Talk About the Ignorant Consulting the Uninformed.

I spotted this page from the Commonwealth the other day which purported to be consulting on the e-Health aspects of the NHHRC Final Report.

e-health

National Health and Hospitals Reform Commission Fact Sheet

Electronic health records are one of the most important opportunities to improve the quality and safety of health care, reduce waste and inefficiency and improve continuity and health outcomes for patients.

A person-controlled electronic health record

A person-controlled electronic health record should be available for each Australian – as one of the most important systemic opportunities to create person-centred health care and improve quality and safety. Giving people better access to their own health information through a person-controlled electronic health record is vital to promoting consumer participation, and supporting self-management and informed decision-making.

By 1 July 2012, every Australian should be able to have and control their own electronic health record with a provider of their choice. People should also be able to approve health care providers and carers to have access to their records.

Privacy in e-health

The Australian Government should legislate to ensure the privacy of electronic health data. Additionally it should be responsible for the development of a national policy and open technical standards framework for e-health.

Encouraging take up of e-health

The payment of public and private benefits for all health and aged care services should be dependent on their ability to accept and provide patient data electronically and this should occur by 2013.

The Australian Government should develop and implement an appropriate national marketing strategy to inform consumers and health professionals about the significant benefits and safeguards of the proposed e-health model.

What do you think?

The Government is undertaking a series of face-to-face consultations and is using this website to seek the views of Australians on these and other options.

What do you think? Tell us at a consultation visit or complete the Tell us what you think form to provide your views.

These views will be compiled and reported to Government prior to deciding what health reform should be undertaken.

Individual responses will not be posted to the views provided on this site.

More information

This is a summary of some of the major recommendations of theNational Health and Hospitals Reform Commission. Full recommendations can be found in A Healthier Future For All Australians – Final Report of the National Health and Hospitals Reform Commission – June 2009

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The page is found here:

http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/E-Health

Now hang on just a moment!

Here is what the NHHRC recommended on E-Health.

Implementing a national e-health system

We recommend that, by 2012, every Australian should be able to:

• have a personal electronic health record that will at all times be owned and controlled by that person;
• approve designated health care providers and carers to have authorised access to some or all of their personal electronic health record; and
• choose their personal electronic health record provider.

We recommend that the Commonwealth Government legislate to ensure the privacy of a person’s electronic health data, while enabling secure access to the data by the person’s authorised health providers.

We recommend that the Commonwealth Government introduce:

• unique personal identifiers for health care by 1 July 2010; unique health professional identifiers (HPI-I), beginning with all nationally registered health professionals, by
  1 July 2010;
• a system for verifying the authenticity of patients and professionals for this purpose – a national authentication service and directory for health (NASH) – by 1 July 2010; and
• unique health professional organisation (facility and health service) identifiers (HPI-O)
  by 1 July 2010.

We recommend that the Commonwealth Government develop and implement an appropriate national social marketing strategy to inform consumers and health professionals about the significant benefits and safeguards of the proposed e-health approach.

Ensuring access to a national broadband network (or alternative technology, such as satellite) for all Australians, particularly for those living in isolated communities, will be critical to the uptake of person-controlled electronic health records as well as to realise potential access to electronic health information and medical advice.

We recommend that the Commonwealth Government mandate that the payment of public and private benefits for all health and aged care services depend upon the ability to accept and provide data to patients, their authorised carers, and their authorised health providers, in a format that can be integrated into a personal electronic health record, such that:

• hospitals must be able to accept and send key data, such as referral and discharge information (‘clinical information transfer’), by 1 July 2012;
• pathology providers and diagnostic imaging providers must be able to provide key data, such as reports of investigations and supplementary information, by 1 July 2012;
• other health service providers – including general practitioners, medical and non-medical specialists, pharmacists and other health and aged care providers – must be able to transmit key data, such as referral and discharge information (‘clinical information transfer’), prescribed and dispensed medications and synopses of diagnosis and treatment, by
  1 January 2013; and
• all health care providers must be able to accept and send data from other health care providers by 2013.

We recommend that the Commonwealth Government takes responsibility for, and accelerates the development of a national policy and open technical standards framework for e-health, and that they secure national agreement to this framework for e-health by 2011-12. These standards should include key requirements such as interoperability, compliance and security. The standards should be developed with the participation and commitment of state governments, the IT vendor industry, health professionals, and consumers, and should guide the long-term convergence of local systems into an integrated but evolving national health information system.

We recommend that significant funding and resources be made available to extend e-health teaching, training, change management and support to health care practitioners and managers. In addition, initiatives to establish and encourage increased enrolment in nationally recognised tertiary qualifications in health informatics will be critical to successful implementation of the national e-health work program. The commitment to, and adoption of, standards-compliant e-health solutions by health care organisations and providers is key to the emergence of a national health information system and the success of person-controlled electronic health records.

With respect to the broader e-health agenda in Australia, we concur with and endorse the directions of the National E-Health Strategy Summary (December 2008), and would add that:

• there is a critical need to strengthen the leadership, governance and level of resources committed by governments to giving effect to the planned National E-Health Action Plan;
• this Action Plan must include provision of support to public health organisations and incentives to private providers to augment uptake and successful implementation of compliant e-health systems. It should not require government involvement with designing, buying or operating IT systems;
• in accordance with the outcome of the 2020 Summit and our direction to encourage greater patient involvement in their own health care, that governments collaborate to resource a national health knowledge web portal (comprising e-tools for self-help) for the public as well as for providers. The National Health Call Centre Network (healthdirect) may provide the logical platform for delivery of this initiative; and
• electronic prescribing and medication management capability should be prioritised and coordinated nationally, perhaps by development of existing applications (such as PBS online), to reduce medication incidents and facilitate consumer amenity.

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So what happened to asking about the necessary implementation of the National E-Health Strategy (see the parts in italics that are being ignored). Without that and the associated improvements in governance and leadership there simply won’t be the information to load up the Person Controlled Records.

In my view it is much more important – as a first step – that we conclude the infrastructure work and the provision of quality applications to healthcare providers. Obviously we also still have to address issues like information quality and governance as well.

Similarly the Draft National Primary Care Strategy specifically recommends implementation of the National E-Health Strategy.

Just because it might actually require some investment and some serious management is no reason to just ignore these when seeking public comment. Frankly it is just dishonest and sneaky.

It should be noted I still think applications of penalties via the Medicare system for not sharing information whose quality is yet to be properly validated and that there has not been discussion with providers regarding what is sharable and what is not. It is my belief the timelines in the NHHRC report are just absurdly optimistic.

David.