not very easy for someone else to pull a smart one over them. Oh no. They’re too busy pulling a smart one over themselves to be caught like that. Put five Australians in a boat, and you’ll have five people with the hand on the tiller, all going in different directions. But they’ll actually only have their hand on the tiller when someone’s looking. Not for nothing do Australians use the Koala for their national symbol – an animal that sleeps for 23 hours a day, and is permanently stoned from the eucalypt leaves it eats.

The only thing that saves Australians from themselves is that they don’t know how to take themselves seriously. Which is why no one else does either. Are they a mini-America? Or just Euro-Wannabies? Do they have a socialist healthcare system, or a private free-market healthcare system like USA? Well, Australians sure can’t make their mind up, and no else can figure it out either. Anywhere else it would actually matter, but, hell, this is Australia. They’ll all just go and throw some prawns on the barbie, and whine about the government over one or two (or many) beers.

I only feel sorry that Thanksgiving is not an Australian thing – our turkey will probably just miss the fun.

I recommend that readers keep an eye out for mention of this in the next week or so. The first thing to know is that anyone with half a brain will instinctively know everything I’ve had to say, and will know just how stupid our Turkey is. So they’ll consider themselves free to take a self-serving position on it. How will the politicians posture to leverage the most advantage off the notion before they kill it? How will the technocrats try and stay away from any consequent project? Which vendors reckon they can get a piece of the action?

Well, it’s healthcare IT, and it ain’t meant to be pretty. I sure hope your turkey tasted better than this one.

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