Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Wednesday, March 03, 2010

A Brave New Health System for Australia Announced. E-Health Details to Follow!

The Media Release says the following

A National Health and Hospitals Network for Australia’s Future

Joint Release

Prime Minister

Treasurer

Minister for Health and Ageing

3 March 2010

The Rudd Government today announced major structural reforms to Australia’s health and hospital system.

The Government will deliver better health services and better hospitals by establishing a National Health and Hospitals Network.

This new national network will be funded nationally and run locally.

These reforms represent the biggest changes to Australia’s health and hospital system since the introduction of Medicare, and one of the most significant reforms to the federation in its history.

  • A National Network: to bring together eight disparate State run systems with one set of tough national standards to drive and deliver better hospital services.
  • Funded nationally: by taking the dominant funding role in the entire public hospital system the Australian Government will end the blame game, eliminate waste and shoulder the burden of funding to meet rapidly rising health costs.
  • Run locally: through Local Hospital Networks bringing together small groups of hospitals, where local professionals with local knowledge are given the necessary powers to deliver hospital services to their community.

The Commonwealth will achieve these changes through the following actions:

  • Taking 60 per cent of funding responsibility for public hospitals by investing one third of GST revenue – currently paid to the states and territories – directly in health and hospitals;
  • Taking over responsibility for all GP and primary health care services;
  • Establishing Local Hospital Networks run by health and financial professionals to be responsible for running their local hospitals, rather than central bureaucracies;
  • Paying Local Hospital Networks directly for each hospital service they deliver, rather than just handing over block funding grants to the states; and
  • Bringing fragmented health and hospital services together under a single National Health and Hospitals Network, through strong transparent national reporting.

These reforms will be put to the states and territories at the COAG meeting to be held in Canberra on 11 April.

If the states and territories will not agree to these reforms, we will take this reform plan to the people at the next election – along with a referendum by or at that same election to give the Australian Government all the power it needs to reform the health system.

The new National Health and Hospitals Network will end blame shifting and cost shifting, and provide national leadership on health and hospitals with increased local control.

Sweeping changes to the way hospitals are funded and run will also lead to less waste and duplication and a health system which is sustainable into the future.

On the basis of these reforms, over the coming weeks and months, the Government will announce critical additional investments to:

  • train more doctors and nurses;
  • increase the availability of hospital beds;
  • improve GP services; and
  • introduce personally-controlled electronic health records.

The establishment of the National Health and Hospitals Network builds on record investments in health and hospitals made by the Rudd Government over the last two years.

The Release is found here:

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr10-nr-nr038.htm

The full announcement page is here:

http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/content/home

You can download the 2.2 Megabyte Report from here:

http://www.health.gov.au/internet/main/publishing.nsf/Content/nhhn-report/$FILE/NHHN%20-%20Full%20report.pdf

There are a huge number of questions and details around all this. One point is pretty clear however. They are still talking about “personally-controlled electronic health records”.

I wonder do they have a clue what they are talking about. I certainly do not.

More comment later I suspect.

David

12 comments:

Peter Kelley said...

After watching the Prime Minister's speech at the National Press Club The one thing that sticks out in my mind is that there will be duplication on a local level of things that should be at a regional or stet level. Take the e-health initiatives in South Australia for example. The ICT governance was taken away from the regions to remove the inefficiencies and promote a centralised strategic approach. It seems that the PM is set upon replicationg these inefficiencies nationwide.

More on my Blog.

Anonymous said...

Typical Rudd. Late to the party, talking it up and now let's watch him botch up the delivery.

This has all of the hallmarks of an NBN.

What has he been doing for 2 years?

I am sick of his BS.

Anonymous said...

Dear Wednesday, March 03, 2010 3:21:00 PM

I always look forward to the informed and often challenging commentary that appears on this blog - the experience and intellect of the readers is tremendous - but I'd hate to see it degenerate into the party political rubbish we see on the comments pages of most of the other media - bottom line - I'm not interested in whether you love or hate Kevin or tony - I am interested in an evidence-based analysis of the e-health issues of the day. So please take this somewhere else.

Anonymous said...

The reason why they are talking about Person Controlled Health Records is that they do not want to pay for Electonic Health Records.

They expect the private sector to stump up with it. The guided market model.

That is fine in theory, but I cannot see PCHR happening in Australia.

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

That is possible but what is a PCHR? Blowed if I know what they mean and how it might work.

Does anyone have a clear idea of what the PCHR is and how they work?

David

Anonymous said...

We've had a dark age of innovation in Australian health (especially eHealth) because:

- the states have had control without the money to invest on making changes, so they've instead focused on cost-saving measures and pretended they were clinical improvements (witness the NSW EMR rollout, VIC HealthSmart, QLD EMR)

- Even if they had the money, the states are bureaucratically run so after taking control away from the regions, they haven't shown any flexibility to innovate based on local needs. Just look at the Health Support Services in NSW debacle.

- the Feds have had the money but little control, so they waste what they have on ineffective programs like PIP incentives that spend hundreds of millions of dollars just for every GP to have a PC and broadband (But no way to share information)

- the private sector has had no incentive to participate in any reform process. Local hospital networks + coordinated primary care (with funding to back it) would enable private and public sector collaboration.

Peter Kelley does raise some valid concerns about duplication, but I do think these can be addressed.

I like what I read. Innovation at the local level, standards and funding at the national level. The states at a management and workforce level and avenues for private and public sector collaboration at a local level.

Bring it on!

Anonymous said...

Cost saving and VIC HealthSmart - would like to see that!

Anonymous said...

Perhaps PCHR means "political correct health record" :-)

Anonymous said...

I think Wednesday, March 03, 2010 4:52:00 PM sums it up very nicely indeed.

From an ehealth perspective I am asking myself:
(a) how will state wide health IT initiatives be impacted? Will the HealthSmart statewide - one-size fits-all initiative continue as such or will the local health networks be able to select their own IT pathway?

(b) and what of the major metropolitan hospitals which receive patients from all round the state. Will they be part of a local health network which is goaled on receiving patients from far outside the network?

Anonymous said...

Re the dark age comment - under the old model where choice was devolved, using NSW as an example, the “good” Areas (ie the Areas where IT is seen as important) got good systems and adequate support– think Sydney South West or Hunter, whereas the “bad” Areas – well, think Sydney West…
Under the old model it took more than 10 years to roll out PAS systems across the state. Currently there is a much more Soviet-style model which everyone in the Areas of course hates – BUT which has seen both EMR and PACS/RIS rolled out to more than half the hospitals in the state in little over 18 months. And in spite of the un-attributed commentary from certain academics/open source ideologues, both the systems have been pretty well received by the great majority of actual users.
My question to the commentariat is – how long do you think you would be waiting for EMR and PACS/RIS if every small hospital board had a choice and did a DIY? And when you say “innovation” do you really mean “lets buy Australian software rather than this American stuff”?
I know these comments will inflame some of your readers, but really I am sick of hearing that devolvement and local innovation is the way to go when history tells us the exact opposite.

Anonymous said...

Re soviet fan's comment (Thursday, March 04, 2010 9:58:00 PM) - oh come on, there has been plenty of innovation during the dark ages - even when there was no money, and we had computers without mouses, we built useful things from shoestrings - like DOCFACS and DOCMAIL, and other locally developed health IT initiatives were shared amongst areas and hospitals with good support - like OBSTET. Even Divisions of General Practice built innovative systems like CARDIAB (a microcosmic shared electronic health record that actually delivered - perhaps still delivers - real clinical benefits!). All cheap and cheerful, but they worked!

Anonymous said...

Friday, March 05, 2010 12:04:00 AM
mouses? mice.
sheeps? sheep.
cows? cows.
peoples? people

The soviet fan is partly correct.

One centralised standardised all encompassing system is concentrating too many eggs in one basket, eliminating competition, creating a monopoly, which undermines the energy and investment needed to encourgae and support innovative initiatives which tend not to emanate from the monoliths.

On the other hand pushing all IT decisions out to the periphery and smaller entities will lead to confusion, fragmentation, unbearable costs on every side - in short - disaster.

The balance lies in maintaining a competitive environment, having a choice of vendors and solutions, and managing the issues from a regional level.