Sunday, April 29, 2012

I Wonder What This Outcome Means? It Does Not Look Good for E-Health In OZ.

This was released yesterday.
Media Releases and Communiques

Standing Council on Health - Communique - 27 April 2012

27 April 2012

Australian Health Ministers and the New Zealand Health Minister met in Canberra today to discuss a range of national health issue including workforce
, eHealth, Indigenous health and aged care. The meeting of the Standing Council on Health was chaired by WA Minister for Health, Dr Kim Hames.

Issues discussed today included:

MyHospitals – New cancer surgery and quality and safety data added

Ministers agreed that following the recent release of cancer treatment services information in March 2012 on the national MyHospitals website, information will also be published on cancer surgery waiting times from May 2012. Initially raw data will be provided with an accompanying narrative about variations in types of cancers along with information about numbers of reporting hospitals, until national benchmarks are developed.

Providing more information about the range and location of cancer-related treatment services and waiting times on MyHospitals enables patients to find out more about local services and helps to drive improvements in hospital performance.

Dementia – a National Health Priority

The meeting was addressed by the Federal Minister for Health, Tanya Plibersek who gave notice to the Council that the Commonwealth will be proposing that dementia be designated as a National Health Priority.

Ms Plibersek said the projected growth in the number of people with dementia will result in many challenges for the health sector. Making dementia a National Health Priority Area would help focus attention and drive collaborative efforts aimed at tackling dementia at national, local and state and territory levels.

The Commonwealth intends to formally bring a paper on this issue to the August 2012 meeting, at which the Commonwealth Minister for Mental Health and Ageing, Mark Butler, will join a substantive discussion on this issue.

Model of care for privately practicing midwives

Ministers today considered a West Australian proposed model of care for privately practicing midwives to provide Medicare-eligible services as part of planned homebirth for low risk women.

Ministers agreed to further discussion on this issue at their next formal meeting in August 2012.

Health Workforce 2025: Doctors, Nurses and Midwives

Health Ministers considered the Health Workforce 2025 Report, which models expected workforce demand and supply for doctors, nurses and midwives to 2025.

While there may be debate over the modeling in this report it identifies indicative broad trends well into the future and without strong reform intervention these estimates will mean services may be unsustainable.

Ministers agreed that the report presents the need for essential coordinated, long term reforms by Governments, professions and the higher education and training sector.

All Governments have made substantial investments in Australia’s health workforce and delivered more doctors and nurses than ever before. These investments have been significant; however, it is clear from the report that we must look further then just adding to the existing workforce profile. Other more innovative solutions are required. Looking further means new ways of thinking, new models of care and new roles and functions across the health workforce.

Aboriginal and Torres Strait Islander Health Worker Final Report – Growing Our Future

Ministers noted the Final Report on the Aboriginal and Torres Strait Islander Health Worker project being delivered by Health Workforce Australia. This report is timely because as of 1 July 2012, Aboriginal and Torres Strait Islander Health Practitioners will join the National Registration Scheme for the first time.

There is significant variability in the roles, functions and title of Aboriginal and Torres Strait Islander Health Workers across Australia and this report proposes a nationally consistent definition for Aboriginal and Torres Strait Health Workers which has been broadly supported by Aboriginal and Torres Strait Islander stakeholders.

The report provides a total of 27 recommendations which will help to inform the development of policies and strategies that will strengthen and sustain the Aboriginal and Torres Strait Islander Health Worker workforce to deliver care in response to the known burden and distribution of disease in the Aboriginal and Torres Strait Islander population.

The COAG National Action Plan on Mental Health 2006-2011 Fourth Progress Report Covering Implementation to 2009-10

Ministers endorsed the Report and agreed that it be submitted to COAG for final endorsement and public release. The report presents updated information on 11 of the 12 progress indicators, and provides details on changes in key areas targeted for reform.

Donate Life Network Progress Report

Ministers reviewed the organ and tissue donation and transplantation outcomes which showed a significant lift in organ donation rates last year.

In 2011 there were 337 donors who made a life changing difference to 1001 transplant recipients.

Ministers agreed on the national and jurisdictional donation targets for 2012 and the projected donation and transplant growth trajectories to 2018.

National Strategic Framework for Rural and Remote Health

Ministers released the new National Strategic Framework for Rural and Remote Health, the product of significant collaboration between the Commonwealth, States and the Northern Territory governments and community stakeholders.

The Framework is an important guide for all levels of government to enable a more consistent and coordinated approach for rural and remote health. The Framework aims to reduce the inequities in health outcomes and service delivery currently experienced by rural and remote Australians. The Framework will be publicly available at www.ruralhealthaustralia.gov.au.
The communique is found here:
What on earth are we to make of this?
All the issues mentioned in the introduction were discussed and outcomes were reached except for e-Health. Does this mean e-Health was discussed and no agreement could be reached to get a line or two in the communique or was the matter mention as being on the agenda but not actually discussed?
And why was the topic mentioned in the communique if there was nothing to say?
I think the most likely meaning is that e-Health was discussed and that either there were some budget implications so no comment was made or it was discussed and no agreement could be reached.
In that context this is interesting:

Health ministers warn of 'unsustainable' services

April 28, 2012

AUSTRALIA'S dependence on imported doctors and nurses - which faces rising international criticism - will continue to grow without reforms in supply and use of local graduates, the first national report on the health workforce says.

The report by HealthWorkforce Australia shows in recent years Australia has imported more doctors than it has produced local medical graduates.

That is despite endorsement eight years ago by health ministers of the goal of ''national self-sufficiency'' in health workforce supply.

The report was released after yesterday's meeting of state and federal health ministers, who warned that ''without strong reform intervention these estimates will mean services may be unsustainable''.

The ministers gave their support to the prosect of big changes in the working scope of doctors and nurses which is likely to include increased use of assistants and technology such as ehealth.
.....

Reforms may include greater use of assistants, the introduction of ''new workforces'' and broader application of technologies such as ehealth and telehealth (the use of telecommunications for consultations, diagnosis and procedures).

.....

More here:
It is interesting to see e-Health pointed out as a workforce issue in the taskforce report to Ministers.
I guess what is going on will all become clearer just 8 days from now if the fiascos around Mr Slipper and Mr Thomson are contained to the extent that the ‘dark clouds’ over the parliament as described by Ms Gillard today have lifted sufficiently to permit near normal operations to re-commence.
We really do live in interesting times!
David.

7 comments:

Terry Hannan said...

All the topics listed by David today deserve specific commentary on their own but here are some that I consider relevant.

Waiting times are NOT a measure of quality. Readers should review the most recent data from the Dartmouth Institute on Variation in Care. Also current data measures of CaseMix, DRG and Activity Based Funding are poor measures of health care quality and can be seen as paramters that drive the "unsustainable" health costs.[See NEJM April 2012]. Unsustainability has been known for decaeds. We have not used the right methods to reduce it. Terry Hannan

Anonymous said...

Perhaps what we are seeing is a re-positioning and re-orientation of eHealth FROM: A glitzy-fix-everything-do-no-harm-ribbon-cuttable-IT-revolution-political-opportunity INTO: A boring, incremental, potentially-risky, software tool supporting the evolutionary optimisation of health care delivery. What it should have been all along!

Cris Kerr said...

eHealth should first target improving health outcomes.

If health outcomes improve, productivity also improves, leading to enhanced sustainability:

McKeon Strategic Review of Health and Medical Research:

Submission No 296
Cris Kerr, Case Health

Anonymous said...

The best health outcomes realizable immediately come from the electronic transmission of prescriptions leading to informed medicines management and compliance.
Doctors and pharmacists need access to the shared medication record to advise and manage their patients safely and effectively. The current system is akin to blind mans bluff or pin the tail on the donkey.

Cris Kerr said...

Electronic transmission of prescriptions will lead to more information about medication being shared, but it will not resolve compliance.

There will still be gaps in the shared medication record:

(1) A prescription written is not necessarily a prescription filled.

(2) A prescription filled is not necessarily a prescription taken.

(3) A prescription taken is not necessarily a prescription taken as prescribed.

Yes, it is better, but it is certainly not best.

Patients could help fill that gap.

Anonymous said...

What Cris Kerr says 5/01/2012 04:11:00 PM is just plain silly. There is no obligation for a patient to get their prescription filled; nor should there be.

Cris Kerr said...

Dear Anonymous, I agree:

' ... There is no obligation for a patient to get their prescription filled; nor should there be ... '

Sorry if that was not clear in my post.

Please read my numerous submissions re PCEHR, including to the Strategic Review of National Health and Medical Research (http://mckeonreview.org.au/sub/296_Cris_Kerr_Case_Health.pdf).

I am a volunteer advocate for the value of patient testimony.

I have continued to propose our ehealth system incorporate capacity for patients to self-report their health outcomes so Australia can begin the process of capturing what works best and what doesn't from the patient's perspective.

Successes shared are successes than can be multiplied.