The Australian General Practice Network (AGPN) Pushes E-Health.

The following appeared a few days ago.

Primary care reform needs $830m kickstart: AGPN

Elizabeth McIntosh - Monday, 1 February 2010

THE Federal Government needs to make a “critical down-payment” on general practice with $830 million in infrastructure grants to fund health reforms, according to the AGPN.

As part of its 2010-11 federal Budget submission, the network has restated previous calls from United General Practice Australia for the Government to invest $530 million in general practice.

A further $300 million is also needed to help practices transform into comprehensive primary health care centres as proposed by the National Health and Hospitals Reform Commission, the AGPN submission claims.

Practices would be able to apply for tax-exempt grants of up to $500,000 for major capital works, up to $250,000 for equipment and up to $50,000 for minor capital works.

However, such grants would also hinge on practices meeting accreditation standards.

“Capacity building needs to be looked at as a quality improvement process,” AGPN chair Dr Emil Djakic told MO.

More here:

http://www.medicalobserver.com.au/News/0,1734,5854,01201002.aspx

I was interested to see whether e-Health was a focus and it was good to see it was.

Under GP Infrastruture there are 3 topic addressed.

• $830 million over three years for a General Practice Infrastructure Program (GPIP)
• $31 million over three years for implementing an eHealth ‘change and adoption’ strategy for primary health care
• $10.2 million over three years to support increased clinical training placements in general practice

The detail is found on the AGPN Site which is here:

http://www.agpn.com.au/__data/assets/pdf_file/0016/22426/20100114_sub_Federal-Budget-2010-11-Submission.pdf

The e-Health proposal reads as follows.

An eHealth ‘change and adoption’ strategy

Within the current climate of health system reform eHealth is acknowledged by many as a key enabler for better connected care and improved communication between health services. The National E-Health Strategy provides a significant, detailed eHealth roadmap for Australia that has been agreed to by Australia’s governments.

General practice, over and above other community providers, has adopted eHealth and has significant capacity to be a driver of greater information exchange and connectivity. The Network provides the ideal framework for implementing change in the primary health care sector.

AGPN and the state based organisations (SBOs) have a long history of active involvement in eHealth and have been funded by the Department of Health and Ageing, eHealth Branch, to deliver the eHealth Support Officer Program (eHSOP). Established in 2005 and funded until June 2010, the program builds on the Network’s successful support of eHealth infrastructure and improvements in the quality of clinical information. The program:

• Encourages and supports general practices and General Practitioners (GPs) to adopt best practice eHealth tools and systems while encouraging participation in eHealth Initiatives such as Individual Electronic Health Records, Unique Health Identifiers and secure messaging via Public Key Infrastructure
• Assists the Network to deliver programs to general practices that are supported by best practice information management solutions.

The Network has been successful in increasing the uptake of eHealth infrastructure and encouraging connectivity across the primary health care sector as a result of the program. However, opportunities for improvement still remain. Barriers such as an historical lack of a nationally consistent approach to eHealth, fragmented funding and variable levels of eHealth literacy have resulted in an eHealth landscape which, while containing pockets of excellence, lacks consistency. The levels of computerisation and eHealth uptake also vary across the primary health care sector: general practice is widely regarded as being highly computerised, allied health and specialist practices lag behind.

While the National E-Health Strategy offers a framework for the consistent and effective rollout of eHealth across Australia, its successful implementation - and indeed the broader health reform agenda - will be reliant on general practice and the wider health sector both adopting eHealth initiatives and contributing accurate, complete, quality data to national data sets and electronic health records.

To achieve this, AGPN recommends expanding the existing eHealth Support Officers Network (eHSON) to provide resourcing and personnel at the local GPN level as well as SBO and AGPN levels. The eHSON would incorporate 60 eHealth officers working at the GPN level to act as change agents, with leadership, coordination and support provided by officers at national and state levels.

The program will build on the accomplishments of 2009-10 to achieve:

A national approach to eHealth throughout general practice and the Network that aligns with the National E-Health Strategy

A collaborative approach between governments and other stakeholders at all levels (national, state/territory and local) to implement of the National E-Health Strategy

Adoption of an agreed data quality improvement methodology by general practice and the Network which in turn will lead to improved clinical data quality in general practice and improved GPN health information management capacity – for improved planning and monitoring purposes

Achievement of organisational efficiencies with the Network in the provision of eHealth programs within a quality improvement framework

Increased eHealth uptake and capacity amongst health care professionals’ including uptake by general practice and the Network of national eHealth solutions, initiatives and priorities as they become available

• Sharing of eHealth related information, resources, knowledge and innovations across the Network and increased sharing of quality clinical data by general practice
• Increased communication and connectivity between general practices, non-GP specialists, allied health professionals and health care facilities via secure messaging and other foundation tools
• The national Network E-Health program would provide consolidated and coordinated support and activity at all levels of the Network to include:
• A local-level focus on promoting the uptake of current and future eHealth initiatives by general practice, increasing the levels of secure electronic communication between health practitioners, and improving the quality of general practice clinical data
• A state level focus on strong engagement with jurisdictions to achieve strong integration between primary, acute and tertiary health care sectors, and to deliver support and education to general practice networks by acting as change agents
• A national level focus on policy development to enable eHealth implementation across the Network; leadership, coordination and support of Network eHealth initiatives, and effective engagement with national eHealth bodies in order to deliver a cohesive and consistent eHealth infrastructure

In this way, the proposed program will enable the Network, as a whole to fulfil its crucial role in supporting the ‘change and adoption’ strategic stream of activity of the National EHealth Strategy and move primary health care towards the more e-connected future required to implement the proposed health reforms.

AGPN estimates a primary health care eHealth ‘change and adoption’ program will cost $31 million over three years.

----- End Extract.

This is actually quite an interesting submission – given the AGPN makes it quite explicit that is is funded by DoHA, who must be assumed to have at least some influence on what was asked for – if not directly, at least via discussions over the last few months.

What we see here is essentially a plea to implement the National E-Health Strategy as envisaged by Deloittes and not a single solitary mention of NEHTA by name!

Who is trying to tell someone something here I wonder? The NEHTA Identifier and Messaging projects are mentioned – but only to say they need to get done and that the AGPN can assist with the “change management and adoption”.

I read this to say they are not all that happy with the way NEHTA is progressing and would probably support the Deloitte recommendations to improve leadership and governance of the whole sector and let NEHTA expire while getting the foundations done with a broader and better led and funded approach.

Good on them is all I can say!

David.