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

Wednesday, May 19, 2010

What Mr Hockey Said on E-Health. He Makes Some Points The Government Needs to Address!

I wanted to find what was said.

Found this

http://joehockey.com/mediahub/nprDetail.aspx?prID=975

No mention. Pity about that!

Then I found this:

Rudd e-health plan a 'falsehood': Hockey

  • UPDATED: Fran Foo
  • From: Australian IT
  • May 19, 2010 2:48PM

OPPOSITION Treasury spokesman Joe Hockey today outlined the Coalition's reasons for rejecting the federal government's controversial e-health records proposal.

In last week's budget Treasurer Wayne Swan said $467 million over two years will be set aside to introduce "personally controlled" individual electronic health records as part of the Rudd government's health reforms.

Patients will control what is stored on their health records and will decide which health professionals can view or add to their files.

According to Mr Hockey, the biggest barrier to e-health adoption was the fact that the Healthcare Identifiers Bill was still in limbo and giving the scheme half a billion dollars was akin to putting the cart before the horse.

"The fundamental issue about the current e-health initiative is the government hasn't even delivered on its e-health identifier ... an e-health identifier is obviously hugely important to health records," Mr Hockey said in answer to a question after his National Press Club budget response.

Under the HI Bill, all Australians using private or public health services will be assigned an identifier by Medicare over time, but the speed of uptake by private practitioners and hospitals will depend on their IT systems having the capability to "populate" internal records with the national number.

The bill has passed the lower house and is now due for debate in the upper house.

Mr Hockey's second reason for rejecting the government's plan was a lack of commitment from the states on software compatibility.

"I would want to see every state government sign up in blood that they're not going to have different software programs that are incompatible when it comes to e-health records.

"I just don't believe them when they say they've got good intentions about harmonising the software that is going to be behind e-health records."

His final reason was the funding element, which he says was grossly inadequate.

The government allocated $185.6m in 2010/11 to establish the base for an individual e-health records regime. In the following financial year it will receive $281.2m.

"The irony of the government's allocation in the budget is they're funded for the first two years but there's a great damn hole for the next two years.

"Hang on, how does that work?

"The first two years we're going to fund this e-health initiative but every single dollar stops for the next two years? It's a falsehood because you've got to keep investing in this so-called wonderful initiative," Mr Hockey said.

Lots more here:

http://www.theaustralian.com.au/australian-it/rudd-e-health-plan-a-falsehood-hockey/story-e6frgakx-1225868733018

I look forward to a willing debate and some real funding to actually address the issues raised by both sides.

I would love comments from all!

There are some comments on the Australian site here:

http://www.theaustralian.com.au/australian-it/rudd-e-health-plan-a-falsehood-hockey/comments-e6frgakx-1225868733018

Right now I think we are all in never, never land!

David.

13 comments:

Anonymous said...

Circa 2000 John Howard promised an EHR by 2010.

Now the coalition promises *NO* EHR by 2012.

Credibility zero!

Anonymous said...

This seems like disturbingly superficial excuse making for doing nothing, or a demonstration of deep ignorance of the whole e-health agenda.

Lets pick these comments by Hockey apart, one by one.

1 - the UHI issue.

"According to Mr Hockey, the biggest barrier to e-health adoption was the fact that the Healthcare Identifiers Bill was still in limbo and giving the scheme half a billion dollars was akin to putting the cart before the horse.

"The fundamental issue about the current e-health initiative is the government hasn't even delivered on its e-health identifier ... an e-health identifier is obviously hugely important to health records"

Analysis. Lets get this straight. He is saying we cant fund anything else until we get the UHI right because it is some magical talisman from which all else follows? If the world was simple and linear and we did one thing after the other, and the UHI was such a thing, then this thinking might fly. But, UHI or no UHI, we need to in parallel (there's difficult concept) work on all the other core elements of a national system (think consent, thing exchange standards, think safety regulations, think workforce, to rattle off a few). Indeed many have in this blog pointed out that we can have a national record exchange WITHOUT a UHI. So, this argument is dead in the water. Yes, as we have decided on the UHI path, we do need to get it right. But it has no special primacy over many other critical elements of the system. Score for this argument out of ten - 0.

2 - The lack of commitment to standards argument.

"Mr Hockey's second reason for rejecting the government's plan was a lack of commitment from the states on software compatibility.

"I would want to see every state government sign up in blood that they're not going to have different software programs that are incompatible when it comes to e-health records.

"I just don't believe them when they say they've got good intentions about harmonising the software that is going to be behind e-health records."

Analysis. If there are working and workable standards around, that are stable enough for industry to commit to, they will do it because the business case is there to invest in making systems standards compliant. In the meantime, public and private health services actually need to treat patients today - safely and efficiently. So, what do you do, you either wait (for Godot) for the standards to arrive, all the while bleeding cash and harming patients, or you put something in that works today. Pragmatism wins. It is ludicrous to blame those that procure systems for the failure to develop useful and usable standards. Blame the victim is a nasty strategy, and if I was a front line organization or a software vendor I would be fuming on hearing this line. Score - 0.

3 - Its not enough cash, so lets do nothing.

"His final reason was the funding element, which he says was grossly inadequate.

The government allocated $185.6m in 2010/11 to establish the base for an individual e-health records regime. In the following financial year it will receive $281.2m.

"The irony of the government's allocation in the budget is they're funded for the first two years but there's a great damn hole for the next two years.

Analysis. (rephrase this argument - look you are starving, and I could give you this bread and water right now, but I think we should wait until I can rustle up enough for dinner at Tetsuya's)

The current budget papers make it clear that this is the first tranche of funding for the $1.6 billion business case, but that release of further funds is dependent upon success in the next 2 years. So, to say there is no more money is to misrepresent the current government's expressed intention.

Having said all this, the current government would do well to actually explain what it is going to do, and I can only hope that they will do so soon. Score 2/10. (we all would like more money)

Anonymous said...

I don't think its worth $2 of funding until a workable standards based plan is released. Personal Health Records are hardly an established technology proven to work and 2 years is not a lot of time. Until there is a plan endorsed my industry I can't see why anyone would commit half a billion dollars on a vague promise.

The is also putting the cart before the horse in a big way as PMS systems and state governments can't be compliant with existing standards, let alone some new, yet to be released one. Its time to bring existing infrastructure up to a reliable, safe level and not fantasize about delivering some grand plan that is doomed to failure.

Anonymous said...

"Its time to bring existing infrastructure up to a reliable, safe level and not fantasize about delivering some grand plan that is doomed to failure."

And who will pay for that? Mr Abbott and Mr Hockey don't want to do anything until we "have a UHI", and they have expressed no policy interest in doing any such thing were they in government. On radio this morning they have made it clear that we 'cant afford' e-health for now.

The "grand plan" that you say is "doomed" is I presume based upon the COAG approved business case for health record interchange nationally - on what basis do you consider the business case vague? What flaws are there in the plan that make it doomed?

The promised funding of $466 million, when the already modest (by international standards) national plan was for $1.6 billion, is hardly grand. We were all already feeling significantly downsized when the government made the announcement. How downsized do you feel now?

It simply is not credible to attack the government, who have something on the table (but we want to know more asap) and the opposition, who have exactly NOTHING on the table. Until there is a credible e-health policy from the opposition, we have to assume that they do not want to play in this space.

Bruce Farnell said...

I am very much concerned about the current e-Health plan and the apparent lack of rigorous analysis underpinning it to date. Without the analysis we cannot realistically tell if the intended outcome of a PHR is achievable or even going to result in improved health outcomes. Presumably, part of the allocated funding will address this so it'll be interesting to see how it works out.

Mr Hockey's stated reasons for rejecting the plan don't really stand up to scrutiny. I think 'Wednesday, May 19, 2010 8:14:00 PM' addresses this quite well. My only additional comment relates to Hockey's second reason for rejecting the plan. The majority of state funded systems are still paper based and workflow issues alone will ensure that these agencies will not be able to contribute much to a patient controlled electronic record regardless of what the states promise. Support from GPs, who already use electronic health records, is necessary if any sort of PHR is to be successful.

Anonymous said...

Hmmmm. The reason we won't have HIs is because the coaltion delayed the legislative process, and now they say they are delaying further eHealth progress because we don't have the HIs.

Where is the coaltion's "Alterantive Government" eHealth POLICY? All I'm seeing is noisy tap dancing!

Anonymous said...

Hmmmm. The reason we won't have HIs is because the coaltion delayed the legislative process, and now they say they are delaying further eHealth progress because we don't have the HIs.

Where is the coaltion's "Alterantive Government" eHealth POLICY? All I'm seeing is noisy tap dancing!

Anonymous said...

Thursday, May 20, 2010 11:35:00 AM "The majority of state funded systems are still paper based".

It is incredible to think that this is still true after the humongous sums spent over the last decade on hospital information systems in QLD, VIC, NSW, SA, and elsewhere.

If that is the case the vendors have much to answer for. They are the ones who sold the story, they are the ones who sold the blue sky, they like Cerner, like iSoft-Lorenzo, like TrakHealth have all sold that they can deliver the paperless hospital, the ehealth record, and today we are still stuck with "The majority of state funded systems are still paper based".

The software vendors have much to answer for - they entered into agreed contracts to deliver and they have not delivered. It is not particularly relevant that the buyers have been naive, it is more relevant to say that it would well seem the buyers have been defrauded into believing that the vendors could deliver what they claimed for the agreed price.

In short the software community should carry the blame. We in the hospitals and our patients have to carry the pain.

Anonymous said...

Vendor: Its OK, that'll be in Phase 2...and that'll be extra.

Anonymous said...

Thank you - and when will "Phase 2" be delivered?

Tomorrow, next week, next month, next year, next decade?

And what are the penalties to the vendor for slippage on that committed delivery date?

And how and when can we terminate the contract when the vendor fails to deliver according to agreed conractual committments?

Anonymous said...

Dr Nathan Pinksier speaking for the RACGP and NEHTA on eHealth said on ABC Radio National this morning at 7.50 am that the UHIs have all been developed and "ready to go". The only hold up is the legislation before the Senate. "Ready to go". How good is that?

Anonymous said...

Friday, May 21, 2010 6:34:00 AM

When - next year.
Penalties - modest.
Terminate - impossible.
Gotcha.

Anonymous said...

It (Friday, May 21, 2010 8:15:00 AM)looks like the beginnings of NEHTAs communications campaign to give the punters a revv. Particularly as we now see a propaganda blurb from NEHTA yesterday on health's HUGE potential for rural Australia. Panic and anguished hand ringing all round sums it up. It will continue to be so.