Australian Health Information Technology

This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Wednesday, January 20, 2010

NEHTA Really Is A Great Example of The Worst in Public Sector Governance.

If you accept that NEHTA is actually a legitimate, legally authorised and constituted public sector organisation, the veracity of which I am somewhat suspicious, then there can be little doubt that its governance is a really bad model for achieving public sector driven reform outcomes.

I say this because I had occasion recently to have a closer look at the National Prescribing Service Limited (NPS) which on the surface is another non-profit limited company that is directly funded by Government, but which has a governance framework which is vastly superior, likely to deliver and sustainable in my view!

The key features of the governance are:

First, an elected board – with the Member Organisations electing the Board. The members are not just the jurisdictions –but a broad sweep of all those with an interest in what the NPS exists for – namely promotion of the Quality Use of Medicines and all that entails.

Here is the current list:

List of NPS member organisations

Our current Member Organisations are:

Second the board is an expert board – i.e. really knows the detail of what it is talking about. One can hardly say that about the current NEHTA Board.

NPS Board members

Members of the NPS Board serve a 3-year term, with a maximum of 3 terms, as defined by the NPS Constitution.

Current Board Members are:

· Dr Janette Randall (Chair)

· Mr Russell Edwards

· Dr Ross Maxwell

· Associate Professor Shane Carney

· Ms Kate Moore

· Dr Kay Price Dr Graeme Killer AO

· Dr Shiong Tan

· Ms Debbie Rigby

Virtually all Board the members have medical, pharmacy or nursing qualifications, with a good number having significant public sector management experience. Management has no capacity to ‘pull the wool’ over the Board’s eyes, which is always a bit of a worry with some of the decisions that come from NEHTA.

Third the organisation has a well defined clear reason for existence and a single source of funding which makes it focussed on achieving the goals it has been funded for – rather than the rather diffuse goal setting we see from NEHTA, and the intermittent and uncertain funding and manadate from COAG.

Fourth there are published evaluations and evaluation frameworks which are public and which are easily available:

See here:

http://www.nps.org.au/research_and_evaluation/publications/reports

The only serious assessment of NEHTA – the BCG Report some 2 years ago – is still to have many of its key recommendations implemented – e.g. at least 2-3 independent board members.

All in all a much better way of proceeding is seen with the NPS and their sort of approach that might actually lead to some success with NEHTA.

Mr Gonski and Ms O’Grady, are you listening? NEHTA could be reshaped to be way better governed than it is at present.

David.

Tuesday, January 19, 2010

Another Non Release from NEHTA. Yet Another Evidence Free Press Release with Vague Claims.

The following appeared from NEHTA today.

Patient privacy to improve under new system

19 January 2010. Confidentiality between doctor and patient will have even more safeguards in place under the new healthcare identifier system being proposed by the Federal Government, Dr Mukesh Haikerwal said today.

Dr Haikerwal, a clinical lead with the National E-health Transition Authority (NEHTA), said good clinical care depended on the absolute confidence that the privacy of each consultation is maintained.

This confidentiality is equally important to both health professionals and the people they look after and without this the system will not fly,’’ he said.

Patient confidentiality is vitally important to us in our work and the good thing about the healthcare identifier is that it not only makes the system safer, more accurate and up-to-date, but it also carries with it additional safeguards over and above what exists today.”

Dr Haikerwal, a medical practitioner and former federal president of the Australian Medical Association, said one feature of the proposed new system was that health professionals will have to be authenticated prior to accessing the system.

“There is also a very strict audit trail so that any individual can know that someone has accessed their record in the system which is an additional layer of security,” Dr Haikerwal said.

He also said that the identifiers are an essential element of any future electronic health record system, which will be patient controlled and not held on a centralised database.

Furthermore, the personal information associated with the identifier will be restricted to name, birth information, sex and address.

Dr Haikerwal said that he had personally been involved in consultations with a wide range of groups including privacy advocates over the past six months.

"You will never satisfy everyone in regard to privacy, but I have far more confidence in the future of e-health and the security of it's records than I do in the current system," he said.

"If confidentiality of the doctor-patient relationship is in anyway compromised I would have no part in it," Dr Haikerwal said.

ENDS

For more information contact Alison Sweeney Media Coordinator

The release and contact details are here:

http://www.nehta.gov.au/media-centre/nehta-news/585-patient-privacy

We all need to recognise this system is meant to commence in less than six months.

Just how are health providers to be properly authenticated – no information. Just why are we seeing differing messages about record content and record access.

The reason is pretty clear. Those involved do not have a clue what they are doing and more than that are not telling the public – in other than carefully spun press releases.

Mr Fleming you will be a former CEO walking out unless NEHTA dramatically transforms its communication of the details of what is planned and fully justifies the rationale of each of them!

How, in detail, will 600,000 health care providers be authenticated, how will it work, what will be the workflow impact, how will fraud be prevented and what exactly will it cost? More, why have these details not been in the public domain for a number of months so they can be considered?

Again – just hopeless! I am getting really tired of this. Where is the quality of openness and appropriateness of public administration we should be seeing?

David.

Weekly Australian Health IT Links - 19-01-2010

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article.

General Comment:

The is little doubt the biggest item this week has been the ‘sham’ consultation process conducted by DoHA / NEHTA on the proposed legislation for the Health Identifier Service.

Civil Liberties Australia made the point most forcefully!

“Timing of the consultations

Finally, we note that the request for comment on this draft legislation was issued on 10 December, with a closing date of 7 January 2010.

We note that the public servants within the Health Department will have been able to enjoy a break over Christmas and New Year while expecting civil society, in the form of unpaid volunteer organisations, to provide unrecompensed analysis and input into making the legislation as good as it can be.

CLA raised this timing issue at the face-to-face consultations, and warned the department against doing exactly what the department has done in terms of timing. In our opinion, there could be no more contemptuous action on the part of the department, representing the government, than to treat the consultation process, and civil society organisations and people who contribute to it, in this manner.

We trust that the public servants of the Department of Health enjoyed their Christmas and New Year break.

We request that the department never, ever do something like this again, and we ask that our request be communicated to the Secretary of the Department for her to issue an instruction to the appropriate effect. Whether she chooses to apologise for the abysmal behaviour of her staff is up to her.”

See here:

http://www.privacy.org.au/Papers/HId_Bill-CLA-100107.pdf

There also some other important issues raised in the submission – some very serious indeed!

Love the paragraph quoted!

Another public service favourite is to release major tenders late in December to close in early February – to ruin responders Christmas Breaks. SA Health stands condemned this year for that annoying act!

See here:

http://aushealthit.blogspot.com/2010/01/south-australian-health-treats-nehta-as.html

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http://www.abc.net.au/news/stories/2010/01/14/2792636.htm

Doctors call for patient privacy protection

Posted Thu Jan 14, 2010 6:02pm AEDT

A group representing general practitioners has called on the Federal Government to ensure patient confidentiality is maintained when privacy laws are reformed this year.

The Government has proposed streamlining the Privacy Act into a national set of principles across the public and private sectors.

The move coincides with a widespread increase in the use of electronic patient data by doctors, specialists and hospitals.

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http://www.australiandoctor.com.au/articles/8e/0c06678e.asp?

E-health patient privacy warning

14-Jan-2010

By Sarah Colyer

A FORMER employee of the nation’s top e-health body is warning of ‘Big Brother’-style privacy breaches if a plan to identify every patient with a unique number goes ahead.

Software developer Peter West, who quit the National E-Health Transition Authority last year, is now facing legal action from his former employer for setting up an alternative patient identification system.

Mr West told Australian Doctor he left NEHTA because he believed its project to identify all Australians in the health system using a single number was a privacy risk.

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http://www.smh.com.au/technology/technology-news/australia-responds-to-threats-of-internet-war-20100115-mcgv.html

Australia responds to threats of internet war

DAN HARRISON

January 16, 2010

HACKERS are launching 200 attacks a month on the Defence Department's computer networks, the Defence Minister, John Faulkner, revealed as he unveiled a new centre to co-ordinate the nation's response to online threats.

Journalists were allowed into the Defence Signals Directorate yesterday for the first time since its creation in 1947. The occasion was the opening of the Cyber Security Operations Centre.

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http://www.liebertonline.com/doi/abs/10.1089/tmj.2009.0079

Telehealth on Advanced Networks

Laurence S. Wilson, Ph.D.,¹

Duncan R. Stevenson, M.Sc.,² and

Patrick Cregan, M.D.³

¹CSIRO ICT Centre, Sydney, NSW, Australia.

²Australian National University, Canberra, ACT, Australia.

³Sydney West Area Health Service, Penrith, NSW, Australia.

Address correspondence to:

Laurence S. Wilson, Ph.D.

CSIRO ICT Centre

P.O. Box 76

Epping NSW 1710

Australia

Abstract

We address advanced Internet for complex telehealth applications by reviewing four hospital-based broadband telehealth projects and identifying common threads. These projects were conducted in Australia under a 6-year research project on broadband Internet applications. Each project addressed specific clinical needs and its development was guided by the clinicians involved. Each project was trialed in the field and evaluated against the initial requirements. The four projects covered remote management of a resuscitation team in a district hospital, remote guidance and interpretation of echocardiography, virtual-reality-based instructor–student surgical training, and postoperative outpatient consultations following pediatric surgery. Each was characterized by a high level of interpersonal communication, a high level of clinical expertise, and multiple participants. Each made use of multiple high-quality video and audio links and shared real-time access to clinical data. Four common threads were observed. Each application provided a high level of usability and task focus because the design and use of broadband capability was aimed directly to meet the clinicians' needs. Each used the media quality available over broadband to convey words, gestures, body movements, and facial expressions to support communication and a sense of presence among the participants. Each required a complex information space shared among the participants, including real-time access to stored patient data and real-time interactive access to the patients themselves. Finally, each application supported the social and organizational aspects of their healthcare focus, creating and maintaining relationships between the various participants, and this was done by placing the telehealth application into a wider functioning clinical context. These findings provide evidence for a significantly enhanced role for appropriate telemedicine systems running on advanced networks, in a wider range of clinical applications, more deeply integrated into healthcare systems.

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http://www.pharmacynews.com.au/article/agreement-ushers-in-new-dispensing-charter/509268.aspx

Agreement ushers in new dispensing charter

14 January 2010 | by Mark Gertskis

A nationwide system of medication information and compliance will be implemented in every pharmacy under the Fifth Community Pharmacy Agreement negotiated by the Pharmacy Guild with the Federal Government.

According to new details of the agreement released yesterday, a new Prescription Commitment will compel pharmacies to issue every patient filling a prescription with a leaflet tailored to the patient and the drug dispensed.

The leaflet will include consumer medicine information (CMI) for that drug, information on premium free products and a patient's compliance score for chronic disease medications derived via dispensary systems.

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http://www.pharmacynews.com.au/article/pharmacists-gain-e-script-incentive/509272.aspx

Pharmacists gain e-script incentive

14 January 2010

Community pharmacies will receive a financial incentive for every prescription they fill using an electronic prescribing system, under a new measure proposed in the Fifth Community Pharmacy Agreement.

New details of the agreement reveal that pharmacies are set to be paid $0.15 per script to "offset some of the costs of providing electronic prescriptions".

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http://www.theaustralian.com.au/australian-it/icsglobal-us-expansion-plans-hits-legal-wall/story-e6frgakx-1225819943165

ICSGlobal US expansion hits legal wall

From: Australian IT
January 15, 2010 1:04PM

ICSGlobal's bid to enter the US health billing and banking market with the $2.16 million purchase of Georgia-based Medical Recovery Services has been marred by financial irregularities in MRS's accounts and alleged misconduct by the former owner, Donna Murphy, the company told the Australian Securities Exchange.

In a statement this week, ICSGlobal managing director Tim Murray said management had begun legal proceedings after "becoming aware of irregularities in the MRS accounts and actions by Ms Murphy and three (of her) relatives, which the company believes are in breach of employment and other agreements they entered into.”
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http://www.zdnet.com.au/news/software/soa/iSoft-lays-off-several-dozen/0,130061733,339300421,00.htm

iSoft lays off several dozen

By Suzanne Tindal, ZDNet.com.au

14 January 2010 12:15 PM

in brief Australian health software company iSoft has recently held a round of redundancies, despite outlining a vision late last year to increase its workforce.

ZDNet.com.au understands that the company laid off around 25 to 30 Australian workers in December, naming a restructure as the reason. There had also been rumours that a further round was planned. The company has declined to comment on the issue.

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http://www.zdnet.com.au/news/software/soa/NEHTA-sicks-lawyer-on-ex-staffers/0,130061733,339300415,00.htm?omnRef=1337

NEHTA sicks lawyer on ex-staffers

By Suzanne Tindal, ZDNet.com.au

13 January 2010 05:35 PM

Two former National E-Health Authority employees who are pushing a self-developed alternative to individual health identifiers have been threatened with legal action by the authority for what it claims is theft of its intellectual property.

NEHTA's charge has been to bring Australia into the e-health era where every Australian has an electronic medical record. It has been working with Medicare on a number for each citizen which can be used to collate medical information.

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http://www.theaustralian.com.au/australian-it/e-prescribing-tender-cancelled/story-e6frgakx-1225818883921

E-prescribing tender cancelled

Karen Dearne
From: Australian IT
January 13, 2010 3:22PM

NINE months after a tender aimed at resolving key management arrangements for new national electronic prescribing systems closed for consideration, the federal Health Department has quietly advised bidders by letter that the project has been canned.

Department officials say the call for a consultancy to develop an e-prescribing and dispensing "benefits realisation and implementation plan" has been overtaken by recent events.

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http://www.6minutes.com.au/articles/z1/view.asp?id=509249

Government scraps e-prescribing project

by Jared Reed

The Federal government has abandoned an electronic prescribing project started last year, claiming that its health reform agenda has changed the course of the project.

The open tender call was launched in May 2009, one month before the National Health and Hospitals Reform Commission released its 123 reform recommendations, and called for advice in the creation of an “e-prescribing and dispensing of medicines benefits realisation and implementation plan”.

http://www.smh.com.au/technology/technology-news/broadband-billions-left-hanging-as-wireless-bites-back-20100112-m4u7.html

Broadband billions left hanging as wireless bites back

ARI SHARP

January 13, 2010

AUSTRALIANS are flocking to 3G mobiles and wireless broadband devices, bringing into question some of the assumptions behind the Rudd Government's $43 billion national broadband network.

A report published yesterday by the Australian Communications and Media Authority shows that take up of wireless technology more than doubled last financial year as quicker speeds and more sophisticated handsets made it a viable alternative to fixed-line internet.

''Australians increasingly seek flexibility in where and how they access communications and content,'' the report found.

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http://www.theaustralian.com.au/australian-it/federal-government-boosts-e-health-funding/story-e6frgakx-1225818209976

Federal government boosts e-health funding

Karen Dearne
From: The Australian
January 12, 2010 12:00AM

FOUR more e-health projects will be funded under the federal government's $60 million Digital Regions initiative.

Communications Minister Stephen Conroy yesterday allocated an additional $6.5m to clinical outreach and telehealth programs.

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http://www.smh.com.au/national/vinnies-misused-donor-data-20100111-m2rr.html

Vinnies 'misused' donor data

ERIK JENSEN

January 12, 2010

THE St Vincent de Paul Society has been accused of breaching public trust and aspects of the Privacy Act after entering into an agreement that allowed one of the world's largest data companies to gather information through a Christmas mail-out from the charity.

The society defended its relationship with Acxiom but admitted to allowing it to write half the questions in the survey - and to collecting only limited data from the four-page questionnaire.

It paid for the printing and mailing of the survey in exchange for a targeted mailing list from Acxiom.

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http://www.psnews.com.au/Page_psn1996.html

New DVA health cards are big deal

The Department of Veterans’ Affairs is to reissue its Repatriation Health Cards which are due to expire in 2010.

Minister for Veterans’ Affairs, Alan Griffin said some improvements would be made to the new cards which would be given to all eligible veterans, war widows/widowers and dependants.

Mr Griffin said the changes would increase the cards’ security, improve provider satisfaction and increase veteran access to services.

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http://news.cnet.com/8301-13860_3-10426627-56.html?tag=rtcol;pop

January 6, 2010 12:04 PM PST

Windows 7 has lots of 'GodModes' (exclusive)

by Ina Fried

Those intrigued by the "GodMode" in Windows 7 may be interested to know that there are many other similar shortcuts hidden within the operating system.

Intended for developers as a shortcut to various internal settings, such features have been around since Vista and even before, according to the head of Microsoft's Windows division, who tells CNET that the so-called GodMode settings folder uncovered by bloggers is just one of many undocumented developer features included in Windows.

In an e-mail interview, Steven Sinofsky, Windows division president, said several similar undocumented features provide direct access to all kinds of settings, from choosing a location to managing power settings to identifying biometric sensors.

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See article for all the possibilities! Just amazing!

Enjoy!

David.

This Commonwealth Health Minister Is Just Utterly Clueless on e-Health Introduction.

This appeared in 6minuites today.

Doctors to pay for e-health upgrades

by Jared Reed

Nicola Roxon says doctors rather than the government will foot the bill for upgrading IT systems during the move towards an integrated national e-health system.

The minister toured the offices of Medicare in Canberra yesterday to look at the various tools that will be encompassed in e-health legislation the government plans to introduce soon.

Ms Roxon says she expects health providers, not the government, to fund the majority of its e-health agenda.

“We believe there's good reasons that healthcare providers and businesses and professionals can pay to upgrade their systems,” she said yesterday.

The government will adopt a more hands-off approach in the execution of e-health, acting instead as an overseer and intermediary between providers, she added.

“This isn’t an entire government enterprise. It’s about government using its role to link the different providers at appropriate times for the benefit of the patient.”

More here:

http://www.6minutes.com.au/articles/z1/view.asp?id=509538

What on earth is she smoking? There is no reason for Doctors to do anything of the sort that I can see, other than those few who operate with a (very deep) sense of altruism or those who are technogeeks and love playing with the blinking lights.

Nowhere else in the world has it been seen to be reasonable to pay for technology upgrades which, after all, typically require time, effort and cost to install and once operational provide the majority of the benefits of the use of the technology to the patient and those who fund the health services.

Technology Introduction 101 is quite clear – those who benefit are those who should pay!

Unless the migration to e-Health is made cost neutral for the health-care providers you can have a rolled gold 100% guarantee progress will be glacial at best!

I wonder just what the good reasons are she has for her "provider to pay" plan. Funny there is no explanation provided. The reason is, of course, that no rational justification exists - as the rest of the world knows!

Just arrant nonsense. I have never seen such silliness from a Minister of the Crown in all my now rather too many adult years!

David.

Monday, January 18, 2010

Ms Roxon Plans to Over Invest in E-Health – One Million Dollars To Get It Started.

If this reporting is accurate one can only despair!

Govt says e-health will deliver a safer system

Correspondents in Canberra
From: AAP
January 18, 2010 6:39PM

THE federal government says its proposed e-health system will improve patient safety and free up GPs.

The system, currently under design, will see patient records stored in one national database that can be accessed by different health professionals.

The government hopes to see the opt-out system up and running in ten years, and says more than $1 million has been put on the table to get it started.

Federal Health Minister Nicola Roxon says it will cut the time GPs spend pulling up patients health records during visits.

She insists the system will be secure and won't affect strict patient privacy laws.

"This doesn't change the existing laws of when it's appropriate for an individual have their records...accessed," she told reporters in Canberra.

States, territories and health professionals will also have to invest in technologies to allow them to link in to the system.

More here:

http://www.theaustralian.com.au/australian-it/govt-says-e-health-will-deliver-a-safer-system/story-e6frgakx-1225820965086

Also we have this:

e-health legislation

Monday, 18 January 2010 06:16

Patient care will be improved and inefficiency in the health system will be cut by new e-health legislation soon to be introduced by the Rudd Government.

Today I visited Medicare Australia to see first hand how the secure e-health system currently being developed will work for patients and health care professionals.

The demonstration clearly showed how useful tools like electronic health records, medications-management systems and electronic clinical messaging (discharge, referrals, pathology, and prescriptions) will help improve delivery of health care – particularly when patients are being cared for by multiple providers.

The first step in creating an e-health system will come into effect in the middle of the year when unique healthcare identifiers are assigned to all health consumers as well as to health professionals and the organisations that provide health care in Australia.

The unique healthcare identifiers will be available on a secure system, operated by Medicare Australia.

These identifiers will be provided in addition to Medicare numbers, as a further step to ensure the security of the system. Legislation to underpin this work – the Healthcare Identifiers Bill 2010 - will be introduced to Parliament in the first half of this year. The draft legislation is available for comment at www.health.gov.au/ehealth/consultation.

More here:

http://australia.to/2010/index.php?option=com_content&view=article&id=559:e-health-legislation-&catid=100:just-in

A ministerial ‘puff piece’ if ever there was one!

What can one say?

Does anyone seriously believe she knows what she is talking about? (Or is she just being badly misquoted?). We are all glad she visited to see stuff that is still unfunded and unwanted as far as she seems to be concerned

Blowed if I know what she is on about. – this really is just unclear policy nonsense.

David.

Ms Roxon Speaks on E-Health Funding

As reported on ABC News Radio at about 6pm 18 Jan, 2009.

The Health Minister does not think we need e-Health which is funded by Government - as is happening in other countries including the US, the UK and Europe. She is confident care providers and vendors will come to the party to save the Government from spending any money.

In the interview clip I heard she provided no reason why she imagined that might be the case.

Seriously clueless is my assessment on the basis of this report. Policy nitwit might also fit.

More to follow once there is more available.

David.

It Looks Like The Pharmacists Have Just Gazumped the Docs.

You humble scribe is easy to confuse but recently the level of confusion has really accelerated.

First we have the announcement I reported last week:

Government scraps e-prescribing project

by Jared Reed

The Federal government has abandoned an electronic prescribing project started last year, claiming that its health reform agenda has changed the course of the project.

But in a letter sent to bidders seven months after the NHHRC report’s release, the government says the recommendations had “materially affected the department’s anticipated workplan” for the e-prescribing project.

Bidders for the contract were required to submit recommendations as to whether the system should be government-owned and operated, government-owned and controlled but industry operated, or wholly industry-owned and operated.

On his blog, health IT commentator Dr David More says the cancellation would annoy groups who had put in a huge amount of development work.

More here:

http://www.6minutes.com.au/articles/z1/view.asp?id=509249

Then following appeared a few days ago in Pharmacy News.

Pharmacists gain e-script incentive

14 January 2010

New details of the agreement reveal that pharmacies are set to be paid $0.15 per script to "offset some of the costs of providing electronic prescriptions".

Dispensing software vendors are also set to receive extra funding to help them implement e-script functions into their platforms.

The new payment, however, coincides with the abolition of the $0.40 PBS Online incentive payment.

More here:

http://www.pharmacynews.com.au/article/pharmacists-gain-e-script-incentive/509272.aspx

and here a similar report.

Govt agreement delivers new incentives to pharmacists

Elizabeth McIntosh - Thursday, 14 January 2010

PHARMACISTS will soon receive new incentives for patient medication management and harnessing new technology, as part of the Fifth Community Pharmacy Agreement.

The fifth agreement between the Pharmacy Guild and the Federal Government will set out community pharmacy funding until 2015, and though negotiations are not complete, the Government has announced ambitions to cut up to $1 billion from the agreement.

According to industry e-newsletter Pharmacy Daily, while details of specific programs have not been released, a new Pharmacy Practice Incentive has been created which will be linked to defined outcomes in patient medication management.

A new Prescription Commitment has been created, which will require provision of consumer medication information and checking patient compliance with chronic disease medications.

Last year pharmacists came under fire from Federal Health Minister Nicola Roxon for a lack of consistency in providing medication information and advice to consumers, despite receiving incentive payments for the service (MO, 27 November 2009).

More here:

http://www.medicalobserver.com.au/News/0,1734,5777,14201001.aspx

We also discover that there are some other changes.

Agreement ushers in new dispensing charter

14 January 2010 | by Mark Gertskis

"We will be the first country in the world to implement a nationwide charter for a dispensing services in a community pharmacy," Guild national president Kos Sclavos told Pharmacy News.

More here:

http://www.pharmacynews.com.au/article/agreement-ushers-in-new-dispensing-charter/509268.aspx

The only detail available from the DoHA is this:

Agreement to Deliver Certainty for Community Pharmacy and Government

24 December 2009

The Australian Government and the Pharmacy Guild of Australia have reached agreement on the major components of the Fifth Community Pharmacy Agreement, which will commence on 1 July 2010.

The current agreement ends 30 June 2010.

The agreement is being negotiated in a very tight fiscal environment, in which the Government has to carefully consider its expenditure in all areas. This is especially the case given the Government’s significant health reform agenda.

Consumers can be assured that the Australia-wide network of community pharmacies will remain viable and at the front line of health care, delivering access to vital medicines to the community and delivering professional services such as medicines counselling and health advice.

The Government will make $15.1 billion available to community pharmacy over the life of the agreement, ensuring a viable community pharmacy network.

At the same time, through working closely with the Guild, the Government will make a saving of $1 billion on the forecast spending for community pharmacy, helping to maintain a sustainable health system and making other health reforms more affordable to Government.

I would like to thank the Guild, and in particular its President, Mr Kos Sclavos, for working so constructively with Government in the interests of the Australian community.

Release is here:

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr09-nr-nr243.htm?OpenDocument&yr=2009&mth=12

So what we have here is a payment for e-prescribing being introduced and the consultation required to determine how e-prescribing would be best done being canned in pretty much the same week.

Can I say I smell a rat!

What is more the doctors have lost the Easyclaim incentive and the pharmacists are being incentivised for providing a service which relies on Doctors doing electronic prescription transmission for which they are not being paid.

It also can’t be in a Standardised way as the standards have not yet been finalised so how is it being done and what is the measure on which payment will be made? More important, who counts?

Pity the actual agreement still seems to be secret, despite copious leaking from the Pharmacy Guild.

This is heading towards a huge mess in my view!

David.

Sunday, January 17, 2010

It Seems The Whistle Has Been Blown on the Commonwealth Department of Health and Ageing.

The following appeared in the Australian a few days ago.

Federal health `riddled with conflict'

David Uren, Economics correspondent
From: The Australian
January 15, 2010 12:00AM

THE commonwealth Health Department is an obstacle to reform and should be broken up, with its core staff numbers slashed by 95 per cent, a report presented to the Prime Minister's Department yesterday recommends.

The report, based on interviews with former commonwealth and state health ministers, treasurers and health administrators, says the department is riven with conflicts of interests and should be split, retaining its core function of specialist policy advice while a separate department would deliver services such as Medicare and aged care.

Ken Baxter, lead author of the report and formerly head of the premiers' departments of NSW and Victoria, said the Rudd government would not achieve its goal of improving health services delivery until the department's roles and responsibilities were sorted out.

"There appears to have been a long-standing culture of obfuscation and opposition to major reform from middle-level management," the report says, adding this was also true of state departments.

The department, with about 5000 staff, had become too broad for a single minister to handle effectively, Mr Baxter said. A pared-down policy advisory department would require no more than 250 specialist staff.

The report, funded by the private hospital and health fund body, the Australian Centre for Health Research, was based on interviews with 15 former ministers and health administrators.

Lots more here:

http://www.theaustralian.com.au/news/nation/federal-health-riddled-with-conflict/story-e6frg6nf-1225819422755

Coverage is also found here:

Report: Health Dept hindering reform

15-Jan-2010

The Federal Health Department is rife with conflict of interests and is a serious obstacle to reform, a report by the Australian Centre for Health Research claims.

The report, which was presented to the Prime Minister’s Department this week, recommends that the department should specialise in providing specialist advice, while another department should be created to oversee the delivery of other services such as Medicare, according to an article in the Australian.

"There appears to have been a long-standing culture of obfuscation and opposition to major reform from middle-level management," the Australian quoted the report as saying, adding this was also true of state departments.

More here (registration required):

http://www.australiandoctor.com.au/articles/e4/0c0668e4.asp

It is interesting that this research has been, in part sponsored by Government – and must have been close to one of the last ministerial acts of the now Opposition Leader.

Press Release

Australian Centre for Health Research

17 October 2007

ABB135/07

Subject to successful contractual negotiations, the Commonwealth Government will provide funding of $500,000 to the Australian Centre for Health Research (ACHR) for its work.

Australia has a very good record in medical research. The Government wants health policy research to match our scientific and medical research in reputation and quality.

The ACHR will consider measures that could be taken to improve the delivery of health services and boost the quality of the performance of the health system.

It is headed by a former national president of the ALP, Neil Batt. A former federal Coalition health minister, Michael Wooldridge, is on its research committee.

The grant to the ACHR should help to establish a critical mass of practical heath policy that can subsequently be supported by competitive NHMRC grants.

The ACHR was established in 2005 as a research body that is representative of the entire health sector. It aims to produce independent, quality research to advance the effectiveness of health services in Australia.

The release is here:

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr07-ta-abb135.htm

One really has to wonder that if these findings are indeed accurate then what sort of impact such division and dissention might be having on policy formation in e-Health. It sure can’t be helping.

Ken Baxter is no amateur assessor of bureaucracies and so his comments deserve, prima facie, to be taken quite seriously. It is a pity the report is not yet available from the ACHR website:

http://www.achr.com.au/

Maybe then we could all form our own views on the reported findings.

Heavens knows what impact all this might be having on the broader, and seemingly stuck, health reform agenda.

I look forward to comments from those on the inside of DoHA telling us all how this is just nonsense!

David.

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Australian Centre for Health Research