Sunday, May 18, 2014

On Thinking About It What Is Being Said By The Government About The PCEHR, It's Incoherent Nonsense.

We were told a few days ago that the PCEHR Program was to continue for another year.
Here is the official press release.

Making eHealth Work for Patients and Doctors

The Abbott Government will move to make the Personally Controlled Electronic Health Record (PCEHR) system more practical for the Australian public, as well as for doctors, nurses, and other frontline health care providers.
Page last updated: 13 May 2014
PDF printable version of Making eHealth Work for Patients and Doctors - PDF 74 KB

13 May 2014

The 2014-15 Budget provides $140.6 million to support the operation of eHealth and the PCEHR system for 12 months, while the Government continues planning its response to recommendations in the recently completed PCEHR review.

Labor promised much with the PCEHR but delivered very little.

Implementation issues have plagued the PCEHR from day one, but the Abbott Government will get it back on track so that it provides real benefits to patients and health professionals alike.

Most clinicians are not using the system.

The Government will need to make it effective, functional and easy for all Australians to use, and clinically relevant to health providers.

The PCEHR review identified key flaws in the current design and implementation of the PCEHR, and made some significant recommendations to improve the system.

The Government will continue to consider the recommendations over the coming months to understand the issues, their implications and the best ways to deliver on the intended outcomes.

The current issues with the PCEHR stem from Labor’s rushed implementation, and this Government refuses to make that same mistake.

Careful planning and consultation are required to ensure that the Government’s response to the recommendations and future investment in the eHealth system provide the best results possible for the Australian people.

The Abbott Government is making decisions that repair the Budget, strengthen the economy and prepare Australia for the long term challenges before us.
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Here is the link:
If the Government can’t work out what to do with the PCEHR in 4 months what on earth is wrong with them?
Now here is the detail from the actual budget papers:

Programme 7.1: eHealth Implementation

Programme Objectives

Operate a national eHealth system
The Australian Government is committed to strengthening the ability to share health care information. In November 2013, the Government commissioned an external review of the PCEHR to examine issues with the existing PCEHR system. In 2014-15, the Government will continue to work with stakeholders with regard to the review recommendations to see how they can best be implemented to maximise the benefits of eHealth for the Australian community.
Provide national eHealth leadership
The Australian Government will lead the national roll out of eHealth technology and services and work with States and Territories to support eHealth foundations. This will include maintaining the eHealth national infrastructure and standards necessary for clinically safe, secure and inter-operable eHealth for adoption by public and private health care providers.
In 2014-15, the Practice Incentive Payment (PIP) eHealth incentive will be used to encourage general practices to safely and securely participate in the use of eHealth systems.
In 2014-15, an evaluation of the Telehealth Pilots Programme will be conducted, with the pilots concluding at the end of September 2014.
Programme 7.1 is linked as follows:
·           This Programme includes National Partnership payments for:
-    Tasmanian electronic patient information sharing.
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 programme, refer to Budget Paper No. 3 or Programme 1.10 of the Treasury’s Portfolio Budget Statements.
·           The Department of Human Services (Services to the Community – Programme 1.2) to support operation of the Personally Controlled Electronic Health Record system.
·           The Department of Industry (Innovative Industry – Programme 1.2) to administer clinical trial reform in Australia.
The allocations of the funds is as followed:

Programme 7.1: Expenses

Table 7.2: Programme Expenses


1    "Non-cash expenses" relates to the depreciation of computer software.
Interestingly there is also a note here which makes surprising reading:
“This KPI has changed from 2014 to reflect the operation of the PCEHR system as the Department’s core business.”
Does this mean the PCEHR - which is still under review for some incomprehensible reason - is to go on forever or not?
Also what we are missing here is just how much is being spent on operation of the PCEHR and what is being spent on the IHI Service, ePIP, clinical trial reform etc. etc.
Note the depreciation of the PCEHR software is factored in for 3 + years and there are no apparent funds for re-development or change or surely what was being depreciated would be updated?
We are also shown an apparent big drop in payments for the whole eHealth program from $177M to about $44M.
To me this is all very confused. The Government can’t decide what to actually do with the PCEHR, is not sure how long it will go and so is funding it a year at the time and leaving the rest of the Australian e-Health sector just waiting around and having their businesses crushed. Additionally there is no mention of NEHTA I can find anywhere. Is NEHTA in the total programme I wonder. If it is there seem to be big cuts planned there as well.
Frankly this is an excessively opaque travesty.
David.

7 comments:

Anonymous said...

Wake up sleepy heads – you missed the opportunity last time around, are you going to repeat the same mistake again?

The Department's big con is about to be rolled out all over again, thus:

1. 2014-15 Budget provides $140.6 million to support the operation of eHealth and the PCEHR system for 12 months

2. over the coming months the Government plan its response to recommendations in the recently completed PCEHR review

3. the Department’s KPI has changed from 2014 to reflect the operation of the PCEHR system as the Department’s core business

…..… when Primary Health Networks are established 1 plus 2 plus 3 will enable the Department to push ahead to continue the Medicare Local eHealth deployment strategy just as before as though nothing much has changed.

Wake up sleepy heads.

Bernard Robertson-Dunn said...

David,

Are you saying that you have not been able to identify funding arrangements for implementing any of the PCEHR review recommendations?

It does seem strange that they have discovered that the implementation was rushed and is flawed but will continue to operate it and not fund fixing it.

Are they expecting the same people who implemented it to fix it, and do so within the operating budget?

And if it takes a couple of years to get it right (assuming they can and do) the system will have been live for four years but delivered little or no value.

Dr David More MB PhD FACHI said...

"Are you saying that you have not been able to identify funding arrangements for implementing any of the PCEHR review recommendations?"

Yup!

David.

Anonymous said...

May 19, 2014 11:19 AM David said YUP.

Which goes to prove what I said on May 18, 2014 6:08 PM
.... Wake up sleepy heads. ..... another great Con is being rolled out. Go, Ms Halton go.

Anonymous said...

I think most of the readers of this blog know there is a con going on.

It is quite likely that there is a secret agenda behind all this, one we are not part to.

Doing something about it is the hard part.

Marko said...

David, I am sure you will have 100% support on your opinionated comments:

"If the Government can’t work out what to do with the PCEHR in 4 months what on earth is wrong with them?" and, "Frankly this is an excessively opaque travesty."

Like the Medicare payment lobby, maybe this also needs a national campaign?? Although for this we minimally require details of the review to be released?

It is also a shame you seem to be lumping the pcehr into the same skip as the identifier service, however.

"Also what we are missing here is just how much is being spent on operation of the PCEHR and what is being spent on the IHI Service, ePIP, clinical trial reform etc. etc."

Dr David More MB PhD FACHI said...

Marko. The reason I put that all together is because I presume they are all funded from the e-Health allocation.

What no one on the outside knows is how much goes to what bits.

If this is all being spent on the PCEHR then how are all the others funded?

David.