Submissions to the Senate Enquiry on the Health Identifier Service Are Now On-Line.

The Senate has outdone itself with the prompt posting of the Submissions.

The Submissions are found here:

http://www.aph.gov.au/Senate/committee/clac_ctte/healthcare_identifier/submissions.htm

I am sure more will be added as the closing time is at the end of today (March, 5, 2010)

I note the AMA is also a little worried about implementation issues:

On Page 1 they say:

“Our submission will address the issues the Committee is specifically considering:

• privacy safeguards in the Bill;

• operation of the Healthcare Identifier Service, including access to the identifier; and

• relationship to national e-health agenda and electronic health records

Our comments on these issues largely relate to concerns about implementation, and are not reasons for the Bills not to be passed. We encourage the Committee to consider making recommendations in respect of the practical implementation of healthcare identifiers in the health care setting, to ensure the objectives of the Bills can be met.”

Submission Number 8.

The Law Council is also quite grumpy most of its earlier suggestions have just been ignored!

Enjoy the browse.

David.

Postscript. 8.00 pm

As as the time of this edit there are 39 submissions posted.

The worry is that only a few recognise how badly this may turn out with the quality of implementation from NEHTA / Medicare Aust. we have seen so far.

I would be very alarmed if I was an ordinary citizen!

D.

Weekly Australian Health IT Links - 3-03-2010

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. Note also that full access to some links may require site registration or payment.

General Comment:

The theme for the week has been the implementation issues and how hard it can be. This makes it important that the Senate make sure there is the appropriate management and management controls on the HI Service should the legislation pass.

See the articles towards the end of this week’s post.

I have spent today (March 4) looking at the new Rudd Health System proposals. I have to say one really has to wonder if any of this will actually happen. Right now it looks like this may be an implementation challenge that makes ‘pink bats’ look like a total doddle.

-----

http://www.theaustralian.com.au/australian-it/numbers-change-for-e-health-identifier/story-e6frgakx-1225833152735

Numbers change for e-health identifier

• Karen Dearne
• From: Australian IT
• February 22, 2010 5:52PM

TECHNICAL details released to help software developers incorporate new Healthcare Identifiers into their products suggest an unanticipated shift in messaging protocol from the commonly-used Health Level 7 version 2 to the next-generation standard, HL7 version 3.

The National E-Health Transition Authority yesterday released an advisory on a method of mapping Object Identifiers (OIDs) used in HL7 v3 systems to the federal Government's proposed 16-digit identifiers for individual patients, medical providers and healthcare organisations.

-----

http://www.smh.com.au/opinion/politics/yourhealth-website-posts-complain-of-a-sick-system-20100224-p1a5.html

YourHealth website posts complain of a sick system

MARK METHERELL

February 24, 2010 - 8:29AM

Myles Peterson, the disenchanted former Health Department speechwriter, makes the Government's health reform web site sound like a propaganda spin machine.

It was Peterson who in The Sunday Age charged the department with extravagance and manipulation of its web site — charges which have been denied by the department's spokeswoman.

The Peterson tirade however has brought attention to a little-known development --- YourHealth, the government website established last year to promote debate on a revamp of our health system.

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http://www.computerworld.com.au/article/337325/aehrc_appoints_research_director/

AEHRC appoints research director

e-Health body to develop low-cost, non-invasive diagnostic imaging technologies

• Computerworld Staff (Computerworld)
• 24 February, 2010 12:16

Australian e-Health Research Centre (AEHRC) has appointed Dr Kanagasingam Yogesan as its new research director.

Yogesan, formerly of eye care organisation, the Lions Eye Institute, will lead the organisation to help develop low-cost, non-invasive diagnostic imaging technologies for the early detection of conditions.

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http://www.earthtimes.org/articles/show/isoft-showcases-health-it-solutions,1182051.shtml

iSOFT showcases health IT solutions at HIMSS that enable institutions to address Interoperability and Meaningful Use

Posted : Fri, 26 Feb 2010 18:16:45 GMT

Author : iSOFT Group Limited

Category : Press Release

News Alerts by Email ( click here )

Press Release News | Home

SYDNEY & BOSTON - (Business Wire) iSOFT Group Limited, one of the world’s largest healthcare information technology companies, today announced that it will showcase its suite of innovative solutions that focus on interoperability at the HIMSS health IT conference in Atlanta in the US from March 1-4, 2010.

iSOFT, which last year entered the important US market through its acquisition of Boston-based technology developer BridgeForward Software (re-named iSOFT Integration Systems), will at HIMSS demonstrate its solutions that are designed to address the requirements for ‘Meaningful Use’ under the US Government’s US$34 billion health IT stimulus package.

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http://abnnewswire.net/press/en/62365/iSOFT_Group_Limited_%28ASX:ISF%29_Interview_With_CEO_Mr_Gary_Cohen_Explaining_Various_Impacts_From_The_First_Half_Result.html

iSOFT Group Limited (ASX:ISF) Interview With CEO Mr Gary Cohen Explaining Various Impacts From The First Half Result

Sydney, Feb 26, 2010 (ABN Newswire) - iSOFT Group Limited ("ISF") recently announced underlying NPAT of A$18.0 million for the first half ended December 2009, down 28 percent from the previous corresponding period, on revenue of A$237.3 million, down 14 percent. On a constant currency basis, i.e. translating the previous first half result at the exchange rates applying in the December 2009 half, underlying NPAT was down 9 percent and revenue was down 1 percent. Your latest guidance is for full-year revenue of A$500 million to A$520 million, representing growth of 6 to 10 percent in constant currency terms. Why aren't we seeing the revenue growth of over 10 percent incorporated in your original guidance?

Executive Chairman & CEO, Gary Cohen

We are in a far stronger position than our reported numbers suggest, even though we had some frustrations where tenders had been delayed or didn't happen. Excluding the UK National Program for IT (NPfIT), our backlog - that is, the contracts we've signed where we expect to make revenue in the future - has grown by about 50 percent compared with last year. This shows we're building the business and positioning it for revenue growth longer term. The total backlog, including the NPfIT, was A$634 million at the end of December, up from A$614 million a year earlier.

-----

http://www.european-hospital.com/en/article/6953-iSOFT_achieves_major_milestones_in_the_Netherlands.html

02/24/2010

iSOFT achieves major milestones in the Netherlands

iSOFT has completed the implementation of Lorenzo 3.5 across all surgical departments at St Jansdal Hospital, Netherlands, with the latest release providing tools for patient management, results reporting, requesting and advanced clinical data capture, for 96 nurses and ten surgeons currently.

The company has also completed the roll-out of the GP Viewer portal for GPs in the local community to view patient records as well as laboratory, radiology and pathology reports at the hospital at Harderwijk. Sixty-seven GPs are now connected to the hospital.

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http://www.masshightech.com/stories/2010/02/22/daily48-Visage-Imaging-lands-2M-software-sale-to-Aussie-medical-imager.html

Visage Imaging lands $2M software sale to Aussie medical imager

By Mass High Tech staff

Medical imaging software company Visage Imaging Inc. of Andover has landed a deal worth $2 million to supply its entire suite of software and services to Australian independent imaging provider Southern Radiology.

Visage Imaging is a subsidiary of Pro Medicus Ltd., a medical IT and e-health provider based in Richmond, Australia. The deal includes Visage’s new Visage 7 thin client PACS, a streaming digital imaging solution for delivering X-ray, MRI and CT-scan images to various offices within Southern Radiology’s system.

-----

http://www.theaustralian.com.au/australian-it/rudd-information-chief-to-oversee-data-security/story-e6frgakx-1225834771466

Rudd information chief to oversee data security

• Karen Dearne
• From: Australian IT
• February 26, 2010 1:44PM

THE Rudd government has appointed Commonwealth Ombudsman John McMillan as the inaugural Information Commissioner - despite a Senate inquiry into the role, functions and powers of the proposed Office of the Information Commissioner not being due to report its findings until March 16.

Professor McMillan will head the new OIC, which will incorporate the well-established Office of the federal Privacy Commissioner as well as a new Freedom of Information Commissioner.

The three agencies will between them oversee a soon-to-be revamped Privacy Act and the new FOI laws, shaped to deal with the challenges of information management, security and access in the digital age.

-----

http://www.zdnet.com.au/news/software/soa/NEHTA-systems-laid-bare-to-industry/0,130061733,339301279,00.htm

NEHTA systems laid bare to industry

By Ben Grubb, ZDNet.com.au

24 February 2010 01:16 PM

In response to health industry concerns, the National E-Health Transition Authority (NEHTA) will unveil a model healthcare community where it will show providers and software vendors how its new e-health systems work in practice.

The model community would be based at the Royal Australian College of General Practitioners in South Melbourne, where it would provide practitioners and software vendors with the opportunity to test the soon-to-be-introduced voluntary national healthcare identifier system, according to NEHTA clinical lead Dr Nathan Pinskier. The model healthcare community was being finalised with the college, he said.

Healthcare software vendors had previously complained about the lack of information they had been given about being compatible with the planned healthcare identifiers — individual numbers to be assigned to all Australians.

-----

http://www.himaabranches.com/wp/?p=1948

Fake patients roll in health numbers game

Posted on February 23rd, 2010 by Catherine Obuch

CONTROVERSIAL guidelines that will allow “well-known personalities” to have fake health ID numbers will be written, starting next week.

Every Australian from July will be automatically issued a new 16-digit health number.

Also known as a “building block”, the health number will eventually allow for medical professionals to share patient health files via an electronic health record.

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http://www.theaustralian.com.au/australian-it/malcolm-thatcher-mater-health-services-cio/story-fn51e41l-1225833136639

Malcolm Thatcher - Mater Health Services CIO

• INFLUENCER
• From: The Australian
• February 23, 2010 12:00AM

A smart hospital strategy has made the Mater Health Group a leader in e-health

THE federal government has failed to grasp the potential for health IT to transform healthcare delivery, Malcolm Thatcher says.

"I'm frustrated that e-health is not yet a mainstream agenda item for the government," he says.

"While they're talking about healthcare reform, I'm not sure there's an understanding of the extent to which e-health can be transformational in that reform."

-----

http://www.isoftplc.com/text/home/nm_latest_3507.asp

22 February 2010

iSOFT boosts solutions portfolio with UltraGenda acquisition

iSOFT Group Limited (ASX: ISF) – Australia's largest listed health information technology company – today announced it acquired Belgium-based health IT company UltraGenda BV for as much as A$16 million (€10.7 million) as part of the company’s strategy of boosting its portfolio of innovative solutions and driving additional sales through bolt-on acquisitions.

UltraGenda generated an unaudited pre-tax profit of A$2.6 million on revenue of A$5.3 million for the last fiscal period. iSOFT paid an initial consideration of A$12.4 million for the acquisition, to be followed by two payments of A$1.9 million each in January 2011 and 2012 subject to revenue growth performance targets. The consideration will be paid in cash.

-----

http://nrha.ruralhealth.org.au/e-health/?IntContId=14853&IntCatId=45

E-health - Individual electronic health records

The Alliance is calling for early investment in the adoption of individual electronic health records so that people in rural and remote Australia have access to their own health information when they need it no matter where they live.

To this end it is critical for people and health services in rural and remote Australia to build their e-health capacity using the technologies currently available. This will ensure they are well placed to participate in the sharing of electronic health records as national standards and protocols are adopted and broadband connectivity and applications improve.

Comment: Useful summary of e-Health events in the last 18 months or so.

-----

http://www.computerworld.com.au/article/336953/isoft_picks_north_america_president/?eid=-6787

iSOFT picks North America president

ASX-listed health information technology company appoints two to global roles based in Boston

• CIO Staff (CIO)
• 22 February, 2010 11:45

ASX-listed health information technology company, iSOFT (ASX: ISF), has appointed a new group operations director and North America president.

Former IBM staffer and president of global sales and service at Carestream Health, Mike Jackman, joins iSOFT as its group operations director based out of Boston in the US.

Jackman's role has been newly created and is aimed at boosting the company's offerings across the globe.

-----

http://www.theaustralian.com.au/news/public-servants-wary-of-hospital-takeover-by-commonwealth/story-e6frg6n6-1225833198905

Public servants wary of hospital takeover by commonwealth

• CHIEF POLITICAL CORRESPSONDENT: Matthew Franklin
• From: The Australian
• February 23, 2010 12:00AM

POLITICIANS and public servants are citing the botched roll-out of Kevin Rudd's home insulation scheme as evidence against a commonwealth takeover of public hospitals, a public policy expert said yesterday.

Australia Institute executive director Richard Denniss said the poor delivery of the scheme, scrapped last Friday, underlined the commonwealth's lack of experience and capacity on service delivery.

Dr Denniss said the Department of Environment had dramatically underestimated the difficulty in rolling out $2.45 billion in public subsidies and found itself unable to respond when the scheme went off the rails.

"This is a pretty clear-cut reason why there are plenty of people in the federal government who are deeply worried about the idea of taking over the hospitals," Dr Denniss said.

-----

http://www.smh.com.au/opinion/politics/how-rudd-the-dud-dropped-australia-in-the-alphabet-soup-20100221-ontz.html?rand=1266756351043

How Rudd the dud dropped Australia in the alphabet soup

February 22, 2010

Rarely has a government promised so much, spent so much, said so much, and launched so many nationwide programs, and delivered so little value for money and expectation. Two years of Kevin Rudd has produced 20 years of debt, and most of it cannot be blamed on the global financial crisis. This alphabet soup is self-inflicted.

Asylum seekers. Unless the government can show otherwise, it appears that about 98 per cent of asylum-seekers are getting Australian residency. In contrast, the latest figures from the United Nations refugee agency show most asylum applications worldwide are rejected. The bulging Christmas Island detention centre has become a grossly expensive sham and a mockery of a core election promise.

Comment: A scary and rather exaggerated list but shows just how bad implementation of some programs have been. The implications for Health and e-Health programs is pretty obvious.

-----

http://www.theaustralian.com.au/politics/labor-split-as-kate-lundy-proposes-opt-out-to-conroy-isp-filter/story-e6frgczf-1225833745627

Labor split as Kate Lundy proposes 'opt out' to Conroy ISP filter

• Joe Kelly
• From: The Australian
• February 24, 2010 9:48AM

A SPLIT has emerged in Labor ranks over Communications Minister Stephen Conroy's filter plan to limit internet porn after a backbencher confirmed she would seek to amend the legislation.

Labor Senator Kate Lundy plans to propose a filter “opt out” when the legislation goes before caucus.

“I think there's a lot of interest in my proposal,” she told The Australian.

-----

http://www.smh.com.au/technology/technology-news/opposition-grows-to-internet-filter-20100224-p3ma.html

Opposition grows to internet filter

ARI SHARP COMMUNICATIONS CORRESPONDENT

February 25, 2010

BACKBENCH MPs on both sides of politics opposed to the government's internet filtering proposal are vigorously lobbying their colleagues, creating a potential roadblock to the plan backed by the Communications Minister, Stephen Conroy.

A group of four young Liberal MPs - Simon Birmingham, Alex Hawke, Michael Johnson and Jamie Briggs - are leading the charge against the filter within the Coalition, while the Labor senator Kate Lundy is putting a case to her colleagues in favour of an optional filter.

-----

http://www.computerworld.com.au/article/337062/google_chrome_chips_away_microsoft_ie/?eid=-6787

Google Chrome chips away at Microsoft IE

Market share statistics show Microsoft IE losing ground to Google Chrome, but Windows 7 gains market acceptance

• Denise Dubie (Network World)
• 23 February, 2010 05:54

Recent market share statistics deliver good and bad news for Microsoft. The company saw its Internet Explorer browser lose more ground, seemingly to Google Desktop and Chrome, while its Windows 7 operating system quickly gained market acceptance.

"The last six months have been a mixed bag for Microsoft," said Victor Janulaitis, CEO of Janco Associates, in a press statement. The research firm points out in its February 2010 Browser and Operating System Market Share Study that Microsoft IE market share has dipped by more than 12% since February 2007, mostly due to interest in competitive offerings from Firefox and Google.

-----

Enjoy!

David.

A Sudden Out Break of Commonsense at NEHTA! A Bit Late I Reckon.

The following appeared a few days ago.

Peter Fleming- National E Health Transition Authority CEO

• INFLUENCER
• From: The Australian
• February 23, 2010 12:00AM

MEDICAL providers should receive some incentives to pick up and use the planned national healthcare identifier program to compensate for costs and drive new ways of providing healthcare, Peter Fleming says.

"It's important that we take a holistic perspective around the change process," he says. "One of the issues in the past, and it's not unique to health, is that we tend to implement IT systems but don't derive the full benefits.

"Technology is the tip of the iceberg here, and we need to look more broadly at how processes could and should be adopted to ultimately lead to far more collaborative forms of medicine."

Fleming says a case for financial incentives to encourage primary care use of national health identity numbers has been put to Nehta's board.

Meanwhile, a mobile version of the "model health community" built by Nehta and health identifier operator Medicare Australia will soon take to the road, "so people around the country can get a feel for it".

Fleming says Medicare completed testing of the HI system in a pre-production environment before Christmas.

The system was initially loaded with 98 per cent of the population's details obtained from the Medicare and Veterans Affairs customer registries. "Release two of that environment takes care of automation of some back-office functionality for Medicare and puts in place the capacity to capture information from the other

2 per cent of the population," he says.

"That will be finished and tested by the end of March.

"Release three will take feeds from the National Registration and Accreditation Scheme.

"This work is on track, and medical providers' information will be available to us by June."

More good news here:

http://www.theaustralian.com.au/australian-it/peter-flemming-national-e-health-transistion-authority-ceo/story-fn51e41l-1225833146016

As readers will know we have just run a poll on this. And the view is that the HI Service is a ‘dead duck’ without something of this sort!

See here:

http://aushealthit.blogspot.com/2010/03/aushealthit-man-poll-number-10-results.html

On the other points raised in the interview we must be all very pleased that everything is going so well. It sounds as though it is all ‘tickety-boo”!

All will become clear in the next few months I am sure – especially with the release of the e-Health component of the National Health Reform Plan some time before the COAG meeting on April 11 (+/- 1 day).

I wonder what the chance of the plan having some incentive funding to help NEHTA is? One also wonders if more money is to be applied, just how appropriate NEHTA remains to administer such a program.

I am certainly hopeful we will see a changed governance and leadership framework out of the e-Health announcement.

David.

AusHealthIT Man Poll Number 10 – Results - 02 March, 2010

The question was:

Will Clinicians and Their Staff Absorb the Time, Cost and Effort Required to Implement and Maintain the HI Service?

Absolutely

- 4 (8%)

Probably

- 6 (12%)

Not Sure

- 4 (8%)

Probably Not

- 19 (38%)

Not In This Life

- 16 (32%)

Votes 49

Comment:

Looks like about 70% say the project is doomed unless the issues around adoption are swiftly adopted! Pity no action was taken in this area advance! It seems unlikely that without serious incentives much will happen.

Thanks again to all who voted.

David.

At A Quick Look At The New Rudd Health Plan - We Need a Great Deal More Detail.

I have now had enough time to read through the new Health Plan.

All the details on what the Government is saying can be found here:

http://aushealthit.blogspot.com/2010/03/brave-new-health-system-for-australia.html

The major issues I see are (other than that it is clear they have not worked out what to do about e-Health yet) are as follows.

1. The planned public hospital networks, as discussed in the plan, seem to be too small to be really efficient or as clinically effective as one might hope.

2. The GP, Specialist interface does not seem to have been really addressed.

3. Activity Based Costing is quite complex and I doubt it can be implemented in the time-frames mentioned in the document.

However the biggie to me is the notional takeover of all GPs and Primary care. The gap in information on this really worries me. I wonder how the GPs feel about this and what it will mean for them?

This is a huge plan and we surely need a great deal more detail to understand how this is all meant to work.

After watching the 7:30 report this evening on ABC 1, is it also clear that until we see all the plans, it is essentially impossible to know where all the parts fit, and if the whole thing makes any sense. Hold the phone till then!

I have to say that this partially formed rather hospital centric, e-Health sparse plan, does not fill one with a great deal of confidence.

Again I fear the role of e-Health as an enabler of improvement and reform has not been properly incorporated into the plans we see.

David.

A Guest Blog From Dr. Geoffery Miller on the Health Identifiers.

Beginning in 1980, I worked as an IT professional for over 20 years: programmer, systems analyst, technical writer, systems designer, business analyst and IT manager, working for government, academic and commercial organisations. For more than half of that 20-year period I worked on database applications. In 2002 I joined the Department of Health and Ageing (DoHA) to work on the Better Medication Management System (subsequently known as MediConnect) and worked on e-health projects within and outside DoHA for about 6 years between 2002 and 2009.

To the extent that I did contribute, formally or informally, to development of a health identifier policy, my advice was consistently that the only practical solution is a single, national system. I believe it is imperative that each individual participating in the system, consumer and provider, has one and only one unique identifier.

The main technical objection to such a scheme appears to come from the people who believe it is unnecessary and that probabilistic data matching on existing data is sufficient. Their experience is obviously different from mine. I have worked on establishing a database that relied on probabilistic data matching (1^st AIF records), and while perhaps 98% or more of the records from different source files could be unambiguously identified and matched, a small percentage required further research and some of those ultimately required guesswork or had to be marked as unidentified.

The very term “probabilistic” implies a degree of uncertainty. That uncertainty could lead to non-identification or, perhaps worse, misidentification of health records, with potentially fatal consequences. As analyst or designer I would consider it unprofessional to advocate a system that does not use the best possible approach to minimise this risk, and that best possible approach is a single, national identification system.

Some of the objections to the concept of a national health identification scheme come from those who apparently value privacy – their own and that of others – above all other considerations. Let me pose a question to those objectors – do you believe that better communication and access to health records has the potential to improve healthcare, particularly for people with complex and/or chronic conditions? If so, are you prepared to deny those people the opportunity to have improved healthcare because of your own obsession with privacy?

However, while I firmly believe that the only technical solution is a single, national identification scheme, there is much room for debate about how this should operate.

Should Medicare Australia assign identifiers to providers? Yes, they have many of them in their system anyway. The only reservation I have about the role of Medicare Australia in assigning individual (i.e. consumer) identifiers is that uptake of the individual healthcare identifier might be limited by a public perception that health data will be used to cross-check claims data. Tempting though this would no doubt be to some within Medicare Australia, there must be an absolute separation between the two. I am confident that Medicare Australia could handle this separation – my concern is with the public perception and its impact on uptake.

Do we need to have a big-bang approach to assigning identifiers to healthcare consumers? I do not believe so. My preferred approach would be to make it easy for anyone to apply for an identifier – I once suggested, not totally facetiously, that the commercial rewards cards could be used as a model, with individuals picking up a pre-numbered card from GP, pharmacist, hospital, clinic, etc. and activating it with their details. For children, I would propose assigning identifiers at birth (and in some cases healthcare needs might make such assignment desirable before birth).

I see no need for a proof-of-identity process beyond perhaps a driver's licence or similar to confirm spelling of name and address. The healthcare identifier serves no purpose beyond ensuring that your health records are linked to you and only you.

This opt-in approach also addresses the concerns of those who see the healthcare identifier as back-door approach to an Australia Card, because it makes participation clearly optional (except for the aforementioned newborns, of course). Those who see the system as a threat to their privacy need not participate, but they make this choice in the knowledge that their healthcare providers may, in an emergency, be unable to access their records.

People with complex or chronic conditions are the most obvious beneficiaries from improved accuracy and availability of their medical records, and this should be the group initially targeted to get them to sign up. Does it matter if people who are currently healthy do not sign up yet? Probably not.

It could be argued that the low-impact, opt-in model for registration poses a risk to data quality. I believe the reverse is the case, for two reasons:

• there is no data source of guaranteed, 100% accuracy for the big-bang model
• people who provide their own data take responsibility for the quality of those data and are made aware of the need to keep them current rather than relying on some unseen, big-brother system to take care of it for them.

At a technical level, incremental growth of a system presents a lower risk than the big-bang model when the inevitable problems occur.

Finally, do we need legislation to define the structure and modus operandi of the identification scheme before there is a practical use for the identifiers? The Medical Software Industry Association might be best placed to comment on this, but as a (former) software developer, I would answer yes. I would need to know what information my software will need to process so I can ensure that the capability is there when people want to use it. Enshrining this specification in legislation would at least provide developers with a solid basis for their work.

Geoffrey Miller

B.Sc., M.Sc., Ph.D., Dip. TCMRM

David's Comment:

I can only agree with all the comments on implementation pace, risk, consent adoption and so on as I have been making similar points. Geoff does not comment on is just how trustworthy he sees the Medicare Databases are, and this, for me, impacts on the choice of source of identifier chosen, I have to say the current plan deeply concerns me.

Thanks for providing another view Geoff.

David.

A Brave New Health System for Australia Announced. E-Health Details to Follow!

The Media Release says the following

A National Health and Hospitals Network for Australia’s Future

Joint Release

Prime Minister

Treasurer

Minister for Health and Ageing

3 March 2010

The Rudd Government today announced major structural reforms to Australia’s health and hospital system.

The Government will deliver better health services and better hospitals by establishing a National Health and Hospitals Network.

This new national network will be funded nationally and run locally.

These reforms represent the biggest changes to Australia’s health and hospital system since the introduction of Medicare, and one of the most significant reforms to the federation in its history.

• A National Network: to bring together eight disparate State run systems with one set of tough national standards to drive and deliver better hospital services.
• Funded nationally: by taking the dominant funding role in the entire public hospital system the Australian Government will end the blame game, eliminate waste and shoulder the burden of funding to meet rapidly rising health costs.
• Run locally: through Local Hospital Networks bringing together small groups of hospitals, where local professionals with local knowledge are given the necessary powers to deliver hospital services to their community.

The Commonwealth will achieve these changes through the following actions:

• Taking 60 per cent of funding responsibility for public hospitals by investing one third of GST revenue – currently paid to the states and territories – directly in health and hospitals;
• Taking over responsibility for all GP and primary health care services;
• Establishing Local Hospital Networks run by health and financial professionals to be responsible for running their local hospitals, rather than central bureaucracies;
• Paying Local Hospital Networks directly for each hospital service they deliver, rather than just handing over block funding grants to the states; and
• Bringing fragmented health and hospital services together under a single National Health and Hospitals Network, through strong transparent national reporting.

These reforms will be put to the states and territories at the COAG meeting to be held in Canberra on 11 April.

If the states and territories will not agree to these reforms, we will take this reform plan to the people at the next election – along with a referendum by or at that same election to give the Australian Government all the power it needs to reform the health system.

The new National Health and Hospitals Network will end blame shifting and cost shifting, and provide national leadership on health and hospitals with increased local control.

Sweeping changes to the way hospitals are funded and run will also lead to less waste and duplication and a health system which is sustainable into the future.

On the basis of these reforms, over the coming weeks and months, the Government will announce critical additional investments to:

• train more doctors and nurses;
• increase the availability of hospital beds;
• improve GP services; and
• introduce personally-controlled electronic health records.

The establishment of the National Health and Hospitals Network builds on record investments in health and hospitals made by the Rudd Government over the last two years.

The Release is found here:

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr10-nr-nr038.htm

The full announcement page is here:

http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/content/home

You can download the 2.2 Megabyte Report from here:

http://www.health.gov.au/internet/main/publishing.nsf/Content/nhhn-report/$FILE/NHHN%20-%20Full%20report.pdf

There are a huge number of questions and details around all this. One point is pretty clear however. They are still talking about “personally-controlled electronic health records”.

I wonder do they have a clue what they are talking about. I certainly do not.

More comment later I suspect.

David

Parliament Publishes a Digest on the Health Identifiers Bill.

The following seems to have been developed before and published on the 24^th February, 2010.

It can be reviewed from this link.

http://www.aph.gov.au/Library/pubs/bd/2009-10/10bd116.pdf

This is a very useful summary of discussions to the date of release. Well worth a download!

Sadly there does not seem to be any discussion of the risks poor implementation by Medicare and NEHTA poses to the overall direction and the recent revelations regarding the behaviour of Medicare Australia were not of course discussed.

See here for all that.

http://aushealthit.blogspot.com/2010/03/would-you-trust-these-people-to-manage.html

We are having an exciting time indeed!

David.