An experienced industry participant and observer sent along the following a few days ago.
It seemed to me there were some interesting questions to which I had not much in the way of answers. So with permission here it is.
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Hi David
I think the COAG outcome has some significant ramifications for NEHTA, in that it has already been given whatever money it is going to get for quite some time
- hence it had better use it expeditiously
- with the new arrangement some of that money might possibly evaporate (but I doubt it)
Now that the Feds are to be responsible for funding ALL 100% of the Primary Care sector plus 60% of the hospital sector why should the states continue to pay 50% of the cost of funding NEHTA?
And take THE BIG projects like Vic's HealthSmart. What does the new COAG agreement do to the development and service delivery model of the one-size-fits-all approach of HealthSmart?
Is this a good time to stop for a rain check on IT development in health in each state?
In Vic does the HealthSmart strategy complement the concept of PHCOs and Hospital Networks as envisaged by the Rudd government?
Does each state need to develop a 'different' Hospital and Primary Care IT strategy or should the same strategy apply to all?
Who should be funding (this) these strategies?
Where does NEHTA fit?
What does it mean for the health software vendors?
Is it business as usual for the foreseeable future or is it timely to review the status quo pronto before events of recent days unravel too far?
I mean, let's face the fact(s), 'for health reforms to be effective they must be underpinned by the delivery of fast, high quality, integrated, health software solutions across the whole of health.
Should Australia be waiting for NEHTA or should a different approach be adopted?
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Anyone got some views, comments etc. I am sure there are also other questions that arise from this non e-Health outcome from COAG.
Have a great ANZAC Day Weekend – Lest We Forget!
David.
The way things are going the states will have a framework deployed before NEHTA manages to come out with standards. South Australia's CareConnect initiatives are going full steam ahead and there is talk of an exchange of electronic information between SA and NT.
ReplyDeleteOn the face of it would appear not much has changed, the States still have control of the Hospital/Acutes service, and have more money to boot.
ReplyDeleteSo the big one size fits all healthsmarts, so beloved of state health bureaucrats, will presumably continue to lumber on distorting e-health innovation and development.
I think it most likely that PHCOs will do nothing to progress ehealth for the foreseeable future ie. 2 years, perhaps more. Think about what might be involved. Will some of the GPNs be forced to amalgamate to cover larger geographies? If so a lot of the GPN bureaucratic structure will need to go somewhere. This suggests some battles are looming for the PHCO positions, for the dominance of one GPN over another of its neighbours, for control of funding which DOHA currently provides to GPNs and presumably therefore can reallocate at its whim in whatever direction it desires. On the other hand some will argue for retaining the GPNs, albeit a smaller number of them post consolidation, and creating a new supervisory administration to become PHCOs with across section representation in their midst from the various stakeholders in the primary care arena being governed - like GPN, Community Health, Allied health, Shire Councils, and others to boot. This would be preferable as GPNs should not be given the role of being the fox in the chook house and put in charge of holding, managing and determining the distribution of funds throughout the primary care sector which is far more encompassing than the services provided by the doctors. The PHCOs need to employ a "whole of health" approach to deliver of services to the entire community and this must embrace the social model of care in the community for all.
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