Kaiser Permanente Health IT - Here is a Good Discussion on A World Leader!

The following appeared a few days ago.

Electronic records keep pulse of patients

Kaiser system gives glimpse of future

Jim Steinberg, Staff Writer

Posted: 08/07/2010 07:10:48 AM PDT

The quest to put medical records on computers are a national priority set by President Barack Obama before he took office.

"This will cut waste, eliminate red tape and reduce the need to repeat expensive medical tests," then President-elect Obama said in early January 2009.

"...It will save lives by reducing the deadly but preventable medical errors that pervade our health care system," Obama said.

Late last month, the U.S. Department of Health and Human Services issued rules for hospitals and physicians to receive financial incentives to promote their use of electronic medical records.

Starting in 2015, there will be penalties for failure to meet the government's 19 guidelines for "meaningful use" of electronic health records.

Although 2015 may not mark the year emergency room teams in any Maine hospital will have access to the health records of a vacationing Southern Californian, "we will be a lot further along than we are now," said Dylan H. Roby, a research scientist with the UCLA Center for Health Policy Research.

Hospitals and doctors across much of Los Angeles County are beginning to exchange health information records in a pilot health information exchange program that is being echoed with similar ventures in various stages across the country.

While some facilities have had a great deal of information on computers for years, others are preparing to dive into the process.

Most health care providers will choose among more than six vendors for off-the-shelf software which they will then customize.

"We have narrowed it down to two software vendors and will make a decision very soon," said Dr. Rafael Amaro, medical director of Long Beach-based Molina Healthcare Group, which has 20 health care centers nationwide targeting the ethnically diverse low-income population.

Molina's Southern California locations include Ontario, Fontana and San Bernardino, Pomona and Long Beach.

Mark Amey, chief information officer of the University of Southern California's health units, said that from the perspective of "change of work flow and process," the computerization medical records is the largest project ever undertaken in the healthcare realm.

Once medical records go on the computer, the patient can be brought aboard the medical team in a way not possible previously.

Better compliance with medical instructions and a happier, healthier patient are the hoped for results.

Among the government's "meaningful use" criteria are provisions for the establishment of e-mail communication between doctor and patient.

Oakland-based Kaiser Permanente is generally recognized as a global leader in its use of electronic medical records and related technologies, including e-mail.

Although one might think patient to doctor e-mail might expose busy physicians to a barrage of questions, symptom updates and lengthy prattles from hypochondriac patients, that overall has not been the experience.

A Kaiser Permanente study found that 75 percent of all patient-physician e-mail encounters addressed ongoing medical problems or care plans.

Leading reasons patients contact physicians are to discuss changes in a health condition, lab test results, a new condition, drug dosage adjustments and the need for a new condition.

In a research project published in the July issue of "Health Affairs," a leading health policy journal, Kaiser Permanente's Southern California region showed e-mail messaging improves the effectiveness of care for patients with diabetes, high blood pressure or both.

The study, involving 35,423 patients, showed 2 percentage-points to 6.5 percentage-points improvements in glycemic, cholesterol and blood pressure screening and control.

"Putting patients and their data at the center of care, quality, access and cost," George Halvorson, Kaiser Permanente chairman and CEO, said in a statement.

"This data proves that health IT (information technology) can be a fundamental component of accomplishing those three critical goals," Halvorson said.

"I call it a revolution," says Kaiser Permanente patient Dan Bozick.

"I take a blood test in the morning and get results on the computer in the afternoon," the Redlands resident said.

"I like it (My Health Manager) because it gives us numbers," said Grace Wong of Hacienda Heights.

Test results give specifics and show normal ranges for those tests so patients can know their system is out of whack.

In cases where results are outside normal ranges, patients can query their doctor to find out if this change warrants a visit, a change in medications or just watching for the next test.

After a trip to the doctor, a summary of the visit will be in their hand at departure and on My Health Manager, for later view after the paper has long ago disappeared.

Something in the details a little fuzzy?

Just fire off an e-mail, Wong said.

Rusty Spencer, of West Covina, lost the use of his legs following a motorcycle accident and has since been plagued by frequent urinary tract infections.

He and his wife use a home test kit and frequent e-mails to their doctor to nip those infections earlier with antibiotics before it progresses into a life-threatening situation.

"I've reduced my emergency room trips 90 percent," he said.

.....

BENEFITS OF HEALTH CONNECT

Paperless

Increased and speedy access to patient history and information. The network is most efficient by region, but a national network is in progress.

Improves patient compliance and overall health outcomes.

Gives Kaiser Permanente medical professionals faster access to new information, i.e., medication alerts and clinical libraries.

Provides Kaiser Permanente medical professionals a trusted network of information as all content is verified by the network's own physicians.

SECURITY MEASURES

Functions are limited to what information/access the user needs to perform their specific job. Different levels of access based on level of employee.

Security level designations approved by manager and reviewed quarterly.

Every action leaves an electronic footprint, so questionable access/action can be traced back.

"Break the glass" function: Puts an automatic alert on certain patient records that asks the person seeking access "Do you really need to know?" (Example use: If someone famous is being treated at a particular hospital, this function prevents staff from attempting to snoop the patient's information on any level.) If the "glass" is broken, and the employee didn't have a legitimate reason for doing so, it is a fireable offense.

Lots more here:

http://www.sbsun.com/news/ci_15704319

Here is a little on what the patients think.

Kaiser Permanente notes gains in members online care management

By IFAwebnews Staff

Posted: August 11, 2010

Health insurer Kaiser Permanente says its members are embracing online communication methods in their medical care.

The company, reporting on its second-quarter earnings, said it has invested in developing the world’s largest private electronic health record system, Kaiser Permanente HealthConnect, which is now in use across Kaiser Permanente. The company operates in nine states and Washington, D.C.

Kaiser Permanente care teams routinely document patient care with an electronic chart in both inpatient and outpatient settings, according to the company.

For the first six months of 2010, members have exchanged 5.3 million emails with their Kaiser Permanente doctors and refilled 4 million prescriptions online. In addition, 12.7 million lab results have been delivered online in the first six months of the year.

More here:

http://ifawebnews.com/2010/08/11/kaiser-permanente-notes-gains-in-members-online-care-management/

And for proof it all seems to work (one of many papers)

Study: Doctor, patient e-mailing improves patient outcomes

August 10, 2010 | Molly Merrill, Associate Editor

OAKLAND, CA – E-mail use between patients with diabetes and hypertension and their doctors resulted in improved quality of care scores, according to a study of patients in Kaiser Permanente's Southern California region.

The study, which was published in the July issue of Health Affairs, observed 35,423 patients with diabetes, hypertension, or both. Researchers found that the use of secure patient-physician messaging in any two-month period was associated with statistically significant improvements in HEDIS (Healthcare Effectiveness Data and Information Set) care measurements. Results included 2 to 6.5 percentage point improvements in glycemic, cholesterol and blood pressure screening and control.

"Putting patients and their data at the center of care allows Kaiser Permanente to improve health care quality, access and cost," said George Halvorson, chairman and CEO, Kaiser Permanente. "This data proves that health IT can be a fundamental component of accomplishing those three critical goals."

More here:

http://www.healthcareitnews.com/news/study-doctor-patient-e-mailing-improves-patient-outcomes-0

If you want more here might help:

http://www.healthdatamanagement.com/web_seminars/-40802-1.html

My Health Manager: The Story Behind Kaiser Permanente's Powerful PHR

Web Seminar Center, September 2, 2010, 11:00AM ET

As a trailblazer in Health IT, Kaiser Permanente continues to set standards with its personal health record initiative to engage patients online with Kaiser Permanente health teams to manage their health and wellbeing.

Anna-Lisa Silvestre, Kaiser Permanente’s vice president of online services, has developed and overseen the strategy for My Health Manager on kp.org. The patient portal now has more than 3 million patients registered to access their PHRs, e-mail physicians and participate in health behavior programs.

This is really important in my view – as it shows what leadership and preparedness to actually invest can achieve.

You can assess what is on offer from our leaders after reading this. Remember the 8 million members of KP are not waiting a further decade this is fully implemented and operational today!

David.

Another Brick in the Wall - More Evidence Provider Systems Save Lives.

Another valuable publication on E-Health Benefits.

Computerized System Can Reduce Inappropriate Medication in Hospitalized Seniors

Fran Lowry

August 9, 2010 — A computerized provider order entry (CPOE) system that uses alerts to warn when the wrong medication has been prescribed can reduce the prescription of potentially inappropriate medications (PIMs) in hospitalized older patients, according to the results of a new prospective study published in the August 9/23 issue of the Archives of Internal Medicine.

"Older people admitted to the hospital are especially vulnerable to adverse drug events (ADEs), which occur in up to 40% of hospital admissions," write Melissa L.P. Mattison, MD, from Beth Israel Deaconess Medical Center, Boston, Massachusetts, and colleagues. "Some medications may predispose vulnerable older patients to ADEs." Based on the consensus of a panel of geriatric medicine experts, a proposed list was made up of drugs were identified as medications that should be avoided in older persons. Despite the publication of this list, known as "Beers medications," "the prescription of [PIMs] to elderly patients remains common," the authors explain.

The aim of this study was to determine whether a computerized provider order entry drug warning system could decrease the number of orders for PIMs in such a population.

The authors used a prospective before-and-after design among patients aged 65 years or older admitted to their medical center from June 1, 2004, through November 29, 2004 — before the addition of the warning system — and from March 17, 2005, through August 30, 2008 — after the warning system was added.

The investigators studied the ordering patterns for 3 groups of drugs: a larger group of drugs included those on the original Beers medications list that were flagged as not to be used, a second group of Beers medications that were flagged to be used at reduced doses, and a third group of Beers medications that were not flagged.

After the warning system was deployed, there was an immediate and sustained decrease in the rate of orders for the medications that were flagged not to be used, the authors report. The mean (SE) rate of prescribing not-recommended medications dropped from 11.56 (0.36) to 9.94 (0.12) orders per day (difference, 1.62 [SE, 0.33] orders per day; P < .001). There was no evidence that this effect waned over time, the authors write.

More here (Registration Required):

http://www.medscape.com/viewarticle/726621

Again good news regarding the impact quality systems, in the hands of providers, can make to overall patient care.

As far as I know no such similar evidence exists for the Personally Controlled EHR or similar PHRs. If you know of such evidence let me know!

Well worth chasing down the original reference for the a read and the files.

David.

An Opportunity to Have Your Say! The Australian Provides A Platform For Questions for 3pm Tomorrow – August 19, 2010.

This just arrived.

Live Q&A with Nicola Roxon

• Fran Foo
• From: Australian IT
• August 18, 2010 4:40PM

FEDERAL Health Minister Nicola Roxon has been driving Labor's e-health agenda as part of the government's wider health reform ambitions.

In December 2006, the Labor member for Gellibrand became opposition health spokeswoman and retained the portfolio when Labor won office in 2007.

She's backing a personally controlled e-health records framework expected to come to fruition by 2012 at a cost of $467 million.

Ms Roxon will take e-health questions from readers of The Australian on August 19 from 3pm (AEST) in a live Q&A session.

-----

Be there or be square!

Follow this link:

http://www.theaustralian.com.au/australian-it/government/live-qa-with-nicola-roxon/story-fn4htb9o-1225906946463

David.

Some Missing Components in Australian E-Health Governance Reviewed But Others Are Also Needed.

The following report was announced a few days ago.

Accenture Finds Information Governance Framework Needed to Guide E-Health Investments and Strategy

RESTON, Va., Aug 12, 2010 (BUSINESS WIRE) -- According to a new report from Accenture, healthcare organizations planning large investments in e-health solutions face challenges in five interrelated disciplines of information governance -- data privacy, confidentiality, security, quality and integrity.

The report, Information Governance: The Foundation for Effective e-Health, details and explores specific targets for the five disciplines and provides an actionable framework that healthcare organizations, such as care providers, insurers, and public health organizations can use to perform a high-level assessment of their current information management situation, challenges and opportunities. The objective is to ensure investments in e-health are supporting strategic goals of increasing efficiency and reducing costs, reducing errors, and improving patient outcomes. The target areas for evaluation explained in the report are:

Data Privacy

-- Patient consent models and mechanisms

-- Patient-provider relationship-based access controls

-- Patient access controls

-- Effective data security and data handling policies

Data Confidentiality

-- Role-based access control models

-- Patient and provider record sealing

-- Identification and authentication

-- Anonymization and pseudonymization

Data Security

-- Message integrity and communications security

-- Event audit and alerting

-- IT security audit

-- Network integrity

Data Quality

-- Error correction

-- Data validation

-- System and interface certification

-- Standards-driven architecture

Data Integrity

-- Code integrity

-- System hardening

-- Interoperability governance

-- Standards-driven architecture and standards management

The new report draws heavily on Accenture's experience supporting health care organizations' efforts to transform administrative and clinical systems, capture and manage data, develop evidence-based insights, and connect fragmented health care systems.

"Health care organizations are making unprecedented investments in e-health systems, and this new framework speaks to the practical but rather complex implementation challenge, namely to ensure the investments are successful," said Mark Knickrehm, global managing director of Accenture's health care practice. "From working on e-health implementations around the world, we have built and are sharing this framework to help organizations address data privacy concerns, ensure compliance with standards and regulations, maximize the value of electronic health record systems, and support physician adoption."

About Accenture

Accenture is a global management consulting, technology services and outsourcing company, with more than 190,000 people serving clients in more than 120 countries. Combining unparalleled experience, comprehensive capabilities across all industries and business functions, and extensive research on the world's most successful companies, Accenture collaborates with clients to help them become high-performance businesses and governments. The company generated net revenues of US$21.58 billion for the fiscal year ended Aug. 31, 2009. Its home page is www.accenture.com.

SOURCE: Accenture

The release is found here:

http://www.marketwatch.com/story/accenture-finds-information-governance-framework-needed-to-guide-e-health-investments-and-strategy-2010-08-12?reflink=MW_news_stmp

The full report is downloadable from here:

http://www.accenture.com/NR/rdonlyres/E4CE4D61-5C50-475F-9BC8-3185402AA7A8/0/Accenture_100473_InfoGovPoV_Final.pdf

This seems to me to be a very useful document that provides a good way of thinking about a range of critically important issues. Within its scope the report provides a very useful framework to consider the matters included.

What is missing in the document – and what I see as equally important for a successful implementation of e-Health – is a clear statement of the importance of parallel organisational governance and leadership. I have to say that as far as Australia is concerned we have serious gaps in both areas and hence I think this document is makes a valuable contribution.

Well worth a download!

David.

And Just Where Will Reliable Information Come From For This?

The present Government has announced it is establishing a web site to provide comparative information on Australia’s hospitals.

Here is the original announcement.

Myhospitals Website

17 July 2010

For the first time all Australians will soon be able to view important data about their public hospitals thanks to a new website being developed as part of the Government’s ambitious health reform agenda.

The MyHospitals website will provide clear, comparable and user-friendly information about all Australian public hospitals in all states and territories, except Western Australia.

People will be able to find, at the click of a mouse, the latest data on their local hospital. MyHospitals will show how that hospital performed compared to national average waiting times for elective surgery and emergency department care, list the medical services provided, bed numbers and if outpatient services, such as allied health and dental services, are provided.

Once operational, all Australians will see – for the first time and from the one source – which hospitals throughout Australia are performing well, and which hospitals may need more targeted assistance to help lift their performance.

Holidaymakers will be able to check whether a hospital at their destination offers accident and emergency services, and expectant mums in Sydney can check whether their nearest hospital has an obstetrics and maternity unit.

Similarly, people in Launceston will be able to see how their local hospital compares against the national average waiting times for a range of elective surgery procedures, while residents in Adelaide will be able to see how many beds are provided in Queen Elizabeth Hospital.

The website is being developed by the Australian Institute of Health and Welfare using the latest nationally comparable data from 2008-09. As a result of the COAG agreement in April this data has been provided with the agreement and support of every State and Territory government except Western Australia. The site will be ready in August.

Measuring and publicly reporting on the accessibility, performance, quality and safety of our hospitals is a key component of our health reform plans.

Full release here:

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr10-nr-nr150.htm

A day or so ago we learnt a little more.

Labor spends $2m on MyHospitals website

• Karen Dearne
• From: Australian IT
• August 12, 2010 12:00AM

HEALTH Minister Nicola Roxon has spent $1.9 million on creating the "MyHospitals" website.

MyHospitals is a twin to the provocative schools comparison website MySchool launched by Julia Gillard in January.

Ms Roxon said the website - myhospitals.gov.au -would be ready this month.

The Australian Institute of Health and Welfare is building the website under a one-year contract to the Health Department, which includes site support until June 30 next year.

The AIHW has also been given $1.5m to boost its data management, analysis and reporting capabilities over the next two years.

Ms Roxon said the website would provide comparable, user-friendly information about all public hospitals nationwide - apart from Western Australia. The states agreed to provide their hospital data as part of the Council of Australian Governments' deal on health funding.

"Once operational, all Australians will - for the first time and from the one source - which hospitals are performing well, and which may need more targeted assistance to help lift their performance," she said when announcing MyHospitals last month.

There are plans to include private hospital data and reports for individual hospitals against a range of safety and quality measures.

See the full details.

http://www.theaustralian.com.au/australian-it/government/labor-spends-2m-on-myhospitals-website/story-fn4htb9o-1225904080312

Playfully the Croaky blog then had a huge range of experts say what content was needed.

What should the new MyHospitals website tell us?

July 23, 2010 – 10:48 am, by Croakey

From next month, Australians will be able to search a MyHospitals website to find out information about public hospitals, according to recent statements from Health Minister Nicola Roxon and the Australian Institute of Health and Welfare.

Roxon says we will learn how any hospital performed compared to national average waiting times for elective surgery and emergency department care, and that the website will also list the medical services provided, bed numbers and if there are outpatient services, such as allied health and dental services. The range of information available on MyHospitals will continue to be developed in the future, including providing data on private hospitals and reporting data for each hospital against a range of safety and quality measures.

What else could the website include? This is a list of discussion-starters that I suggested, and keep reading below to see a wealth of other ideas from Croakey contributors:

• how healthy is the food provided to patients and available for visitors/staff etc

• how effectively the hospital engages with Indigenous patients and communities

• the demographics of patients compared with demographics of population need (to determine relative servicing of SES groups)

• how many staff smoke, drink to risky levels, are physically active (to determine the reach and effectiveness of health promotion programs for staff)

• the range and impact of efforts to improve local population’s health

• the support available to patients from rural or remote areas

• patients’ access to parking and its cost

• what proportion of the hospital’s funding is spent on administration, clinical service delivery, population health programs, research, teaching?

And here are stacks more suggestions from Croakey contributors…

There are all a huge number of suggestions here:

http://blogs.crikey.com.au/croakey/2010/07/23/what-should-the-new-myhospitals-website-tell-us/

In case you think this is forward looking – note this recent report.

DH reviews Dr Foster Intelligence

10 Aug 2010

The future of Dr Foster Intelligence, the UK’s best known provider of hospital performance information and analysis, is under review by KPMG on behalf of the Department of Health and Dr Foster Holdings LLP.

Dr Foster Intelligence is best known for its annual hospital guides, providing league tables of hospital performance data.

DFI was launched as a joint venture between Dr Foster and the NHS Information Centre in 2006. On 9 July the IC transferred its shareholding to the DH.

The review will explore strategic options for the future of DFI in line with government’s stated objective to create an open market in health performance and outcomes data.

This was a key aim of the recent white paper 'Equity and Excellence: Liberating the NHS', which stated the government’s commitment to an NHS "information revolution", providing patients with quality information and data on all aspects of healthcare.

Lots more here:

http://www.e-health-insider.com/news/6149/dh_reviews_dr_foster_intelligence

Of course the critical thing here will be whether useful, reliable and comparable data can be found and made available in a timely manner.

The key providers of the basic information, it seems, will be the Australian Institute of Health and Welfare (AIHW).

See here for their site.

http://www.aihw.gov.au/

There is no doubt that AIHW does a great job in collecting a very useful range of statistics and indicators and their two flagship publications are highly credible and carefully put together pieces of work.

See here:

http://www.aihw.gov.au/publications/index.cfm/title/11374

And here:

http://www.aihw.gov.au/publications/index.cfm/title/10872

However there is a serious ‘fly in the ointment’ in all this. This blog explores the issue and reminds one of the key issue:

http://aushealthit.blogspot.com/2010/04/just-watch-bureaucrats-game-this-system.html

Bottom line, as soon as you make comparable data available there will be winners and losers and the losers will have a strong incentive to ‘game the system’.

The only way a genuinely credible system can be created is when the activity and similar statistics are collected automatically from operational systems that are used to deliver care.

I think we are all aware we are a day or so away from that being a reality!

One can only wish the AIHW luck in this endeavour. It is interesting that the proposed new National Performance Authority which was planned to measure all this information does not seem to be mentioned in the press release. I wonder why that would be?

David.

AusHealthIT Poll Number 31 – Results – 16 August, 2010.

The question was:

How Confident Are You NEHTA and DoHA will Deliver a Successful PC EHR?

Extremely

- 6 (13%)

Moderately

- 6 (13%)

Neutral

- 3 (6%)

Not Really Sure

- 6 (13%)

Not A Snowflakes Chance in Hell

- 24 (53%)

Votes 45

I think it is fair to say there is a degree of scepticism out there about all this!

Again, many thanks to all those who voted!

David.

E-Health Features at the Labor Party Campaign Election Launch – Sort Of!

Prime Minister Gillard focussed on E-Health at the Labor Party Campaign Launch today, as reported a few hours ago on the blog.

Coverage has now appeared here:

Gillard stakes political future on broadband and health at Labor launch

• Patricia Karvelas, Political Correspondent
• From: The Australian
• August 16, 2010 12:45PM

JULIA Gillard has vowed to transform the health system by allowing rural and regional Australians to see specialists using videoconferencing and online consultations.

Linking her national broadband network to the health of Australians, the Prime Minister said that from July 1 2012 Australians would have access to rebates to see doctors through the internet as part of a $392.3 million investment.

Ms Gillard said in the middle of the night a parent with a child with swelling or rash would be able to get help through the power of broadband access to the internet.

She said Tony Abbott would let children down, while Labor would complete the education revolution for every child in every school.

More here:

http://www.theaustralian.com.au/national-affairs/gillard-stakes-political-future-on-broadband-and-health-at-labor-launch/story-fn59niix-1225905855473

and here:

Updated: NBN to deliver online consultations: Gillard

Fibre-to-the-home network essential in delivering healthcare to regional and rural Australia, PM claims

• Tim Lohman (Computerworld)
• 16 August, 2010 13:05

Prime Minister, Julia Gillard, has used the Labor Party’s official campaign launch to link the future health of Australians with the National Broadband Network (NBN).

Speaking in Queensland, Gillard said the Government would use the speed and connectivity of the NBN to facilitate online consultations between patients and doctors via videoconferencing.

The $392.3 million initiative would see Medicare rebates issued from 1 July 2012 for some 495,000 online consultation services over four years to rural, remote and outer metropolitan areas.

The scheme would also include financial incentives for general practitioners and specialists to participate in delivering online services in tandem with an expansion of Labor’s GP after-hours helpline.

The new service would provide a link between a nurse or GP and the patient allowing online triage and basic medical advice to be delivered via videoconferencing.

A fund to support the training and supervision of health professionals on how to use online technologies would also be set up.

According to Gillard the NBN would be essential in curbing the rates of cancer-related deaths in regional and rural Australia.

“It is unacceptable to me, it is offensive to me, that if you live in rural and regional Australia you are three times more like to die within five years if you are diagnosed with cancer, than other Australians,” she said.

“That is because it is harder for people in regional and rural Australia to get access to the services, to the healthcare professionals they need. I want to transform that relying on the National Broadband Network.”

Patients would also be able to access specialist healthcare staff via dedicated videoconferencing units at their local GP’s office or medical centre, rather than commuting to the specialists’ offices.

According to the Government, more widespread utilisation of tele-health services outside of hospitals had been held back by lack of infrastructure, poor bandwidth and lack of Medicare rebates for consultations delivered online.

More here:

http://www.computerworld.com.au/article/357077/updated_nbn_deliver_online_consultations_gillard/?eid=-6787

and here:

http://www.theaustralian.com.au/business/news/julia-gillard-announces-392m-health-plan/story-e6frg90f-1225905869843

Julia Gillard announces $392m health plan

• From: AAP
• August 16, 2010 1:08PM

PRIME Minister Julia Gillard has announced a $392 million plan to modernise the health system, including allowing patients to access Medicare rebates for online consultations.

Ms Gillard said a re-elected Labor Government would use the internet to modernise the health system by funding online consultations and videoconferencing.

"For the first time, patients will be able to access Medicare rebates for online consultations across a range of specialties, helping Australians, including those in our regions and outer suburbs, get the healthcare they need," Ms Gillard said.

The announcement was made as Ms Gillard addressed the party faithful at the official launch of the Labor party in Brisbane.

The package includes $250 million for online consultations, providing about 495,000 services over four years for rural, remote and outer metropolitan areas.

There will also be financial incentives for GPs and specialists to deliver the online services at a cost of $56.8 million and an expansion of the GP after-hours helpline at a cost of $50 million.

Labor would also spend $35 million to support training for health professionals using online technologies.

and lastly here (so far).

Labor promise: Medicare rebates for online consults

16th Aug 2010

Andrew Bracey

LABOR has promised to establish Medicare rebates for online consultations if returned to government this weekend, with an announcement today it will allocate $250.5 million over the next four years.

The new funding would be shared “across a range of specialties”, according to a Labor statement, along with an additional $56.8 million in financial incentives that would be available to GPs and specialists who participated in delivering online services.

The latest election promise, which Labor estimated would provide about 495,000 additional services to Australians in remote, rural and outer metropolitan areas, has been welcomed by GP groups.

RACGP president Dr Chris Mitchell said that while more detail was needed regarding the levels of rebates and what they would cover, the college would be keen to work with a re-elected government to implement the program.

“There are issues such as having a quality framework around these [rebates] to make sure they are being used appropriately, but it is very innovative suggestion,” Dr Mitchell told MO.

“While this is not a substitution for face-to-face consultations, there are in fact a number of consultations that could very effectively be delivered through [telehealth].”

More here:

http://www.medicalobserver.com.au/news/labor-promise-medicare-rebates-for-online-consults

I guess I have two reactions to this:

First these seem like reasonable initiatives to help improve services to those patients who do not have easy direct access to specialists. I do wonder why there needs to be delay in implementation to 2011 and 2012 given how well Skype video conferencing works - which would be adequate for many consultations today while faster services are eventually rolled out - given the full NBN delivery time table is 7-8 years.

Second I am a little concerned that if these funds are available that they might have been better spent on more coherent and strategic delivery of other, more central, e-Health initiatives as per the National E-Health Strategy. Drip feeding funds into e-Health is really not the way to provide the leadership, governance, coherence and support the e-Health space needs.

One sort of gets the feeling this sort of ‘almost e-Health’ is being used politically for points scoring while we are still in the dark about what is happening with the harder and rather more important stuff in my view. Anyway at least e-Health seems to be a bit more ‘top of mind’ than it has been to date which is a good thing!

I liked the comment posted in response to the flash announcement. Good thinking 99!

David.

E-Health Flash From Labor Campaign Launch - Aug 16, 2010

According to the ABC a re-elected Gillard Government will provide payments for practitioners who provide services (e-mail, consults etc) via the Internet.

More to come!

David.

Update:

6minutes.com.au is reporting the following:

http://www.6minutes.com.au/articles/z1/view.asp?id=522106

Medicare rebates for online consults

Prime Minister Julia Gillard has just announced that a Labor government will allocate $250 million to fund Medicare rebates for online consultations for people in rural and regional areas. Labor will also offer $57 million in incentives for GPs to deliver online services from July 2011.

David.