Is it Time to have the Auditor General Review E-Health?

Last week Government Health IT in the US published an article entitled “HHS needs focus despite health IT progress, GAO says”

The article said, in part, that:

“The Department of Health and Human Services has made progress in its efforts to promote the use of health information technology, but it still lacks the detailed plans, milestones and performance measures necessary to meet President Bush’s goal for electronic health records, according to a recent Government Accountability Office report.

The report cites as positive developments the Certification Commission for Healthcare IT’s recently defined parameters for certifying ambulatory electronic health records and the group’s certification of several dozen vendors’ products.

It also pointed to the 90 interoperability standards selected for tools such as electronic health records and the proposed functional requirements for a nationwide health information network.

However, the report states that although HHS has set those objectives and developed high-level strategies for accomplishing its goals, it still hasn’t defined the kinds of plans and measures it will use to meet those goals.”
It went on to say that:

“Last year, GAO told Congress that federal agencies still faced many challenges in their efforts to improve the public health infrastructure, including integrating current initiatives into a national health IT strategy and adopting consistent standards for interoperability.”

And the GAO concluded without there being clear plans and time lines in place “ it’s unclear how the government will achieve Bush’s goal of widespread adoption of interoperable electronic health records by 2014.”

Reading this, I wondered to myself has our equivalent of the GAO, the Australian National Audit Office (ANAO) ever reviewed Health IT in Australia, and if so what was concluded.

The short answer to that question would appear to be no, although there was an audit of the internal information technology within the Commonwealth Department of Health and Aging in 2002/3. There is also no audit of e-Health planned in the 2006/7 fiscal year.

As far as the States are concerned – I became quite excited to find an e-Health Audit report in NSW – only to discover the e-Health referred to was purely supply chain and not clinical e-health. At least, however, the Auditor in NSW has heard of the term! (The basic conclusion of the audit was that implementation and benefits were proving very slow to be realised).

With this background it seems to me the time has truly come for such an exercise to begin and for the work to be scheduled ASAP. Why? Essentially because a clear impartial view of the activities of the Commonwealth and State Governments and of the relevant Departments and Agencies and their successes and failures would surely provide a base of information on which to improve the likelihood of success with future investments.

There have been hundreds of millions of dollars spent by the Commonwealth and States on Health IT since 1999 and there has been no public accounting, at least that I am aware of, of what we the public have got for our money and what lessons have been learnt that need to be applied to the planned forward investments which are likely over the next decade to amount to at least a billion dollars according to the Commonwealth and NEHTA.

The Productivity Commission last year expressed a degree of unease about the Commonwealth plans for HealthConnect and the apparent lack of progress. The validity of these concerns has become even more obvious since that report.

As taxpayers we deserve to know what has been going on and who is to be held accountable for the apparent lack of progress and waste of money.

The time has surely come!

David.