Those who aren’t explicit ‘employees’ of Te Whatu Ora seem to be excluded from both reading and contributing to this.
I’ve had a crack at registering via email, but this has been the reply:
Could you confirm what is your work email please?
As the consultation is internal, we can give access only to Te Whatu Ora employees so I just need to get clearance with your work email so I can then set you up with this email below address instead.
Mmmm. so on that basis, is the intent that this document for implementation only by those working for Te Whatu Ora? If it’s intended to be broader in it’s acceptance, then broader consultation and input would surely benefit the process? There are a lot of CiLN members I would think working outside of Te Whatu Ora roles.
I’d be interested in this and also for sharing with my students on our PGDip Digital Health course. Cheers, Chris
After spending some time reading and trying to understand the finer points of the D&D change document I am sad to say that in my opinion whilst there is an understandable focus on national and regional needs the consultation document leaves me with two pressing worries:
I think there may be two processes going on, albeit they are related. One is an organisational change process (which the consultation documents relate to). This impacts a range of people who have been assimilated into Te Whatu Ora from around 28 previously separate organisations, with direct and indirect impacts on peoples employment, reporting lines and potentially conditions.
The other process is around wider health sector reform, which as we know, is not the exclusive domain of Te Whatu Ora. I suspect these two issues are being conflated somewhat.
Yes, I think role title and function are important differences that need to be considered. Getting the functions right, and more to the point, connected, should really be the main focus. Form should follow function.
I am a clinician of 35+ years who managed to weave IT through my clinical career. I have now moved over more to IT and see patients one day per week. I work at the engagement interface between clinical staff, HSS and the IT service. I do this because I, like many on both sides, understand that for good IT to support good clinical outcomes we need to be able to translate what the clinician is looking to achieve (outcomes) in to a product the IT team can develop or purchase and deploy. My IT colleagues are grateful that I can translate for them the clinical requests and manage the clinical interface, including helping prioritize the local projects based on clinical need/outcomes. I focus on ensuring we integrate our clinical systems across our Districts and look to drive solutions that are scalable to Regional (and National) needs and delivery. I am in support of rationalizing how we provide our overarching clinical IT systems. However, I am very concerned that the day-to-day reasons for the change have been missed out of the D&D change process. Health care is delivered at local and District level, face-to-face using the system we implement and support. We are often referred to as enablers in health care when in fact we are partners in health care. I partner with all of my clinical colleagues when I am working with them to identify and deliver a solution which is designed around their outcome requirements. I partner with my IT colleagues when I ask them to work out how we will deliver a solution, and my IT colleagues partner with clinicians when they bring the technical expertise into our clinical environment. From what I see of the D&D change the interface at local and District level is missing, stopping at a Regional level. I believe this will have significant consequence at the local District level and will lead to the old days of work arounds and fixes, and USB sticks loaded with patient data. Yes, we have a lot of work to do at National level to bring our IT systems up to scratch, but lets not forget, patient health outcomes are provided at the local level.
So will there be a wider stakeholder discussion / consultation on this? Te Whatu Ora staff and employees are not the only stakeholders affected.
Hi Inga. You would need to ask those leading the consultation. As you say, there are wider stakeholders to the sector reforms, but at present, Te Whatu Ora employees are subject to organisational change proposals.
I agree there are two issues here.
Clearly it’s v appropriate for an internal operational consultation to only involve direct employees. However this operational and organisational change clearly appeals to a broader set of issues that have wider future implications.
I wonder if there is capacity to involve external expertise in providing constructive feedback for the benefit of data and digital. There appears to be a number of external voices that provide or are affiliated with Te Whatu Ora (and likely to be impacted) who may have worthy insights.
As somebody who’s job is not directly impacted, my dispassionate observations are: (I have added these to the formal channel, but put them here so people can know who to blame, and in a single post so that Lara might see how my feedback integrates across the whole document, rather than being fragmented into individual sections )
Hope that helps. Mat
I have enquired and been told the initial consultation had a wide array of external stakeholders in the lead-up to this change proposal.
This one is an important consultation with the Te Whatu Ora staff directly and indirectly affected, and we need to remain true to that process. In this part, we want to capture the internal perspectives. This is a proposal, it’s very clear there needs to be a robust counter-proposal and that is going to be worked through over the next 6 weeks. If significantly different, further consultation will occur.
Once the outcome of this consultation is known, then the wider digital health sector will be consulted again.
Thank you for clarifying this Lara. I tried to gain access and when the registration form told me it was too late to register (that’s a puzzle) I wrote to the email address that was supplied and asked to be registered (I used my university signature). I was given access to an account.
What troubles me is that the registration form has a very limited list of professions. No-one with digital health responsibilities as their role (part or full) can indicate their role. For me this is a serious omission because if you’re consulting about data and digital you should include those whose whole of part job is about data and digital. It’s as though they/we don’t exist/are invisible.
HI Karen
sorry, don’t know the form you are speaking about - but your main thrust about being invisible is one we have to actively combat! That is not the intention at all
Is interesting - the consultation process has highlighted to me that we have people working “for/in” Data and Digital and “for/in” clinical informatics - whose roles are not directly in Data and Digital (they were “missed” / misplaced in the proposal and hence the plea to tell us if you feel you should be here) and whose role titles placed them in a different mapping (some have made direct contact, when we have that via WSY or email - we can make the changes immediately, although we can’t reflect that in the online document as it has to stay the same during the consultation - there will be others who we don’t know about so will need another call to make sure you have checked for yourself/your team members)
We also have a lot who work in say Labs - as Colin Osborne’s post mentioned - these are resources who all retain a level of clinical work and many don’t want to split their days/FTE with the D&D work they do - they would however, quite rightly, really like to have a more formal relationship / bold dotted line into D&D clinical informatics. For Labs, during COVID we set up the National Informatic Laboratory Alignment and Interoperability Group (NIILAG) which has been really helpful in aligning things nationally and making sure they have strong Data and Digital links.
It is these networks and communities of practice that we should find ways of fostering and nurturing. Very keen to hear some specific ways you think we can do this.
Thanks Lara. This invisibility is rife and needs to be addressed, a difficult thing to pull off for all the reasons you list.
I am co-editor on a book on this topic and will get a copy to you. Where can I drop it off?
Butler-Henderson, K., Day K, Gray K. The Health Information Workforce. Butler-Henderson K, editor. Springer International Publishing; 2021. https://link.springer.com/content/pdf/10.1007/978-3-030-81850-0.pdf
Ahh Karen - thank you so much for the offer but you have triggered two of my strongly-held beliefs
I have purchased one and will read it - thank you for the recommendation
Lara, I had forgotten your approach to gifts. I was given three complementary copies by the publisher and have held onto the last one (except the one I’m keeping for myself and my descendants) to give to the right person with the power to do something about the hidden workforce. Thanks for purchasing a copy.
I’m doing new research on the hidden career pathways of the hidden workforce. It’s a biographical study in its early stages. I’ll start a new discussion thread this week about this research and how we as a community can use it to make a difference.
Congratulations on your recent appointment Lara and thanks for your post. It got me thinking about consultation and I came across the IAP2 document below which, on further googling, turns out to be widely referenced globally including by our own government agencies.
It describes how the level of public consultation needs to scale as the impact increases on those affected by the decision.
Given that decisions taken by Te Whatu Ora and its agencies, including those made by Data and Digital, will affect us all at some point in our lives, then I argue that consultation should be leaning toward the right hand side of the chart. This means collaboration i.e. active participation in both design and decision making as required to build the the new system. As things stand Government and local authority consultation seems to be at the ‘inform’ or ‘consult’ level (at best) which is too low a level of participation given the impact on the decisions being taken.
https://www.iap2.org/page/pillars
Spectrum_8.5x11_Print.pdf (754.5 KB)
Thanks for this.
Building-closer-partnerships-with-Maori-Principles.pdf (1.1 MB)
good to compare with our local principles.
Thanks for sharing the Te Arawhiti example. The IAP2 version provides a rationale for the different levels of engagement (increasing impact on the decision) and why you would choose one approach over another. It might also help to explain why some consultation exercises are more successful than others.
Agree, They are very complimentary for my brain. .