Over a year ago this was published:
Changes to My Health Record System
Aust Gov
1st June 2017
Regulation Impact Statement - Department of Health
The Government announced changes to its My Health Record system as part of the 2017-18 Budget. The My Health Record system will change to an opt-out model.
As a result of these changes, every Australian will have a My Health Record unless they prefer not to. Transition to opt-out participation will bring forward benefits to patients and medical service providers many years sooner than the current opt-in arrangements.
The Office of Best Practice Regulation (OBPR) assessed the Regulation Impact Statement (RIS) prepared by the Department of Health as best practice.
The RIS estimated the average annual regulatory savings of the proposal to be $3.13 million. The OBPR has agreed to this estimate.
Here is the link:
The benefits claimed are here:
Impact on Government
There will be a short term cost for Government to support an increase to the capacity of the My Health Record system and to undertake public communication campaigns, healthcare provider-readiness activities and training and education to support National Opt Out arrangements.
For a one-off cost of $180.9 million over four years (to the end of FY 2020/21) to implement Opt Out arrangements nationally, benefits will be delivered within the forward estimates period, and much sooner than under a continuation of the existing arrangements.
The Government would gain significant economic benefits and return on this investment through reductions in the growth of healthcare costs arising from improvements such as:
- reduced hospital admissions;
- improved individual care including better management of chronic disease; and
- a more efficient healthcare system.
Health Benefits
Broader participation and meaningful use of the My Health Record system will put the person at the centre of their healthcare and support sustainability through better availability and use of health information, which has the potential to enhance policy formulation, innovation and allocation of resources thus improving the quality and the safety of healthcare and service delivery costs.
Encouraging increased participation and effective use of the My Health Record system can lead to improved coordination and better integration of the healthcare system, resulting in a reduction in adverse events and in duplication of treatments and tests.
The reductions in time taken in finding information and the performance of unnecessary investigations would result in improved productivity for the health workforce.
Enhancing participation and meaningful use of the My Health Record system will be of particular benefit to individuals with chronic and complex conditions, older Australians, Indigenous Australians, mothers and newborn children, and individuals living in rural and regional areas, as they are more likely to access healthcare from numerous healthcare providers.
In addition, it would mean that individuals and their families will be able to go anywhere in Australia to receive high quality and convenient healthcare, reducing the time and costs associated with undertaking duplicate tests or repeating information.
Increasing the uptake and meaningful use of the My Health Record system would lead to:
· Improved health outcomes, avoided hospital admissions and saved lives through fewer adverse drug events (more Australians die each year because of medication errors than from road accidents), better coordination of care for people seeing multiple healthcare providers, and better informed treatment decisions ($2.10 billion estimated over ten years);
· A much more efficient health system. For example, healthcare providers will spend less time searching for information about their patients ($2.81 billion estimated over ten years);
· Avoided duplication of diagnostic tests - pathology and diagnostic imaging ($2.08 billion estimated over ten years);
· Putting the person at the centre of their healthcare, so they play a greater role and take greater responsibility for their own health ($1.41 billion estimated over ten years);
· Enabling innovation and developments in healthcare through secondary uses of health information, enabling unprecedented levels of insight into population health outcomes, which better-inform policy decisions, make resourcing more sustainable, and inspire new clinical developments ($6.19 billion estimated over ten years).
It is anticipated that benefits in health outcomes will be skewed towards vulnerable families as they currently face more challenges in accessing timely and appropriate healthcare and will have more to benefit from increased participation and meaningful use of the My Health Record system. Based on current experience, these people are less likely to participate in the existing opt in model as they are more likely to be challenged by the registration process. Vulnerable population groups may include Aboriginal and Torres Strait Islander people, families with a member who has a mental illness, families in which English is a second language, and families with low socio-economic status. These groups are expected to experience more pronounced benefits as the My Health Record system will help reduce the burden carried by these families.
----- End extract from Pages 7 and 8.
The move to opt out was to provide $14.59 Billion over 10 years of which almost half was derived from Secondary Use Initiatives rather than clinical benefit.
This is the clearest statement yet of what the myHR is actually for. It is not as Mr Shetler said Your Health Record but a Government Record of your health information!
We can only marvel as to how these figures were derived but the Government does not show its working….
Read closely and you will also see the so called beneficiaries are likely those who will not have the means or capacity (internet etc.) to interact and use the myHR. The wrong side of the Digital Divide.
What a fudge.
David.
3 comments:
If nothing else that RIS would seem to put to bed the assertion given to yesterday's Senate Inquiry that there isn't an opt-out business case.
"A business case was used to prepare this proposal (A My Health Record for Every Australian) which seeks a Government decision on how to maximise the return on government’s existing investment in the My Health Record system. The business case considered three options: Opt Out arrangements, Continued and Improved Operations and Accelerated Opt In. This consideration included detailed financial cost/benefit and risk analyses. The analysis showed that Accelerated Opt In – which was largely an education and marketing campaign – delivered significantly reduced benefits with very little cost reduction"
There was the equivalent of a business case options (4 of them with #3 in two parts), documented in the Explanatory Memorandum of the Health legislation amendment (ehealth) bill 2015
Available from here:
https://www.aph.gov.au/Parliamentary_Business/Bills_Legislation/Bills_Search_Results/Result?bId=r5534
A direct link to the word version is here:
http://parlinfo.aph.gov.au/parlInfo/download/legislation/ems/r5534_ems_211631f6-fc59-4890-8ab0-a99237f40152/upload_word/503821.DOCX;fileType=application%2Fvnd.openxmlformats-officedocument.wordprocessingml.document
The only costs in this document are those of the government and are associated with implementing the system and with registering individuals.
They went with option 3B trials then full opt-out.
There is no costings in either the Explanatory statement or the RIS that refer to on-going costs to the health care industry of using the system, as borne by health providers, when almost everybody has one.
The calculation I included in my submission to the Senate Inquiry was based upon an average of 3 minutes per GP visit to manage a patient's MyHR, 400,000 GP visits per day and $100/hour.
This comes to about $720m/year. Then there are all the other costs for hospitals, specialists, pathology labs etc. Call it a round $1b, a not insignificant amount.
The business case as developed by the government only partially covers the full costs - surprise, surprise.
Re the Regulation Impact Statement
There is an interesting sentence: "A figure of 2% (for opt-out) has been assumed in the following analysis"
So much for Tim's assertion that they were expecting a higher number.
A realistic figure - one that represents the number f people who know about the myhr opt-out and who have the ability to opt-out is probably nearer 10%
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