Wednesday, August 25, 2010

Is This A Credible Study or a Bit of Spin? You Be the Judge.

We had an interesting release appear just before the election.

Wednesday, August 18, 2010

Another study boosting broadband

Actually it doesn't even mention the NBN, but that's the impression you are meant to get..

Minister for Broadband, communications and the digital economy


Senator Stephen Conroy, Minister for Broadband, Communications and the Digital Economy said a new report by Access Economics estimated the benefits of telehealth to Australia could be between $2 billion and $4 billion a year.

The report, Financial and externality impacts of high speed broadband for telehealth, found telehealth offers the potential for significant benefits to Australia’s population, especially for people who are elderly or who live in rural or remote communities.

“Telehealth including online consultations, electronic health records, in-home care, and online health education will not only open up new possibilities in health care delivery, but will have significant savings on the health budget,” said Senator Conroy.

The report found one of the reasons telehealth in Australia has been held back is the lack of high-speed broadband, particularly in rural areas.

The report noted that even where high-speed broadband was available, it often had slow upload speeds and reliability could be patchy.

“The National Broadband Network will fix these issues once and for all,” Senator Conroy said...

More here (including a neat display of the 30 page report)

Nice one Peter Martin!

The report is headed as follows:

Financial and externality impacts of high-speed broadband for telehealth

June 2010

The Executive Summary makes for some very interesting reading.

Executive Summary

The Department of Broadband, Communications and the Digital Economy (DBCDE) requested Access Economics to report on the financial and externality impacts of ubiquitous high-speed broadband in relation to health and aged care costs, in particular the impacts that would result from increased use of:

  • tele-medicine for remote consultations;
  • remote home-based monitoring of chronic-disease patients and the aged; and
  • remote training of medical professionals (using haptics); while
  • excluding the benefits of personalised electronic health records (EHRs).

The report was required to:

  • identify and articulate the nature of the impacts;
  • determine a methodology to estimate these impacts, both on a net present value (NPV) and an annualised cash basis; and
  • provide high-level estimates of the impacts.

Tele-health offers the potential for significant gains to Australia’s population, especially for people who are elderly or who live in rural or remote communities. Unfortunately, however, despite a myriad of tele-health studies, it is difficult to measure such benefits. Tele-health studies to date have been constrained by poor economic and health data and methods.

Most studies have, however, shown that tele-health is cheaper and faster (and at least equally effective) compared to transporting patients or health care providers over large distances.

Thus, it should be possible to estimate time and money savings at a national level, if not health gains.

  • There does not appear to be sufficient data to estimate the benefits of online training for rural / remote medical professionals.

Using a combination of a national level United States (US) study into one aspect of tele-health (tele-consulting) and a national level Australian study that was mostly based on EHRs but had tele-health components, Access Economics estimates that steady state benefits to Australia from wide scale implementation of tele-health may be in the vicinity of $2 billion to $4 billion dollars per annum.

----- End Extract

It would have to be said that this is one of the most vague, assumption laden and non coherent pieces of work I have ever seen. Access Economics themselves admit that, and make it clear without a lot more work, their rather vague set of figures should be treated as ‘guesstimates’, if that.

A close reading makes on think this is little more than a proposal to do a lot more detailed modelling while admitting that comparable useable information from Australia is essentially non-existent and only slightly better in the US.

It is also clear that even if the benefits were accurately assessed, which they clearly can’t be on the basis of what is offered in this report, then the impact of more or less bandwidth being available is utterly unknown and totally unpredictable.

For Senator Conroy to claim the proposed National Broadband Network (NBN) is an answer to all the issues identified here and to claim these findings in anyway justify the $43B investment in the NBN is clearly, in my view, laughable. It is this type of nonsense generalised political claim that undermines the case to sensible e-health implementations which have a strong supportive evidence base – including aspects of much that is mentioned in this report as well as EHRs.

Of course, one also wonders why a report completed in June, 2010 suddenly appears a day or so before an election?

Telehealth can be wonderful, for example there is little doubt tele-psychiatry, referring doctor to specialist telemedicine and remote home monitoring are valuable useful technologies! However none are cost free and all need to have serious investment and planning to succeed,

I really wish there was more rigour in the debate in the e-Health space.


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