NEHTA’s role in relation to the HI Service has changed since the transition to service operation as they have moved from a strategy and development role to that of Managing Agent. NEHTA also has a key role in stakeholder engagement and managing communication, clinical safety and assurance of the Healthcare Identifiers system. There have been some challenges in this transition and there are aspects of the service delivery where the boundaries of NEHTA’s and DHS’s roles and responsibilities are not clear.
Although the focus has shifted to service operation, there is an ongoing and potentially long term role for NEHTA to manage the development roadmap for the HI Service and in ensuring the effective co-ordination, definition and prioritisation of new requirements emerging from multiple programs. This requirement should be considered in decisions about NEHTA’s future funding and structure.
Stakeholders acknowledged the significant levels of support that NEHTA has provided to them to implement Healthcare Identifiers. The structures adopted by NEHTA, with designated implementation leads and architects to support sites through implementation, are working effectively, and the expertise and assistance given is acknowledged by end users. However, it is noted that even large sites are reporting that they have experienced considerable difficulty in completing integration with the Service and have been dependent on extensive assistance, both from a policy and technical perspective. As the number of participating organisations increases, this may have a substantial impact on NEHTA’s resourcing and capacity to respond.
As more organisations attempt to implement Healthcare Identifiers it is becoming apparent that the optimal implementation approach and the type of issues that need to be resolved vary considerably between types of health services. This is highlighting a number of policy issues that still need to be addressed and also has impacts for the communication tools and implementation guides that are needed to support different types of health services.
Prior to implementation NEHTA actively engaged with stakeholders through governance groups, reference groups and “tiger teams” (groups of subject matter experts brought together to work on specific issues). Since the system became operational, stakeholders do not feel they have adequate opportunities to provide input and ensure that their priorities are being recognised. It is understood that all NEHTA reference groups have been disbanded. It is critical that stakeholders continue to be actively engaged as the HI Service (and other e-Health programs) begins to be more actively used. There will continue to be issues discovered that will need input both from the Commonwealth, Service Operator, clinical users and the jurisdictions which need to ensure solutions are appropriate within the broader end to end IT context. There is a need to re-engage end users of the system, particularly the jurisdictions, through mechanisms such as Reference Groups and tiger teams.