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Wednesday, November 11, 2009

Can Medicare Australia Help Dig Australian E-Health Out of A Hole?

The following appeared a couple of days ago

Medicare turns into online services factory

Karen Dearne | November 03, 2009

MEDICARE Australia has become a key supplier of information and payment services for other government agencies as it continues to position itself as a national platform for broader electronic health programs.

Chief executive Lynelle Briggs said the nature of the services Medicare provided was "shifting as the government leverages our relationship with the community", such as its delivery of ceiling insulation stimulus programs on behalf of the Department of the Environment.

"Almost all residents, doctors, pharmacists and other health professionals have some connection with Medicare," Ms Briggs said. "We continue to focus on information and communication technology as a key business enabler."

Other initiatives included the Defence Force Family Healthcare and Teenage Dental programs, and a purpose-built combined Medicare and Centrelink office at Narooma on the NSW south coast.

Medicare's technology capabilities are based on its high-availability business processing systems, secure messaging over the internet using public key infrastructure and transaction connections with the health sector, banks and government agencies.

According to its 2008-09 annual report, more than 80 per cent of Medicare's business is conducted electronically.

Ms Briggs said online claiming of Medicare benefits had become widespread.

"Our focus is to increase the level of patient claiming (from the doctor's office), as this is where the benefits to both the community and government lie," she said.

About 9500 out of some 22,500 general and specialist medical practices offer Easyclaim facilities, and nearly 21 per cent of patient claims were made over the system at June 30.

More here:

http://www.australianit.news.com.au/story/0,24897,26295109-15306,00.html

This got me thinking that there might be a few important roles for Medicare Australia (MA) that could actually advance things at the cost of a very small proportion of the MA budget.

Among the most obvious are:

First to see whether it would be possible to contract Microsoft, Google or whoever to work with them to create a National PHR system – as they mention later in the article, they have at least some of the basic information already available and to provide a refined, more polished and richer offering might just be worthwhile and of use to all concerned.

Second, with the work already apparently close to complete in Individual Health Identifiers – or so NEHTA says – this may be the time to being some other useful work. An good place to start might be to consider setting (or contracting for provision of) up a standards based e-prescribing hub as NEHTA are proposing – which could then link all prescribers and dispensers in a NEHTA certified and standardised way using current messaging providers etc. (Appropriate inclusive governance and management are assumed) The cost would be relatively trivial and once established – and operating on an audited cost recovery basis – it would be the sponsor of competition at the GP, Specialist and Dispensing System level while ensuring appropriate regulation security and so on. It is a no brainer and just requires a little get up and go on the part of MA.

Third MA could procure and deliver a national health information portal as recommended in the National E-Health Strategy to offer services for both providers and consumers – perhaps integrating the present DoHA and State based initiatives. A really good and quite inexpensive idea that could also make a difference.

The only caveat in all this is that there is a really difficult history of MA initiatives, at least initially, being somewhat clumsy and lacking user focus. It would be good for MA management to work out what they could do to avoid repetition of this sort of outcome (you need to carefully listen to all those affected and respond sensibly etc in the design and pilot phases).

It seems to me with DoHA and the Minister of Health having vacated the field and NEHTA having constrained funds outside its mandate that the only other possible source of a little forward momentum might be MA. They should at least give it some careful thought. An yes I know there will be many reasons why not! Comments pro and con welcome!

David.

2 comments:

Anonymous said...

Why not - you ask? Well cast the mind back to when MA tried to do just what you are now proposing. How much was spent? what was achieved? I know you can't be really serious - at lease I sincerely hope you are not.

"An good place to start might be to consider setting (or contracting for provision of) up a standards based e-prescribing hub as NEHTA are proposing – which could then link all prescribers and dispensers in a NEHTA certified and standardised way using current messaging providers etc. (Appropriate inclusive governance and management are assumed) The cost would be relatively trivial and once established – and operating on an audited cost recovery basis – it would be the sponsor of competition at the GP, Specialist and Dispensing System level while ensuring appropriate regulation security and so on. It is a no brainer and just requires a little get up and go on the part of MA.

Excuse me. The no brainer is to make sure MA doesn't go down that path again.

Dr David More MB, PhD, FACHI said...

Well, good to get a reaction. I think these things need to be floated - even to be knocked down - rather than have zilch happen!

All feel free to kick..It is a "straw man" for discussion. As is clear in the last paragraph!

David.