The following appeared today and really is a major worry.
Report puts e-health back on table
Wednesday, 01 July 2009 | Julian Bajkowski
A push by health experts to tie federal funding for state health services to the adoption of electronic health and medical records could become a reality by the end of this year after a key report on hospital reforms was handed to Health Minister Nicola Roxon yesterday.
Sources familiar with the document have said the final recommendations contained in the National Health and Hospitals Reform Commission (NHHRC) report have retained a desire to use funding mechanisms to drive modernisation of the health system.
If adopted by Canberra, the linkage to funding could fast-track state and private sector participation in a national e-health roll--out that has so far struggled to gain traction for more than a decade.
The renewed attempts to modernise health information and records systems came as the federal government yesterday backed away from the highly controversial option of taking over underperforming state hospitals.
Estimates provided to the federal government indicate that savings of between $6 billion and $7.9 billion over 10 years could be achieved by adopting electronic health and medical records through a reduction in adverse incidents and better management of medications.
The National e-Health Transition Authority has been working on a unique health identifier linked to the present Medicare number, and has said it will deliver a substantial portion of its technical work by the end of the year.
Much more here:
There are a number of points to be made.
First is that the Health Minister will encounter powerful resistance if there is an attempt to implement an NHHRC recommendation to attempt to force adoption of e-Health through the reduction in re-imbursements for services delivered rather than via positive incentives. If that is what is actually planned it could easily cause the mother of all resistance from clinicians and I feel it would be seriously counterproductive to the thrust for e-Health in general.
Second the article suggests that there will be some decisions on e-Health funding coming from tomorrow’s COAG meeting. Bluntly this would be just ridiculous unless it is to just to fund implementation of the National E-Health Strategy – and even this may some require some re-thought with the release of the NHHRC report and its overall implications.
To provide funds for the NEHTA sponsored IEHR proposals, or anything else, without their having been an assessment of the recommendations of the NHHRC in the e-Health area and considerable public discussion on the merits of what are a wide range of strategic options would just defy logic and commonsense.
Third, because e-Health is a facilitator and enabler of Health Reform, in its broadest sense, we need clear reform directions and objectives before the relevant e-Health approaches and solutions can be identified. Given the NHHRC report itself is neither public, nor is the Government response, to be funding anything at this point would be folly. (Note this is not to say I don’t want appropriate levels of funding – and way more than is spent now! – I just want whatever is available, given the GFC, directed to achieve the optimal outcome!)
Fourth there is really no way any funds should be allocated without at least a few weeks of public discussion of the costs and benefits of each of the three prospective proposals (The Deloittes developed National E-Health Strategy, the NEHTA Business Case and the NHHRC recommendations) in the context of the overall NHHRC directions as modified by the Government response. On the basis that none of these documents are presently in the public domain, for discussion and review, for COAG to imagine it has any serious basis to believe it can make any decisions in private is really terrifying and I believe would come back to bite all involved politically – and sooner rather than later.
The right way to proceed is to make the documents public, develop a consumer friendly summary of each and then properly consult the community, permitting domain experts to make informed contributions to the debate following release of the Government response to the NHHRC.
Maybe then some community support and consensus could be developed on a way forward that would have community understanding and would have a chance of success.
Anything less would risk, as the title says, making a very, very big mistake! The old ready, fire, aim approach would be just disastrous.
Just for a bit of amusement here is the other NEHTA.