The really good news is provided in the second paragraph where we are told “The Australian Government agrees that better clinical outcomes and improved efficiencies can be achieved with better use of e-Health” while pointing out patient choice, privacy and confidentiality are matters that need to be carefully and fully addressed.
I will leave it for readers to form a judgement on just how much progress has actually been made for the funds expended and whether what has been done has been cost effective. On the basis of there being 36,300 GP(s) in 2005 it seems the Practice Incentive Program (at $40,000 per practitioner) has cost $1.432B or so over the last few years. When this is added to the other sums mentioned ($310M) to total expenditure (not including the $105 Million for NEHTA) is perilously close to $2.0Billion.
It seems to me, prime face, that spending $128 Million on providing an electronic health record for 10,000 people could hardly be seen as cost effective. Heavens, to expand to the population in general we would then be over $256 Billion (about a quarter of the national GDP). If even 5% of this sum could be found life would be just wonderful!
It should be pointed out that to date there have been no reports on the clinical impact of any of these initiatives that are seen as credible. It is a lot of money that might have been spent inappropriately!
Back to the good news. It is important to read work is actively underway on e-prescribing. It would be good if the plans for this were being developed more transparently with more discussion with all the relevant stakeholders.
In the second last paragraph we are told a combination of financial incentives, regulatory reform and Standards development are being supported to move the agenda on. All good as far as it goes – BUT – without a coherent e-Health Strategy that brings all these parts together will may well wind up wasting a good fraction of the next $2Billion if a second chance is ever offered.
Overall the lack of identification of the Australian Health Information Council’s (AHIC) importance to provide a workable strategy is worrying. NEHTA is not the answer for this problem. We can only hope AHIC is.
Many thanks for the good news Mr Eccles. Now can we have a plan please?
David.
The longest bureaucratic obituary?
ReplyDeleteThe figures on 94% GP computer use and 60% of practices with B4H participation seem very rubbery to me.
The 30% of BB claims done online is an astonishing admission after all this time.
It is interesting that the 70% of GP's using computers at 2000 ignores the initial update period following the PIP incentives, not then tied to accreditation, from May 99 to the end of 2000. That was when the real jump in uptake occurred.
And, of course, the much vaunted and allegedly funded-like-no-other-project Eastern Goldfields Regional Reference Site doesn't rate a mention! It appears to have become a state secret!
The last part is sweet, but really means they are passing the buck to the states.
The regulatory impediment reduction is a fantasy. Dongles for signing electronic referrals is a show-stopper still, despite Andrew MacIntyre's best efforts.
Its also evident that the $40,000 per GP over 7 years paid by the PIP only refers to the cost per PIP participating GP, not the whole GP community. So the total spend has been much smaller than the impression given.
ReplyDeleteThe PIP IM&T tier, whilst the PIP's shining star, has only encompassed a proportion of GPs and practices.
Many of the other PIP initiatives, that have relied on IM&T use to make them feasible have faired much worse. The asthma 3+ plan being the standout failure that was persisted with for over six years before modification
It is a common situation that bureaucrats are constrained by the bounds of their programs when thinking about such issues and don't carefully qualify their statements, giving these erroneous impressions.