A few days ago the following article appeared on the MIS Australian web site.
Coonan moots plan to stitch up e-health
Julian Bajkowski
The Australian Financial Review | 31 Aug 2007 | Information
The Howard government's tactic of staging federal interventions in state health matters is primed to escalate after Communications Minister Helen Coonan gave the strongest indication yet that Canberra was ready to create a national electronic health record.
Senator Coonan yesterday confirmed that discussions with Health Minister Tony Abbott on a standardised national electronic health record were well advanced and had included how costs and medical fee structures could be affected.
"This issue has been identified in the Health Department and my understanding is that they are well advanced in getting an announcement [ready]," Senator Coonan said.
Senator Coonan's comments came during the announcement of $29.5 million in federal funding for five new electronic health projects under the $117 million Clever Networks program.
These included electronic medical record sharing facilities for the Royal Flying Doctor Service, interoperability funding for remote Western Australian hospitals and funding for new applications in the NSW Hunter-New England region.
….. (go to www.misaustralia.com to read full article)
If this was not enough we also have this announcement:
Clever Networks: improving the quality of life in Australian communities
…..
“Round Two projects (in the Clever Networks Program), include:
- $5.2 million for the Loddon Mallee Virtual Trauma Care Unit project to install videoconferencing units connecting Bendigo, Echuca, Swan Hill and Mildura regional hospitals with base hospitals in Melbourne. This will allow metropolitan trauma specialists to provide ‘virtual’ consultations with doctors in emergency rooms across the Loddon Mallee region of Victoria.
- $9.3 million for the Bush Medivac Western Australia project to implement interoperable data networks to enhance the communications and coordination capabilities of all major health and emergency services in the state. This will make a significant contribution to Western Australia’s ability to respond to emergency incidents and health crisis situations in regional and remote areas. This project builds on a Round 1 proposal and also dovetails with the following proposal.
- $2.7 million for the eHealth for Remote Australiaproject for an electronic medical record system providing essential patient information. This will allow the Royal Flying Doctor Service to provide better primary health care for up to 750,000 Australians living in remote and isolated areas of New South Wales, South Australia, Queensland and Western Australia.
- $3.1 million for the Enhancement of Telehealth in Western Australia project to enable improved health service delivery for up to 454,740 residents in regional, rural and remote communities across the state, including more than 44,900 Indigenous Western Australians. This will address problems such as low life-expectancy and retention of health professionals in remote communities of the state.
- $3 million for the Clinical Outreach – Hunter New England project to provide greater access to advanced clinical applications to an additional 23 health facilities in the New England region. This will promote better health outcomes for residents of the region by improving communication, minimising treatment delays and supporting clinical practice. It also brings the total number of New South Wales hospitals and health facilities that are benefiting from the program to 138.”
….. (go to the URL above for the full release)
And as well as that we have:
Strengthening Communities Through Technology
Address to 5th Annual Australian Telecommunications Summit
Sydney Thursday, 30 August 2007
Here we hear about the following (in part)
“For example, many communities in regional, Tasmania will benefit from improved medical care thanks to the VirtualCare@TAS project, which I announced in July at the Launceston General Hospital.
It is worth explaining what this project has done to improve health care services throughout northern Tasmania by linking patients in the region with high-quality expertise via wireless and video conference technology and associated specialist equipment.
The VirtualCare@TAS program is made up of four innovation streams:
- The Statewide Medical Advice, Referral and Transfer Network;
- The Chronic Disease Health Coaching Network;
- The Remember Me Aged Care Network; and
- The Telehealth Tasmania Outreach Network.
This new service will focus on rural emergency management, diabetes, oncology, aged care and mental health rehabilitation in regional, rural and remote Tasmania.
The Statewide Medical Advice, Referral and Transfer Network will provide a first response remote medical advice, patient triage and assessment capacity, with access to specialist advice for rural hospital staff in an emergency.
During a medical emergency the network will provide access to remote specialist clinical support for patients in small rural hospitals.
Remote specialist advice will likely be invaluable to volunteer ambulance and emergency officers responding to an emergency in a remote location such as Flinders Island.
The Chronic Disease Health Coaching Network will provide remote clinical supervision for diabetes, cancer, mental health and spinal care and it will help people living in rural and remote Tasmanian communities, and there are many.
This means that a cancer patient will be able to undergo chemotherapy treatment locally administered by their local health professionals delivered via satellite clinics and video conferencing units.
These video conference units will enable peer support and specialist advice in the treatment of patients.
This will reduce the risks of severely ill patients in remote areas travelling long distances to receive their treatment in major centres.
When it comes to treating the sense of isolation in these communities, it’s not just the patients who benefit.
The opportunity for health professionals to increase skills and to engage in professional development without travelling vast distances and leaving these communities is an essential part of recruitment and retention.
The VirtualCare@TAS Program will tackle these critical issues head-on and, in this way, will not only keep more Australians healthy, but keep more Australian communities vibrant and viable.”
Suddenly Minister Coonan is all over the country announcing e-health initiatives and pre-empting Minister Abbott (who is meant to be the Minister for e-Health) by letting it be known there is to be a standardised national electronic health record!
What is to be made of all this?
Can I suggest a few things.
First it is hard to escape the conclusion – on the basis of these announcements – which are not even joint announcements with Health – that state agencies and area health services have got sick of asking the Health Department (DoHA) for e-health network infrastructure and have simply gone elsewhere in frustration.
Second it is clear there is no co-ordinated e-Health agenda or plan existing within Government or there would be much better co-ordination than this!
Third having Minister Coonan announce a EHR initiative is really bizarre. No wonder the NEHTA CEO felt the need to offer ‘no comment’ when asked..given this is what NEHTA said it was doing as recently as a few days ago. Were I him I would be feeling a little gazumped!
Fourth it seems clear DoHA has lost control the e-Health strategy and now any agency that feels like it can just announce what they want when they want. One really wonders how sustainable this flourish of little initiatives will be in the long term. One never seems to see much in the way of evaluation if initiatives of this ilk become public.
All this is really bit part nonsense and puts off further the day when common sense and rationality will be applied to the e-Health domain in Australia. It is virtually inevitable, in my view, a good portion of these funds will wind up being wasted – we can just hope not!
The pre-election period we are presently in does really yield much strangeness.
David.
5 comments:
Canberra ready to create a national electronic health record - they must be joking. Have they learnt nothing over the last 5 years or so?
Foot-in-mouth disease can be quite contagious. Let us hope Senator Coonan recovers quickly and that Tony Abbott tells us all about his new plans for a standardised national electronic health record. We await with bated breath.
Discussions with the Health Minister Tony Abbott on a standardised national electronic health record are well advanced! What does this mean?
Is the Minister for Health and his Department so out of touch with reality or is it just the thin air in Canberra causing lack of oxygen to the brain. Does Dr Reinecke at NEHTA know what the Minister and DoHA are doing? Do any of them know what Medicare Australia is doing? It looks very much as though they are all jostling to get a lead on each other even though no-one seems to be leading anywhere with much clarity of purpose.
I don’t think you can say “it seems DoHA has lost control the e-Health strategy and now any agency that feels like it can just announce what they want when they want.”
Government is a ubiquitous organisation. Different parts of Government have different agendas. Helen Coonan’s department is a kind of catalyst to facilitate the uptake of technology in many forms. Not all the Clever Networks funding is spent on health projects - but if health related applications are predominant then there will be a bias of funding in that direction. Videoconferencing, communications and networking could be considered useful adjuncts to scatter around far and wide. Particularly in an election year - assuming Government doesn't change.
Bear in mind too that of the $219 million allocated as part of the ‘Clever Networks Innovative Services Delivery’ only $78.5 million (38.5%) has come from Senator Coonan. This is for 22 projects (which cannot be described as successful - because they have barely started). Also don’t overlook the fact that “Funding for each of the projects is provided subject to the successful negotiation of a funding agreement” which can take many months to put into place. All this may evaporate after the election!
What I think you can say however is that Medicare Australia has control of the e-health agenda and that DOHA and NEHTA are mere pawns in the game, tugging and pulling on the end of the line. They have not yet been reeled in, but that inevitably will happen in time because Medicare Australia controls the biggest purse.
Hi,
You make excellent points. I had meant to say in the initial post that some of these proposals may have considerable value and certainly should be considered with an open mind.
My concern is the lack of co-ordination - which when it manifests like this - inevitably seems to end in both tears and waste.
Your comments on Medicare Australia are very prescient and I believe very much correct. I have seen them as the strategic elephant in the room for a good while now.
David.
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