Wednesday, May 15, 2013

DoHA Budget 2013-14 and E-Health - What Do We See? Looks Like A Major Slowing In Investment After 14 Months From Now.

The relevant part of the Budget is DoHA - Outcome 10.
The link is here:
Right at the top we read.
Outcome 10

HEALTH SYSTEM CAPACITY AND QUALITY

Outcome Strategy

The Australian Government, through Outcome 10, aims to improve the long-term capacity of Australia’s health care system with a particular emphasis on quality and safety. To achieve this, the Department funds systemic improvement activities focused on management, performance, information, infrastructure and research.
The implementation of the Personally Controlled Electronic Health Record (PCEHR) system is playing a significant role in the Government’s long-term strategy to improve the capacity and quality of the Australian health care system. The PCEHR system enables key health information to be available for individuals when and where it is needed, while ensuring that records are private and secure. In 2013-14, the Department will continue to work with key stakeholders to promote awareness of the benefits of eHealth and to encourage take up of the PCEHR and other eHealth tools by consumers and providers.
The Department will also work with states and territories to further use technology to improve health and reduce health care costs. A key activity commencing in 2013-14 will be the rolling out, over three years, of the PCEHR in Tasmania’s hospitals and enabling allied health, pathology and diagnostic imaging services to connect to eHealth in Tasmania.
The details are here:

Program 10.2: e-Health implementation

Program Objectives

Provide national eHealth leadership
Every time a consumer visits a health care professional, hospital or other medical facility, important information about their health is created and stored at that location. Currently, it is hard to access and share this information with the health professionals involved with the consumer's care because the health sector is fragmented across public and private organisations, with many different approaches to managing health information.
The adoption of eHealth improves the quality, safety, efficiency and coordinationof health care by reducing the fragmentation of information across the health care sector and increasing its accuracy and availability. The Australian Government is leading the national rollout of eHealth technology and services by partnering with state and territory governments to fund the National EHealth Transition Authority (NEHTA). NEHTA will maintain the standards necessary for eHealth, including clinically safe, secure and inter-operable eHealth specifications for adoption by public and private health care providers and secure joint projects on the exchange of clinical information.
The Australian Government, through NEHTA, has now delivered a number of key eHealth foundations: Individual Health Identifiers for eligible Australians; a system of identifying health care providers and their organisations; secure messaging, and technical specifications for inter-operability of clinical information systems.
The Australian Government in collaboration with Health Direct Australia have delivered a National Health Services Directory (NHSD). The NHSD is a consolidated and comprehensive national directory of health services and provider information. It covers all Australian jurisdictions with services across the public and private sector. The directory can be accessed via the web and a mobile application. The NHSD is being expanded to support finding health care provider end points that support telehealth and secure messaging.
Operate a national eHealth system
The introduction of the Personally Controlled Electronic Health Record (PCEHR) system for individuals allows them to register for their eHealth record either online at ehealth.gov.au, by phone, via Medicare shopfronts, by post or by assisted registration and eventually with their GP or at hospital. Once an electronic health record is created, individuals control access to information held within the record. People can track their health progress, and record their medications and allergies, while health care providers are able to create shared health summaries, upload event summaries or discharge summaries and view a record which accesses up-to-date information at the point of care to improve clinical decision making. The national eHealth system provides a better and more efficient health care experience for participating consumers, with a smoother transition of information between care settings, a reduction in the time spent repeating clinical history or waiting for test results to be located, and a reduction in adverse medical events. As the PCEHR system grows, additional functionality will be added, beginning with the Child Electronic Health Record and the National Prescription and Dispense Repository (NPDR), which for the first time will facilitate access to prescribing and dispensing information for consumers and their authorised health care providers via PCEHR portals and compatible software. The NPDR will allow prescribers and dispensers to make more informed decisions regarding medications for their patients which in turn will improve the safety and quality use of medicines in the community.
The Department will continue to work with key stakeholders to promulgate the use of eHealth across the health sector. The ePractice Incentive Program (ePIP) will encourage the adoption of new eHealth technology to assist practices to improve administration processes and the quality of care provided to patients. The Department has funded the Royal Australian College of General Practitioners to assist general practices to participate in the PCEHR system, through training and professional development.
Provide eHealth services
In 2013-14, the pilot program to promote the use of telehealth services in the home using the infrastructure of the National Broadband Network (NBN), will be implemented. Patient-centred telehealth services to the home will be provided to participants of this program. The focus of the program will be on aged care, cancer and palliative care.
Program 10.2 is linked as follows:
This Program includes National Partnership Payments for:
- Cradle Coast Connected Care Clinical Repository.
Partnership payments are paid to state and territory governments by the Treasury as part of the Federal Financial Relations (FFR) Framework. For Budget estimates relating to the National Partnership component of the program, refer to Budget Paper 3 or Program 1.10 of the Treasury’s Portfolio Budget Statements.
The total funding is apparently:
2012-13 $105,711,000
2013-14 $148,925,000
2014-15 $56,949,000
2015-16 $42,481,000
2016-17 $29,097,000
While it hard to know why but it seems the funding falls of a cliff in about in 14 months time. A little hard to know - to say the least!  
What is also interesting is this little zinger:
KPI
Number of consumers who register for a PCEHR(Note 1)
2012-13 500,000
2013-14 1,500,000
2014-15 2,200,000
2015-16 2,600,000
2016-17 2,800,000
Note: 1 This program has funding until June 2014 and 2014-17 targets are subject to funding being carried forward at current levels.
Looking at this - with the money tap apparently stopping in 14 months and enrolments slowing dramatically after 2014 it is hard to believe the hard push is going to continue for very long.
The associated commentary above is also well worth a read to see what is going on.
David.

1 comment:

Anonymous said...

This is interesting wording:
"enabling allied health, pathology and diagnostic imaging services to connect to eHealth in Tasmania."
How do you connect to eHealth? I thought eHealth was a general concept. Can you only do this in Tassie?

Also, sadly, no mention of some of the less clinical eHealth good things happening like supply chain.