HealthConnect's New Website – And a New HealthConnect!

Last week (May 10, 2006 to be exact) I had occasion to visit the old HealthConnect web site at www.healthconnect.com.au. I needed to find a copy of a study into the benefits of Health IT that I knew was there. All was as expected, I found the report and was able to send it to the colleague who wanted to read it.

On Monday (May 15, 2006) I was alerted to the fact that a major change had occurred and that the old and familiar site had disappeared. As a regular commentator on the Government’s HealthConnect saga I felt it my duty to investigate the new site. What is there to report?

First it has a uniquely unmemorable URL so it will now be necessary to bookmark the site in the hope of ever being able to find it again – did someone not pay to maintain the URL one wonders.

Second, oddly, the new site seems to have been largely developed well over three months ago but it only appeared a week ago. Enquiring minds wonder about the delay.

To more serious matters – what can one learn about the status of the HealthConnect change management strategy? The following are some random observations:

1. An all new sense of time seems to have developed for the site. We are told:

“ The expectation is that by 2008, Australia will be well advanced in achieving the goal of electronic connectivity between all major health institutions and health care providers.”

It would be difficult to imagine something more vague and non-specific. My guess is that it means someone will assemble a directory of e-mail addresses and make sure “all major health institutions and providers” can swap an e-mail. I thought they could largely do that now! Maybe I was misled?

2. We are offered on the same “What’s Happening page” the following as well:

“Looking to the future
There are a number of developments currently underway in various stages that could be nationally implemented within the next 12 to 18 months:

• e-prescriptions is about a prescription for medication in the form of an electronic message being sent from a health care provider to a community pharmacy
• e-referral could replace the current paper based referral or request sent from one health care provider to another (for example, from a doctor to a radiologist)
• hospital discharge summaries, which is a summary of the treatment provided and the proposed future care plan could be sent electronically from a hospital to a doctor, a specialist or an aged care facility.”

The operative words here clearly are “could be nationally implemented”. Not will just "could". Given the lack of HealthConnect funding in the present, just announced, budget the subtext is clearly if we can work out who will pay for it.

3. It is great to see we now know who is responsible for implementing HealthConnect. On the Governance page we find the following useful information:

“Governance arrangements
HealthConnect is managed under the national e-health governance arrangements established by the Australian Health Ministers’ Advisory Council as a joint Australian, State and Territory Governments’ project.

The Australian Health Ministers Advisory Council (AHMAC) whose members are the chief executives of Australian, State and Territory Government departments of health, has responsibility for HealthConnect.

The national implementation of HealthConnect is the responsibility of the National Health Information Group (NHIG) which is an AHMAC sub-committee. NHIG obtains stakeholder advice in consultation with the Australian Health Information Council (AHIC).”

So the NHIG is to be accountable!. Now who are they?

“The National Health Information Group (NHIG) has been established by Australian Health Ministers to provide advice on national health information requirements and related technology planning and management requirements. NHIG manages and allocates resources to health information projects and working groups where joint Commonwealth/State and Territory resources are involved.”

They are clearly a policy committee with no obvious implementation capability and no significant budget other than that they can agree on between all the jurisdictions. The committee does not even have its own secretariat to manage its internal affairs as best it can be identified.

4. The actual implementation of the HealthConnect vision it to be driven as follows:

“National coordination
The e-Health Branch within the Department of Health and Ageing has a national coordinating role in managing the implementation of the HealthConnect change management strategy. It carries out its role by leveraging existing Australian, State and Territory Government and private sector initiatives to achieve the goal of a shared electronic health record network.

The Branch, in partnership with the State and Territory Governments, is fostering strong relationships between key peak stakeholder groups representing healthcare providers, consumers and industry to engage them in the implementation of the strategy.”

Here we have a lot of fostering, leveraging, consultation and partnering but sadly not much actual spending and implementation!

5. The last really interesting point – and there are all sort of goodies to be found comes from the FAQ page.

“Where will the information be held?
Event summary information that is exchanged between providers will be held at the point of care. At the point of care, the health provider will be able to draw together, with the consumer’s permission, relevant information from other providers involved in a person’s care.”

Translation – No actual Shared Electronic Health Record is planned and no repositories are to be built or paid for – we will hold information at each point of care and exchange on demand. Much cheaper that way, assuming you can make it work.

All I can say is “Welcome to the world of New HealthConnect!” The old one has gone!

David.