Sunday, July 13, 2014

The Parliamentary Library Provides A Post Budget Briefing On E-Health. Good To See What The Politicians Are Being Told.

This appeared a little while ago:

Budget Review 2014–15 Index

Dr Rhonda Jolly and Amanda Biggs

E health

Since the 1990s, e health has been increasingly seen by most developed countries as central to the provision of current and future high quality, patient-centred care. Electronic health records, in turn, are considered the cornerstone of e health development.
In seeking to advance the e health agenda at a national level the Rudd Government allocated $466.7 million specifically for the purpose of creating a personally controlled electronic health record (PCEHR) for Australians who chose to ‘opt in’.[1] The PCEHR has been plagued, however, by development problems and criticised by numerous stakeholders since it was first announced in the 2010–11 Budget.
In Opposition the Coalition also criticised Labor’s approach to the introduction of electronic health records.[2] Hence, soon after it took power in 2013 the new Health Minister, Peter Dutton, announced a review of the PCEHR.[3] The review, chaired by the head of Uniting Care Health Queensland, Richard Royle, was given the task of investigating some of the problems associated with the PCEHR. Of particular interest were issues surrounding clinician and patient useability. The review was also tasked with considering what incentives could be employed to encourage people to register and use the PCEHR system.[4]
The Review reported to Minister Dutton in December 2013 with what the Minister considered was ‘a comprehensive plan’ for the future of electronic health records.[5] The Minister did not publish the report, however, which prompted some stakeholders to apply, unsuccessfully, under freedom of information for its release. The report was released by the Minister on 19 May 2014.[6]
This budget has provided funding of $140.6 million for one year to allow for the continued operation of the PCEHR, while the Government ‘finalises its response’ to the Royle Review.[7] What responses there have been to the budget announcement have been almost indifferent and can be summarised in the response from David More, long-time critic of the manner in which the PCEHR project has been conducted. More wrote that the announcement simply indicated that the Government ‘just couldn’t decide what to do’ about the PCEHR.[8]
Another view was more sympathetic to the dilemmas the Government faces with regards to the PCEHR:
… we are seeing a similar situation to the Coalition’s dilemma with regards to Labor’s National Broadband Network project. No Coalition Government would organically decide to throw half a billion dollars at an electronic health records project. However, as Labor has already spent that money, and as the project has some legs, it appears the Coalition does not yet feel it can cancel it wholesale just yet.[9]
Ovum public sector research director Kevin Noonan was more positive. Noonan noted that although the PCEHR has a troubled past, the Government ‘is still committed to the concept’.[10]
It appears the year’s respite for the PCEHR is intended to give the Government time to decide exactly how that commitment will be refined and transferred into policy directions.
There is coverage on a few additional topics (PHNs and Medicare Locals and a few other matters).
It’s nice to see some responsible context setting and to have a breadth of views reported - along with references at the bottom of the full article.
I wonder is Dr Jolly’s and Ms Brigg's view at least partly formed by reading the comments around this topic from readers of the blog?
I have to point out that the Minister’s claim of the Royle Report being a “comprehensive plan” has indeed turned out to be arrant nonsense now we have all seen it and that although some of the material is more than sensible there is no real way forward for the PCEHR (if there is one) revealed.
The really worrying thing about all this is just what damage is being done to the rest of the Australian E-Health sector while the Minister / Department dithers trying to work out what to actually do.
We need to remember it is now six months since the Minister received the PCEHR Review and it has to be a concern as to just what is behind the delay in response. It might be that there is a difference of perspective between the Department and the Minister or it might be that the Department is struggling to form a coherent view in the absence of Ms Halton.
Rumours and insights welcome!
David.

2 comments:

Anonymous said...

David - you said . the Department is struggling to form a coherent view in the absence of Ms Halton.

With respect may I suggest you have that back to front. There was never a coherent view while Ms Halton reigned - all we ever got from her was eHealth gobbledygook and obfuscation as reflected in her eHealth comments over 7 years of Senate Estimates.

Dr David More MB PhD FACHI said...

I did say they might be struggling but your point is well made!

David.