The 2009/10 Budget has been released and those concerned with e-Health have again been obfuscated and let down as best I can tell!
Go here and download the .pdf for the details.
Search for “e-Health” finds really pretty much nothing except some spending in Northern Tasmania. The core material is on Page 271 and a few following pages.
It seems we are to have IHIs (identifiers) implemented by 2012/13 (way later than expected adoption) and that investment in e-Health implementation is to move from $55M to 57M next year. (Page 272)
Amazingly the Program 10.2 (e-Health Implementation) shrinks by 2012/13 from $50M to 30M or so.
The guts of what DoHA is saying is here (Page 281):
“In 2009-10, the Department will develop a legislative and regulatory framework to support the use of identifiers in the delivery of health services, and will support the development of appropriate levels of protection of health information to ensure the privacy of an individual’s health information. This will help to provide consumers with confidence that their personal health information is managed in a secure environment. The Department will work closely with State and Territory Governments, professional groups and consumers to support the development of this infrastructure.
The Department will also support secure messaging services to assist the widespread take-up of electronic referrals, prescribing and discharge summaries, and develop policy parameters for a long-term approach to IEHRs.
The national approach to e-Health has continued through the development of a National E-Health Strategy, supported by all jurisdictions, which provides a structured focus for considering national e-Health implementation. The National E-Health Strategy includes a practical roadmap for further national e-Health development and implementation by the Australian, State and Territory Governments, and allows prioritisation of existing and future investment in national e-Health infrastructure and activities. The Strategy was endorsed by all Health Ministers at the Australian Health Ministers Conference meeting in October 2008. The Government is seeking policy and implementation advice from the Department on e-Health issues to develop its response to the National E-Health Strategy.”
Slightly earlier in the document we find (on Page 222) this rubbish.
“Support for General Practices in Delivering Care
e-Health
To meet the Australian Government’s objectives for this initiative, the Department will introduce a new Practice Incentives program e-Health Incentive in August 2009. The aim for the incentive is to encourage general practices to keep up-to-date with the latest developments in e-Health and will require practices to have secure messaging capability, public key infrastructure certificates, and use electronic clinical resources. This incentive will assist practices to improve administration processes and the quality and safety of patient care. This incentive also lays the foundation for practices to securely exchange information such as discharge summaries, pathology reports and specialist reports electronically, send electronic referrals and pathology orders, and to participate in prescribing electronically as the technology emerges. This incentive has been developed in consultation with the National E-Health Transition Authority (NEHTA), and aligns with the directions set out in the National E-Health strategy. The Department will continue to work closely with NEHTA and Medicare Australia to assist practices to understand and meet the technical requirements of this incentive”
This initiative has and continues to set records for the worst planned and executed in DoHA history!
Overall Translation of Document – We have no clue what to do strategically so we will just provide nonsense words to shut the Minister up on e-Health. Of course there is no funding to implement the National e-Health Strategy I can see.
I am amazed just how often the National E-Health Strategy – that has not been made public – is used to justify what is done. How can we know if it is being followed if we can't see it?. Open Government bah!
Not funding the implementation of the National E-Health Strategy is just an appalling oversight for which all responsible should be condemned. The time has come!
Pathetic and hopeless. Thoughts of this lot's ability in organising a drinking party in a brewery and an inability to do so with unlimited funds flash to mind!
David.
12 comments:
Quite shocking really. Either e-heatlh has really fallen off the agenda completely now (and if so it would be fair to us all to simply say it has in an open and transparent way(we are grown ups no?), or there other shots left in the locker for later this year.
I can think of two - firstly the health and hospital reform commission is yet to produce its final report, and there are I think substantial funds set aside to implement that. E-health could get a guernsey here.
Secondly, COAG is also yet to consider any implementation allocations for e-health, and together the jurisdictions could collectively stump up the $ needed for core national infrastructure.
So, half full? Half empty. Time will very quickly tell.
But as of tonight, not happy, and perplexed enough to think that there 'has to be' something yet to come, because the gap in tonight's budget is so palpable ie there is a hole here not by neglect but by design.
Why is Health still waiting after all the gazillions that are being spent in other sectors in the last year?
Blowed if I know!
David.
Thank you David for being - as always - so on-the-ball and keeping us all in the loop. I appreciate the inordinate amount of time it must take you to not only write this blog, but to do the necessary research and analysis so quickly.
" The Department will work closely with State and Territory Governments, professional groups and consumers to support the development of this infrastructure..."
Is this just passing the buck to the states?
Does anyone have any idea what is behind the health network reference in the following extract from the budget papers:
"The Super Science initiative will build Australia's capacity in key areas including space science and astronomy, marine and climate science, and future industries. Funding will invest in items such as a centre for Square Kilometre Array Science, an integrated marine observing system, and collaborative infrastructure networks for health research."
The health networks are probably part of the NCRIS process, providing shared computing facilities for storage and analysis of large scale data sets eg population and bioinformatics data, in support of research
Why is anyone surprised? After the perceived debacles of the NPfIT, HealthSmart, and NSW Health EMR projects, why would any Government think that this stuff is even possible - how many billions of pounds have been thrown at the NHS, with little to show? The big vendors are on a hiding to nothing as they don't appear able to get these projects to work - and I suspect that the customer is equally to blame here.
The fact Practitioner nurses and midwives will be authorised to issue prescriptions for PBS-listed drugs under a new measure announced in the Federal Budget last night is just one more urgent reason to centralise patient records. I cannot see any other efficient way to do do than electronically.
Surely it is time to push for the appropriate DoHA eHealth and NEHTA heads to resign. When you see all the infrastructure spending in other industries, it is very hard to accept that these "leaders" could not obtain an overall budget increase. If they could not get funds when the government was actively searching for nation-wide initiatives, when will they ever get anything? NEHTA supposedly had a business case developed, had completed significant work on the building block standards, and still could not obtain any long term commitment for this critical area. The majority of projects announced in last night’s Budget span a number of years, so the chances of any significant initiatives over the next few years are going to be very slim indeed. SHAME UPON OUR E-HEALTH LEADERS. Opportunity well and truly lost.
It's not just sad that eHealth has been ignored. Primary and community health has been cut across the board to pay for new hospitals.
Precisely what we don't need: Some $550million + is being cut from funding programs
Assistive Technology in Community Care program — discontinuation: cut of $25.8 million over four years.
Australian Better Health Initiative — cease promotional activities for 45 Year Old Health Check (cut of $3.5 million over four years)
Australian Better Health Initiative — further efficiency. (cut of $80.9 million over three years).
Australian Better Health Initiative — promoting healthy lifestyles — further efficiency (cut of $37.9 million over three years)
Continence Aids Payment Scheme — (cut of 17.7 million over four years)
e Health programs — further efficiency (cut of 34.8 million over three years)
Fairer income testing in residential aged care — ending the 28 day income test exemption (saving of $40 million over four years)
General practice training — consolidating regional training providers — further efficiency (saving $10.4 million over four years)
General practice training — expanding the role of General Practice Education and Training Ltd (saving of $2.6 million over four years)
General practice training — extension of time for rural placements (saving of $0.8 million over 4 years)
Hearing services — introduction of hearing threshold (savings of $33.9 million over 4 years)
Indigenous access to health care services — further efficiency (saving $10.3 million over 4 years)
Investment in Preventive Health (Environmental Health) program — further efficiency (savings of $0.9 million over four years)
Leadership in mental health reform — continuation and further efficiency (savings of $20 million over four years)
Magnetic Resonance Imaging unit in north west Tasmania — redirection of funding (saving of $4.8 million over four years)
Medicare Benefits Schedule — Better Access Initiative — continuing professional development (savings of $21.4 million over four years)
Medicare Benefits Schedule — Better Access Initiative — improved targeting for the most in need and better quality of services (savings of $21.7 million over four years)
Medicare Benefits Schedule — reversal of proposal to fund magnetic resonance imaging scans of the knee or brain — further efficiency (savings of $15.3 million over 4 years)
National Illicit Drug Strategy — a more strategic approach (savings of $24.7million over 4 years)
Practice incentive payments — quality and administrative improvements — further efficiency (savings of $25.8 million over four years)
Primary care — Sharing Health Care Initiative — further efficiency (Saving $3.3million over 2 years)
Priority Health and Medical Research program — further efficiency (saving $17.2 million over 4 years)
Public Health Education and Research Program — discontinuation (Saving $29.5 million over 4 years)
Radiation oncology — national radiotherapy single machine trial — discontinuation (saving of $5.4 million over four years)
Reduction of the business management training initiative — further efficiency (savings of $4.7 million over four years)
Shared Responsibility and Regional Partnership Agreements — further efficiency (savings of $10million over 4 years)
Stoma Appliance Scheme — implementing a new program framework (saving of $13.3 million over four years)
Support for diabetes — remove duplication in research effort (savings of $31.9 million over 4 years)
Super Science ??
see http://minister.innovation.gov.au/Carr/Pages/SUPERSCIENCEMARINEANDCLIMATE.aspx - Minister for Innovation Senator Kim Carr
I wonder if the Minister for Innovation would like to bring E-Health into his portfolio? Maintaining a superseded vessel while building a new purpose designed vessel seems to be the skill set needed to run E-Health. Already has a billion sized budget so no problem with scope!
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