Thursday, June 05, 2014
Senate Estimates Hearing - June 3 2014 - E-Health Section. Obfuscation Central I Have To Say!
Here is the transcript:
First the Cast of Characters:
Senators as Linked In Text and:
Senator Nash, Assistant Minister for Health
Professor Jane Halton, Secretary
Mr Paul Madden, Chief Information and Knowledge Officer
Ms Linda Powell, First Assistant Secretary, eHealth Division
Here is the transcript:
CHAIR: We will now resume with outcome 7. The plan was to run through in seriatim—to borrow Senator McLucas's phrase—except that we will do program 7.6, blood and organ donation, together with the two relevant authorities if that suits people. There are questions in almost every area, so we will have to try to stick quite rigidly to time.
Senator CAROL BROWN: How many Australians now have an e-Health record?
Mr Madden : There are about 1.66 million Australians registered for an e-Health record so far.
Prof. Halton : Ask us tomorrow morning. It will have gone up by another 3,500.
CHAIR: Why is that, Professor Halton? Does it do that every night?
Prof. Halton : Basically. Sometimes 4,000 and sometimes 3,000, but about that.
Senator CAROL BROWN: When does that 1.66 million date from?
Mr Madden : That is from 1 July 2012.
Senator CAROL BROWN: Can you remind me when the e-Health system was up and running?
Mr Madden : Registration for consumers was available through the DHS call centres from 1 July 2012, and it was available online for consumers on about 18 July 2012.
Senator CAROL BROWN: You are probably going to need to take this on notice. Could I have a month by month breakdown of the enrolments?
Mr Madden : Sure, we will take that on notice.
Senator CAROL BROWN: Are you able to provide that sort of information across the states and territories at all?
Mr Madden : Yes, we can give a break up of enrolments by states and territories, by sex and within age groups as well.
Senator CAROL BROWN: Could I get that?
Mr Madden : Yes.
Ms Powell : I was just going to let Senator Brown know that we have, in fact, provided the month-by-month breakdown of the consumer enrolments in a previous question on notice. We can update that, and I can also give you state-by-state breakdown now if you would like that.
Senator CAROL BROWN: That would be good. Given that it goes up so dramatically daily, that would be handy. That state and territory information would be particularly good to know.
Ms Powell : In New South Wales, we have 506,000; in Victoria, we have 355,000; in Queensland, we have 334,000; in South Australia, we have 169,000; in Western Australia, we have 147,000; in the ACT, we have 57,000; in the Northern Territory, we have 21,000; and in Tasmania, we have 64,000.
Senator CAROL BROWN: Would you also be able to provide me with the percentages as well?
Ms Powell : Yes.
Prof. Halton : As in of the population of the state?
Prof. Halton : It is interesting, Senator. Given we had that discussion about the ACT and its characteristics earlier on today, I feel a small obligation to skite about the ACT. I think we are sitting on about 15 per cent of the population in the ACT.
CHAIR: What is the figure overall of the eligible percentage?
Ms Powell : Sorry, Senator. I am not quite sure I understand your question.
Prof. Halton : If it is 23 million people in the population and 1.7 rounded million, we can do the math.
CHAIR: It is about eight per cent.
Prof. Halton : That is right.
Senator MOORE: Ms Powell, when you get the data in terms of the update month by month and also the state distributions, can we now have them put into a Fierravanti-Wells table that we get at every Senate estimates?
Prof. Halton : I think she will be very flattered by that.
Senator MOORE: She knows. We have actually agreed that that is the terminology we will use.
Prof. Halton : Absolutely great.
Senator MOORE: If we can get an FW process there—and they are the kinds of data we want to keep an eye on all the way through—if we could get that every time, that would be our standard request.
Senator CAROL BROWN: Just for my interest, do you have the percentage of the Tasmanian figure there in front of you?
Ms Powell : I do not have the percentage of the Tasmanian population.
Senator CAROL BROWN: I will wait till you provide it on notice. At the last estimates we were also told that all public hospitals in Queensland had gone live with eHealth records?
Prof. Halton : With discharge summaries? I think we took that.
Senator CAROL BROWN: Can you give us a bit of an update on how that is progressing?
Ms Powell : Certainly. A total of 265 public hospitals are connected to the PCEHR. Twenty-eight of those are in New South Wales, seven are in South Australia, one is in the ACT, 219 are in Queensland, three are in Tasmania and seven are in Victoria. They are all connected to the PCEHR.
Senator CAROL BROWN: So there are 265 across the country.
Ms Powell : Some of those are connected to view information, and some of those are connected to actually upload discharge summaries.
Senator CAROL BROWN: Do you have that breakdown?
Ms Powell : I do. The only place is Queensland, where 111 are able to upload discharge summaries. The numbers are the same everywhere else. There is a program rolling out across the states.
Senator CAROL BROWN: And what is your target with connecting the hospitals?
Ms Powell : NEHTA have been working closely with all of the state governments. The way they have been doing their rollout has varied according to different things that are going on in their states. For example, in Queensland, because they had a number of upgrades happening across the state at the same time, they were able to connect all of the hospitals. In New South Wales they have started with smaller numbers and they have been progressively rolling out as they are able to.
Senator CAROL BROWN: What is your expectation of when we will be able to see all the public hospitals across the country connected?
Ms Powell : I am not sure when we will have all of them connected. In WA, for example, there is much more of a staggered approach; they will be starting in the urban areas and rolling out much more slowly into other areas. So I do not have that information. I can see what other details I can get for you.
Senator CAROL BROWN: What was the situation in Tasmania?
Ms Powell : In Tasmania three hospitals are connected.
Senator CAROL BROWN: How many specialists have registered? Do you have that information?
Ms Powell : There are 112 specialists that we know have registered to connect to the system. The way the registration works is that health provider organisations register to use the system as well. For example, if you have a hospital that is registered to use the system, specialists within that hospital might be accessing it. So we do not have those numbers.
Senator McLUCAS: Do you have the number of private specialists who are registered?
Ms Powell : I do not have that information.
Mr Madden : The way we keep the tally of who is registered is that, if you are registered, as Ms Powell put it, as a provider organisation, all of the specialists, GPs and health providers within that organisation can use it. We cannot keep a count of how many are in that. For those who have registered with a health provider identifier as an individual, we can know the specialty or the particular type of healthcare provider they are, but it does not discern whether they are a private practice or a public practice. We do know what type of provider they are, but not all providers register with a healthcare provider identifier as an individual. Most come through as an organisation.
Senator McLUCAS: If you were a specialist who did a little bit of work at a public hospital as a VMO, you are captured there and you do not have to reregister in your private practice?
Mr Madden : That is right. They could be registered in their own right within their own private practice but, if they are in a hospital as a public VMO, they will be using hospital system's HPI-O to get that.
Senator CAROL BROWN: I want to move to the review. I know it has been released, but when was the review completed?
Mr Madden : The review was tabled around 23 December 2013. It was released publicly on 19 May 2014.
Senator CAROL BROWN: Did you say 24 May?
Mr Madden : 19 May.
Senator CAROL BROWN: When will the government be formally responding to the review?
Senator Nash: My understanding is we are working through that at the moment, Senator. We are working through the response to the review now.
Senator CAROL BROWN: No suggestion of a time frame there, Minister?
Senator Nash: I can take it on notice for you—but, at this stage, not from me.
Senator CAROL BROWN: Not in the near future?
Senator Nash: I would not like to make an assumption.
Prof. Halton : Let us be clear: at one level the government already has responded to the review by funding actually the PCEHR—
Senator CAROL BROWN: Funding for the one year.
Prof. Halton : Yes, absolutely. And the minister is on the record in relation to the forward commitment to this.
Senator CAROL BROWN: I have seen what is in the budget papers and the funding provided for 2014-15. It is what is beyond that, obviously, that is of interest.
Prof. Halton : Yes. But, again, go to the language used by the minister. There are some issues that need to be resolved which, as the minister says, are being worked on at the moment. The PCEHR or what it becomes based on the recommendations of the review, with all the things that are covered in the review, is an important part of infrastructure.
Senator CAROL BROWN: Are you able to tell me what the cost of the review was?
Mr Madden : I do not have the cost with me. Ms Powell, do you have that detail with you? I am pretty sure we provided some of that in the last series of estimates, so it will not be hard to pull out.
Ms Powell : Yes, I do have that information. The total cost of the review, all up, was $196,000.
Senator CAROL BROWN: Has the department provided a brief to the minister on the review?
Prof. Halton : Several.
Senator CAROL BROWN: Right. I will not ask when, then. The transition from the personally controlled electronic health record system to the 'my health' record—has an appropriation been made for that transition?
Mr Madden : At the moment that is one of the recommendations in the review and we do not have a formal position on any of the recommendations.
Senator CAROL BROWN: So that is under consideration by the minister—whether he will take up that recommendation.
Senator Nash: That is right.
Senator CAROL BROWN: How many staff are employed on the implementation of the eHealth records?
Mr Madden : On the current operation of the system?
Ms Powell : In terms of the staffing arrangements, the information I can give you that is probably the most useful is the number of staff that are working in the division, which covers a whole range of activities: the operation of the eHealth record, policy, work on the legislation and many eHealth related activities. We have got 57 staff at the moment, plus a number of contractors.
Senator CAROL BROWN: Can you tell me how many contractors?
Ms Powell : We have 18 contractors in a variety of arrangements.
Senator CAROL BROWN: Doing a variety of roles within the division?
Ms Powell : That is right.
Senator CAROL BROWN: I will not ask the government's position on some of the other recommendations. I am assuming that is all under consideration. The e-health summit and implementation of the clinical trial functionality into jurisdictional e-health systems—are we proceeding with that?
Ms Powell : The e-health summit?
Ms Powell : I am thinking that you might be referring to a conference run by CHIK Services earlier this year. I am not sure what the e-health summit is.
Prof. Halton : It is not self-evident what that means, Senator.
Senator CAROL BROWN: What is that?
Prof. Halton : It is not self-evident what you mean by eHealth summit.
Senator CAROL BROWN: It is my understanding that there was a summit that proposed—
Prof. Halton : By whom?
Senator CAROL BROWN: I understand that it was a decision made between the state and territories and the Australian government. I could be wrong, but that was proposed.
Prof. Halton : Not that I have any visibility of.
Senator CAROL BROWN: Just before I finish, the National E-Health Transition Authority—what is the appropriation for that? I cannot find it here.
Mr Madden : The Commonwealth's share of that is $34 million and that means that the state contribution combined would be the same value.
CHAIR: Has the state contribution been made, Mr Madden?
Mr Madden : As far as I am aware, all but three states have worked through that to commit. The other three are still working through the administrative processes.
CHAIR: Are you able to tell us which—
Mr Madden : I will take that on notice, if that is all right, Senator.
Senator CAROL BROWN: So that $34 million is over how many years?
Mr Madden : For one year. That covers the operation and servicing of things like the Healthcare Identifiers Service and the National Authentication Service for Health, as well as all the standards.
Senator CAROL BROWN: Okay. I am just trying to find some information about the summit. I might have to come back and ask for some indulgence, Chair. While you are there and I am looking through my information, is there an ongoing promotional strategy for e-health records?
Mr Madden : No, Senator. We continue to provide help, support and information to people who make inquiries or are wishing to connect to the system. There is a level of information and communication out there in the community and through the public hospitals through the admission process so people are made aware of the fact that they can have an e-health record, but we do not have any publicly espoused communication strategy from the Commonwealth at the moment.
Senator CAROL BROWN: Is it just through those two streams that you just mention?
Mr Madden : All of the information which has been provided publicly about the e-health system is still out there in private and primary practice. It is available through the hospitals and clinics. It is all there. It is all of the information that we put out last year. We have not embarked on a campaign or any advertising or education beyond what we have already done so far.
Senator CAROL BROWN: You are not considering anything like that?
Mr Madden : While we are considering the position on all of the recommendations, how far we push those things will depend on how we go with some of those recommendations.
The link is found here:
I have put the bits I think interesting in italics but I have to say the quality and depth of questions was a bit sad.
Well I suspect the next big event will be the release of the Government response to the PCEHR Review.
This really is like pulling teeth!
Posted by Dr David More MB PhD FACHI at Thursday, June 05, 2014