E-health goes back to basics
Karen Dearne | May 15, 2008
FEDERAL bureaucrats are back in charge of the e-health reform agenda, with the Rudd Government allocating $60.6 million to solving the "challenges" of complexity, pace of technology development and lack of consultation with stakeholders.
Budget documents say the Government, through the Health Department, "will work with the states, professional groups and consumers, to address the aspects of e-health requiring national leadership and coordination. This includes the development of a national e-health strategy".
The declaration ends the arm's-length approach to e-health adopted by the previous government, which created the largely ineffective National E-Health Transition Authority (NEHTA) to manage the issue then cut existing projects such as the HealthConnect nationwide patient record-sharing system.
Underlining the shift away from NEHTA, the Budget statement adds that the department "will specifically oversee the development of national standards to enable compatibility of e-health systems across the national health network. The department is working to ensure health systems are interoperable, and can safely and securely exchange electronic health information between health professionals with patients' permission".
NEHTA founding chief executive Ian Reinecke resigned unexpectedly in late March, amid increasing calls for a clear strategy and state health departments embarking on their own, separate, health IT projects.
Andrew Howard, chief information officer of Victoria's Human services department, is currently acting chief executive while an international search is conducted for a replacement for Dr Reinecke.
A formal review by Boston Consulting found the authority had failed to communicate with health and IT industry stakeholders whose support was needed to resolve complex technical and workplace reform concerns.
In contrast, the new government has promised to consult with "medical groups, the software industry, other professions and the community to ensure the needs of all are taken into account" and the benefits of e-health properly communicated.
It's understood NEHTA will be required to report directly to department officials, who will "ensure work is delivered within agreed timeframes".
However, e-health has taken a Budget cut of $4 million to $60.6 million in 2008-09, compared with $64.6 million in the previous year.
In 2006-07, the Howard Government left $41.5 million unspent out of $79 million allocated to national health IT projects, as it lost interest in e-health reform.
Superficially this may seem to be good news but I would suggest it needs to be treated with considerable caution. Why?
First, with the unstable and unfocussed shambles that e-Health has been over the last few years, virtually anyone with any long term corporate understanding of the e-Health domain has left DoHA for pastures green.
Second those who remain have done a pretty poor job of providing Federal Co-Ordination of e-Health initiatives and have funded a series of non-strategic pilot projects in a planning vacuum they must have been clear existed.
Third these same people stood idly by while NEHTA ran amok causing frustration, annoyance and anger among virtually every impartial observer of what was going on. Surely the central bureaucracy could have had a major influence on what happened once it became clear just how badly NEHTA was behaving in 2007.
Fourth, what funds they have obtained have not apparently been spent as they should have been, and have presumably been lost to the Tanner razor!
Fifth there is no evidence at all that the very senior Departmental leadership has any interest in, understanding of or concern for e-Health, rather seeing it as a poison chalice that can result in severe career limitation.
Whether having DoHA more involved is a good thing will be easily measurable. If in the budget next year there is not significant new investment planned as a result of the National E-Health Strategy we will all know the unsatisfactory status quo prevails. I for one will be watching closely.
Just how we expect $60 million spent on e-Health Implementation in a Commonwealth Health Budget of $50,728,515 million (that is 0.00018%) to actually make a difference is beyond me! To do anything that would actually make a difference must cost in the billions not the tens of millions!