It seems the 4th Estate has been working to get Ms Roxon to have a few words to say on e-Health.
First we have:
Canberra stalls on e-health details
Karen Dearne | February 03, 2009
AUSTRALIA finally has an agreed national strategy for e-health adoption, but the Government is withholding details of the plan, which could save billions of dollars in costs resulting from medical errors.
Costings for the National E-Health Strategy have not been released, nor has a rollout schedule. The strategy was developed at a cost of $1.3 million by consultancy Deloitte after extensive consultations with health stakeholders, and was endorsed by the Australian Health Ministers' Conference in December.
The Deloitte report says up to 18 per cent of medical errors result from lack of access to patient information, with these adverse events costing about $3 billion a year "in avoidable expenditure - money that could be better spent on health demands driven by an ageing and sicker population".
.....
Federal Health Minister Nicola Roxon this week declined to reveal further details of the e-health strategy, and yesterday a spokesman said the full report could not be released without the consent of all AHMC members.
"Together with my health minister colleagues, I was pleased to endorse the national strategy in early December," Ms Roxon said. "It will allow prioritisation of existing and future investment in national health IT infrastructure and activities."
But instead of the anticipated changes the minister said the National E-Health Transition Authority would continue its foundation work on interoperability and information security.
Astoundingly, more than $5 billion has been spent on e-health projects and trials by federal and state governments over the past 10 years, with only "marginal progress" resulting.
....
It is (also) unclear how NEHTA, revitalised under a new regime, will be restructured to create a new, entirely separate, e-health entity, as envisioned by Deloitte.
Full article here:
http://www.australianit.news.com.au/story/0,24897,24998724-5013040,00.html
We also have the following from Medical Observer.
Roxon gains new insights after day at the coalface
Shannon McKenzie - Friday, 6 February 2009
Ms Roxon on:
National E-Health Transition Authority:
“I do not consider it a failure, however I do not think the previous government gave it a clear direction. I think we will begin to see progress with the new CEO and chair. If we do not make the investment in e-health our reforms will not work.”
Full article here (for those with access):
Simultaneously we have the budget submission process wrapping up and we see some pressure for e-Health consideration.
Budget 2009: AMA pushes e-health agenda
02 February 2009 05:21 PM
The Australian Medical Association has named e-health infrastructure as one of the highest priorities to receive cash from the government's $10 billion Health and Hospitals fund, in a submission to the 2009-2010 Federal Budget released today.
"Further investment in e-health infrastructure, particularly in hospitals, medical practices, aged care, pharmacy and other allied health practices, is needed to fully enable the sharing of patient information electronically in Australia," the submission said.
The Health and Hospitals Fund was formed by the Rudd Government to enable investment in health and hospital facilities and equipment, medical technology and major medical research facilities. Applicant guidelines for the fund specify that capital funding can be used for information management and technology systems installation.
The AMA named e-health infrastructure as one of three "critical" investment areas alongside equipment in rural hospitals and training facilities in general practices.
Last week, the Australian General Practice Network (AGPN) also lodged a submission to the Budget, calling for its e-health funding, which ends this June, to be extended. It recommended $13 million per year be allocated.
More here:
The AMA Press Release is also available on line:
Mr Rudd – what happened to health?
4 February 2009 - 1:00pm
The AMA has called on the Federal Government to urgently explain why health was excluded from yesterday’s mini budget.
AMA President, Dr Rosanna Capolingua, said health should be a high priority on any list of nation building infrastructure development.
“But we didn’t even make the list. Forty two billion dollars - that’s forty two thousand, million dollars of taxpayers’ money - and not a cent will go to the nation’s crumbling health infrastructure,” Dr Capolingua said.
Full release is here:
We also have a HISA submission to the Budget process:
HISA has delivered its prebudget submission to the Federal government.
Recognising the progress made in establishing the Deliottes National E-Health Strategy and the work of the National Health and Hospitals Reform Commission, HISA urges that we continue to move forward. We have requested the delivery of a set of foundation activities that will allow the realisation of the objectives articulate though these strategy and discussion documents.
Click here to download the complete submission.
(Note: I am not personally in agreement with the priorities outlined in the HISA submission. They really only become relevant once implementation of the Deliottes National E-Health Strategy has been properly funded and implementation commenced. This is yet to happen! Once this has what HISA is saying is also important!)
All in all Ms Roxon must be well and truly aware that more than she has already done to explain what she is actually planning is required. There had better be some good announcements regarding the use of the Health Infrastructure Fund or plans for the 2009 Budget pretty soon now or the discontent will only build.
David.
In this current economic climate it is perhaps a bit unrealistic to expect the Deloitte National E-Health Strategy to be fully funded. What needs to be done is this.
ReplyDeleteDeloitte, the author of the strategy, needs to be re-engaged and asked to review and revise their strategy for incremental implementation within a nominated budget range.
This does not mean the strategy has to be rewritten. And it does not mean it has to be discarded. It means that it needs to be tailored in a way which is both practicable and sympathetic to today’s rapidly deteriorating economic circumstances. Also, it is most important that this ‘opportunity’ is not lost by handing that task to some group of consultants who were not involved in developing the original Deloitte strategy. The brains that put it together must be used to re-sculpture it as required. Therefore to maximise this opportunity Deloitte needs to do the job.
This should lead to preserving the excellent strategy already proposed by Deloitte and to a reasonable, albeit more conservative less ambitious, approach to implementing the National eHealth Strategy.
Good comment if Deloittes was talking about billions. They were not. We are talking $150M p.a. or so for a couple of years - which given the $42 Billion on assembly halls, handouts, blackspots and pink bats seems good value to me!
ReplyDeleteDavid
I wonder if it would make more sense to see Health IT as part of a meta-structure that is (for want of a better description) a National Framework for Health and Welfare. The best value is always going to be in spending on prevention, especially in early childhood. What I mean is, discrete technological solutions (there is one or more in every dog-and-pony software shop, right?) will become less attractive to policy makers, the further we are dragged into the economic crisis.
ReplyDeleteIt seems your (Monday, February 09, 2009 9.45 pm and 9.57 pm)commentators are both pretty much in agreement. That the Minister, the overriding authority, has said she is not in a position to release the full Deloitte report is beyond any reasonable comprehension. It seems that is the only document available which provides a clear understanding of the projected costs of the Deloitte strategy.
ReplyDeleteIt is virtually impossible to hold an informed discussion on the affordability of the Deloitte strategy without such data being available. There are plenty of bureaucrats with access to this information beavering away on their pet projects to get something up which will attract some funds to keep them employed for many years to come. We can have absolutely no confidence their pet projects will dovetail in any way, shape or form, into a well integrated coordinated development pathway, if for no other reason than because the many silos within the bureaucracy, which mitigate against this being possible, remain in place.
It is fair to say the Minister is being irresponsible in withholding the Deloitte strategy which no doubt she is doing on the advice of her bureaucrats. To suggest the full report could not be released without the consent of all AHMC members is quite untenable. It demonstrates how little control the Minister has and how much control her advisors and spin merchants have over her.
In the first article by Karen Dearne we read "Astoundingly, more than $5 billion has been spent on e-health projects and trials by federal and state governments over the past 10 years, with only "marginal progress" resulting."
ReplyDelete!!! five thousand million dollars !!!!!! five THOUSAND MILLION dollars !!!!!! FIVE thousand million dollars !!!!!! five thousand million DOLLARS !!!
The Deloitte report also said:
The amount of dollars invested in E-Health by Commonwealth, State and Territory governments alone over the past ten years is estimated to be in excess of five billion dollars. Despite this investment Australia has only made marginal progress towards being able to electronically exchange information across different parts of the health sector due to the limited coordination of E-Health plans and investments.
Without some form of national coordination there is a very real risk of extensive duplication of E-Health effort and expenditure and the creation of a whole range of new solutions that cannot be integrated or scaled across the continuum of care.
There is a point at which the number of these disparate systems will be so great, and integration so difficult, that the ability to realise the gains from creating an integrated system may be prohibitively risky and expensive to attain.
This would represent a major lost opportunity for Australia to take a very significant, technology enabled step towards the delivery of safer, more efficient and sustainable health care services for all Australians.
What's the bet the $5 billion dollar comment was an oversight by those who prepared the Summary Report. What other pearls of wisdom are concealed in the full report?
Ms Roxon got 'IT right' when she said: "If we do not make the investment in e-health our reforms will not work."
ReplyDeleteThe hard part is putting the investment in the 'right' place. As your commentator above said ..... that doesn't mean drip feeding the whims of the bureaucrats sitting in their silos with pet projects aplenty. It means being transparent. As a first step it means making the Deloitte Report accessible to all.
Hey, if they can do that with the KPMG Report why not Deloite's?
On the National E-Health Transition Authority the Minister said:
ReplyDelete“I do not consider it a failure, however I do not think the previous government gave it a clear direction. I think we will begin to see progress with the new CEO and chair. If we do not make the investment in e-health our reforms will not work.”
Can we infer from this that Ms Roxon is of the view the Government has now given NEHTA a clear direction?
Does anyone have any idea what NEHTA's clear direction might now be?
ReplyDeleteDavid would probably know if the "clear direction" which the Minister refers to has been set or not. There doesn't seem to be anything 'new' on NEHTA's web site to that effect that I can see.
ReplyDeleteWithout the burden of knowledge of whatever is contained in the Deloitte's report, this rank outsider is prepared to offer a sombre warning about expectations. We often get the perception, from glossy promotions, that all the government needs to do is bolt together a raft of "solutions" from the software market and Voila! - Health IT in a snap.
ReplyDeleteAnother view requires looking at mass shifts in labour forces - a reconfiguration of workplaces across the health care domain, if anyone wants to chew on that from the perspective of EBAs - because economic rationalists in Australia have publicised the seeming excess of "bureaucrats" in the health workforce. Was it Halamka in the US who came out recently with a forecast of so many tens of thousands of new jobs that will be created in the Health IT domain under the Obama funding plans? Even if it's possible to train everyone from surgeon to ward clerk in new IT skills, there will still be a need for new labour in the establishment and the maintenance of integrated IT across health care. If anyone thinks the MUA-Patricks affair on the waterfront a few years ago was drawn-out and bloody-minded, try and imagine how thousands of existing clerical level staff in hospitals will give away their jobs to IT technocrats.
A lot of the argument for Health IT seems to be pitched at "high value" targets. Some good examples are over at http://www.healthcareitnews.com/
The claims that IT can prevent prescribing errors are in this bag, that of vendors selling a product with a profit margin that can be jacked up by emotional appeal to "innocent victims". For goodness sake, if a company decides to put a drug on the market, whose responsibility is it to prevent prescribing errors? Doctors write prescriptions, so the onus must be on prescribers and their training and accreditation colleges to deal with the consequences of close similarities in trade names of drugs, without expecting the public to pick up the costs. Nurses administer IV medications in hospitals, so who should ensure that ampoules of (lethal) concentrated KCl are not remarkably similar to ampoules of NaCl? See Intravenous potassium chloride prescribing and administration practices in Victoria: an observational study.
The Review of the National Innovation System
could be a useful guide.
In reference to your comment Aushitman [Monday, February 09, 2009 9:57:00 PM] I think it fair to say you are misrepresenting the figures somewhat.
ReplyDeleteFrom what we have been led to believe the estimated costs of the Deloitte-AHMAC National eHealth Strategy range from $1.5 billion over 5 years up to $2.6 billion over 10 years.
I hope you agree that is considerably more than what you said "We are talking $150M p.a. or so for a couple of years". I'm sure you would agree it doesn't help by distorting the facts.
Hi,
ReplyDeleteIt was an accident. The figures are close to as you say - i.e about $260M p.a. over the 10 years.
That said in the context of the $42B for the stimulus - which is to go for 18 months it is maybe 1-2%.
Sorry about the wrong figure.
David.