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Saturday, November 29, 2008

E-Health Update from COAG

Official word on the COAG outcome came out a few minutes ago (8pm 29/11/2008).

See:

http://coag.gov.au/coag_meeting_outcomes/2008-11-29/index.cfm

"E-Health

COAG noted the progress of the National E-Health Transition Authority and agreed to the continued funding of $218 million (50:50 cost shared between the Commonwealth and the States) for the period July 2009 - June 2012 to enable it to continue its existing work program."

So $75 Million a year for 3 years to just keep NEHTA funded. Just hopeless and pathetic. These decision making ministers are just beyond help.

Note: The actual funding document says as follows

E-health (NEHTA)

2009/10 - $28.7M

2010/11 - $39.2M

2011/12 - $41.0M

Total $108.9M

Not a strategic dollar to be seen anywhere.

What this decision does is reward a deeply dysfunctional and un-reformed NEHTA while failing to acknowledge the desperate need for major change in e-Health governance, applications, education and service delivery.

NEHTA was reviewed a year or so ago, told to improve drastically, really has not and now is given three more funded years to mess things up even more!

Previous post says it all! This is the worst possible outcome I could have imagined and I find it very sad for the health system in Australia - that will labor without the technology support it so desperately needs.

A pox on all their houses in my view.

David.

16 comments:

Anonymous said...

So I guess this is the end of your blog then....

Anonymous said...

We live in tough times. No major new initiatives which could lead to budget blow-outs down the track such as the IEHR; make do with what you’ve got like NEHTA and existing infrastructure; batten down the hatches; and be happy.

Anonymous said...

NEHTA’s Annual Report (page 31) shows Revenue of $38.7 M for 2008.

Yesterday you reported “COAG …. agreed to the continued funding of $218 million (50:50 cost shared between the Commonwealth and the States) for the period July 2009 - June 2012 to enable it [NEHTA] to continue its existing work program."

COAG’s Funding Package confirms the following for E-health (NEHTA):
2009/10 - $28.7M
2010/11 - $39.2M
2011/12 - $41.0M
Total $108.9M

If $28.7 M = 50% of COAG’s funding contribution to NEHTA’s revenue for 2009/10 then is it correct to assume that NEHTA’s budgeted revenue for 2009/10 will be $57.4 M?

If that is correct then NEHTA will enjoy an increase of $18.7 M over and above its reported 2008 Revenue - an increase of 48.3%.

Is that a correct interpretation?

Aus HIT Man said...

In response to most recent comment that looks about right to me - presumably to fund the IHI, NASH and SNOMED CT work. It is not obvious why there is quite such a planned jump - a covert IEHR maybe?

Note that by 2011/12 the figure becomes $82M per annum. That is a hell of a lot of money for NEHTA's present programs.

In regards to the other comments - I am not at all happy and yes I am really thinking about what return patients and health systems are getting for my efforts - which is the only reason to press on. Right now it is pretty dis-spiriting.

David.

Anonymous said...

Some of that jump to which you refer "it is not obvious why there is quite such a planned jump - a covert IEHR maybe?" might be an added contribution from the unspent DOHA e-Health dollars as reported on 31 October in the Australian "http://www.australianit.news.com.au/story/0,24897,24580759-15306,00.html

Some e-health funds unused
Karen Dearne | October 31, 2008 as follows:

.......... THE federal Health Department has once again underspent its e-health implementation budget, spending only $42.5 million out of $53.8 million allocated for 2007-08.

Spending on e-health had crashed during the previous year, with $41.5 million left unspent out of $79 million allocated to national projects, including the now defunct HealthConnect.

But even the heavily trimmed allocation for the past financial year was underspent by $11.2 million, the Department's annual report reveals.

Anonymous said...

David,

Having read your blog on and off for the past couple of years, I would just say please don't even consider throwing it in. It's almost impossible to piece together the nebulous promises, fictions and blatant lies surrounding eHealth in Australia. Your blog has been an invaluable contribution, even if only to the many people who are not 'decision-making' (or rather indecision-making) bureaucrats and politicians, but who are just trying to make a small difference.

Sadly, the Minister and the bureaucrats may have no idea of the damage they've caused by wasting this opportunity.

With regard to the posts about funding, I think you only have to look at past history of funding (from their annual reports):

2005-2006: Revenue $19.1m
2006-2007: Revenue $24.6m
2007-2008: Revenue $38.7m

Take these numbers and extrapolate, you'll get:

2009/10 - $57.4M
2010/11 - $78.4M
2011/12 - $82.0M

If you look at what NEHTA has achieved with the funding growth during 2005-2008, I think it would be safe to assume that a large portion of their future increase will be just to pay for their increasingly bloated bureaucracy.

I doubt there's much chance of enough money to operationalise even their core unique identifiers project - considering it's likely to be years late. Nevermind, trying anything as ambitious and misguided as an IEHR.

The only thing that the Minister could have done better would be to have abolished NEHTA completely and refused all funding - that would have been better than keeping that organisation on life support.

At least then we could start with a clean slate and actually start work on some well thought out, practical capabilities even if it is some time in the future.

This decision has consigned NEHTA to irrelevance. It would have been better to consign that particular bureacracy to history.

Anonymous said...

Looks like you might have got what you wanted on the IEHR - not a cent - is the way I read it.....

Friday, November 28, 2008 2:42:00 PM Aus HIT Man said.....
Only on the basis that we move from a nebulous vague IEHR pseudo-proposal to the next step forming up the details of just what is proposed, how it will work, how privacy and security will be addressed, how it will be delivered and what it will actually cost. If the funding is to get that detail into the public domain for proper discussion - OK. If not - not a cent until that is the plan. David.

Anonymous said...

The Deloitte National eHealth Strategy document did not need to be considered by COAG for it to be relevant. There is no reason why it should not be made available for public comment. Of course, if the intent is to put it aside for six months or so and consider it alongside other reports like the National Primary Care Strategy then it could be quite a long wait before it sees the light of day.

Anonymous said...

I am amazed you are so surprised about the NEHTA funding.

Page 36 of NEHTA’s Annual Report made it perfectly clear NEHTA would be funded into the future.

The Report said “it was anticipated that NEHTA Ltd would remain in operation until 30 June 2009. This period was extended, following the Commonwealth, State and Territory Governments agreeing that NEHTA should continue operations”.

Aus HIT Man said...

The Report did not suggest the funding would be doubled by 2011!

That surprised me - without added roles

David.

Anonymous said...

Pages 17 to 21 NEHTA’s Annual Report (Shaping the Future of eHealth) lists what NEHTA, and by association the Ministers, has identified as the best examples of eHealth projects underway in Australia today.

They are:
* 1. NT - Shared Electronic Health Record Program
* 2. WA - Health Corporate Network e-Procurement System
* 3. ACT - ACT Health Patient Master Index Project
* 4. NSW - Health eLink EHR Pilot at Maitland Hospital and The Children’s Hospital at Westmead
* 5. QLD - Mater Health Services - Standards for Electronic Communications
* 6. TAS - Tasmanian Ambulance Service HealthConnect Electronic Patient Care Record Project
* 7. VIC - Barwon Health’s Secure Electronic Network
* 8. SA - HealthConnect Secure Electronic Messaging Project

Anonymous said...

That means each state has an ehealth project of some kind underway. I would be very interested to know how advanced is each project on a score of 1-10? What is the budget for each project? How do they all fit together into NEHTA's grand plan for the nation?

Anonymous said...

NEHTA is now a pretty well institutionalised project that will attract triennial funding well into the next decade unless it fails to deliver big time under its new CEO and new Board Chair.

Anonymous said...

Monday, December 01, 2008 8:25:00 AM asked some pretty reasonable questions. I have searched high and low for budget/funding information on each of these projects and drawn a blank. I do not think there is any information publicly available. Why not?

Anonymous said...

Anything to do with money always seems to cause problems. Look at is this way. NEHTA is an ongoing project in need of funding. Whether NEHTA might change its modus operandi or project scope or priorities is anybody’s guess. If it did, in what way would it do so? Well, that is up to NEHTA’s Board which is made up of Heads of Health Departments who report to COAG’s Ministers. Sound familiar. The aim is to control ehealth funds as tightly as possible, so all new initiatives, whatever they might be, will come via NEHTA. For the foreseeable future, or until it stumbles badly, NEHTA reins supreme.

Aus HIT Man said...

See my blog post for later today for another funding alternative that may suit many who read here.

David.