Karen Dearne - More Money for PCEHR but Little Oversight and Real Uncertainty over Future e-health Programs.

Karen Dearne

10 February, 2013

THE National E-Health Transition Authority has been awarded almost $10 million to provide services relating to the introduction of the Personally Controlled E-Health Record, according to a newly published contract notice.

The federal Health Department will pay $9.9 million for the work, between December 11, 2012, and June 30, 2014.

It follows a previous $110 million contract to provide similar services from December 31, 2010, to June 30, 2012, in the lead-up to the official launch of the PCEHR system last July 1.

NEHTA's answers to questions on notice from the October Senate Estimates session show that the authority's commonwealth and state owners will provide $69 million in core funding for the current year's operations.

NEHTA told the Community Affairs committee that it has also carried over Council of Australian Government funds totalling $28.4 million.

"In regard to the PCEHR managing agent responsibilities, as contracted to Health, NEHTA has approximately $63 million in carried forward funds against future commitments," NEHTA says.

NEHTA's core operations are described as "the development and maintenance of national e-health foundations including the operation of a Healthcare Identifiers service, the operation of national authentication and clinical terminology services, and maintenance of a national product catalogue", according to Victorian Government's Budget statements.

Victoria allocated $8.3 million to NEHTA as its share of core funding for each of the 2012-13 and 2013-14 financial years.

Among other recent federal government PCEHR-related contracts, consulting firm APIS Group has been awarded $5.3 million for support services from last September to June 2014, and the Australian Commission on Safety and Quality in Health Care received $4 million to build "key national health components of the PCEHR" by June 2014.

The Royal Australian College of General Practitioners was given $2.55 million to assist implementation and rollout of the system until the end of June, while Workstar will receive $1.2 million for hosting support and development of online capabilities for the PCEHR change and adoption strategy until June 2014.

Meanwhile, the Health Department has told the Senate Community Affairs committee that COAG's Standing Council on Health has come to a decision on the future of commonwealth-state funding for e-health.

"The eHealth Memorandum of Understanding, which replaces the National Partnership on E-Health (this expired at the end of June last year), was agreed by SCOH on November 9," the department says.

However, the communique released after that meeting simply states: "Today, Health ministers noted progress on the eHealth MOU."

The MOU is yet to be publicly released.

Briefing papers provided to Health Minister Tanya Plibersek when she took over the portfolio said the "development of an E-Health Intergovernmental Agreement" needed urgent attention, due to the pending expiry of the previous joint commitment.

The Key Decision Brief document, released late last year under Freedom of Information laws, show that the minister's approval was to be sought "to circulate a draft of the eHealth IGA to (state and territory) health ministers in mid-February" for discussion at the next SCOH meeting.

"Subject to decisions of government, an agreement is required to set out and communicate the collaborative funding, governance, legislative and administrative requirements of e-health from July 2012," it states.

The COAG Reform Council (CRC), tasked to report on progress and efficacy of the many recently established National Partnership Agreements in meeting targets, previously signalled its difficulty measuring performance in the e-health space.

In its annual Progress Report, released in September, the CRC rated the timeframe for this reform as "at risk", noting that some milestones had not been met.

The Health Department has told the Senate committee that the scope of the previous NPA "dealt largely with the implementation of the Healthcare Identifiers service".

An interim review conducted to determine the NPA's progress towards achieving its objectives found that the "NPA has proved effective and appropriate in achieving the intentions of all jurisdictions in providing funding for NEHTA and successfully establishing the HI service".

But the performance of NEHTA and the federal Health department were not subject to scrutiny.

"Performance measurement for NEHTA and the department were not addressed through the NPA, because it is a COAG document which sets out roles and responsibilities for all jurisdictions," the department's response says.

"The funding agreement in place between NEHTA and the department specifies the roles and obligations of each agency."

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David.