Earlier this week an eight page brochure entitled “e-Health NewsLetter” June 2006 appeared in my e-mail inbox. A nicely produced eight page brochure which was suggesting all was absolutely wonderful with all the e-health projects being sponsored by the (what was thought to be up until now the defunct) HealthConnect program.
Oh joy…all will be well in e-health I thought – such a professional polished brochure can only contain good and exciting news.
Sadly it is not the case. What is in fact contained in the Newsletter, which for some odd reason was not found with a Google search for ["e-health newsletter" healthconnect] on July 2, 2006, is a sad illustrated repeat of all the failures and lack of progress we have seen over the last six years.
I finally located an on line copy at http://www.health.gov.au/ehealth/. It was made available on 28 June, 2006 according to the download page. Quite odd that there is not even a pointer to it on the HealthConnect web site itself. Clearly this brochure is meant to be very low key indeed in its public exposure.
What do we learn from the contents?
Firstly we discover the national consumer health information line (Healthinsite), after 5 plus years of operation receives less that 12,000 unique visitors a day. Hardly usage that Google or Yahoo would see as a commercial threat. (I must say however the site is valuable and really should be much better marketed to the public – pity the good work is not more widely known.)
Secondly we hear that a few months ago the Council of Australian Governments provided $130 million over 3-4 years to identify patients and health providers and progress clinical terminologies. Still no idea how the identity systems will relate to the proposed Access card of course.
Next we get a recital of all the various HealthConnect Trials that have been conducted over the last 4-5 years.
We discover that South Australia is implementing a proof of concept care co-ordination system because SA has the oldest patients in the country and need it most. No specific technology, patient groups, time lines, outcomes etc are discussed so we will all just have to wait and see.
In the Northern Territory is seems the Shared EHR has been such a success that it has needed to be supplemented with point to point (P2P) messaging of clinical information (i.e. secure e-mail between doctors). The discussion also has real issues regarding tense. Part of the document implies a lot is up and working and then further on there are comments saying that what is being done will comply with yet to be finalised standards. I know the evaluation of the initial NT trials were very negative and have no certainty much is really happening at present either.
The latest news from the Townsville trial is that everyone thought it was a good idea. Again, no discussion of what difference it made, how many better outcomes achieved etc
From NSW we hear that the Health-E-Link project began a pilot implementation in March and is a great success because only five percent of patients have opted out. Commentary recently suggests the trial is not going all that well technically – and certainly there have been no public claims of progress I have seen. Again we need to wait and see – a franker discussion of numbers enrolled, access made to records would provide a few facts to support the brochure assertions.
In Victoria and Western Australia there have been broadband implementations which may improve regional communications and provide VoIP and e-mail etc. Clinical benefits are not yet apparent and the costs of service provision are a major issue in the WA project continuing after Commonwealth Funding ends.
Lastly, in Tasmania Hospital Systems have been modified to send an e-mail or fax, based on patient administrative system data, when a patient is admitted or discharged. Possibly useful – but rather a far cry from the Shared EHR vision which HealthConnect was meant to be about.
In essence this brochure is simply an admission of failure, after what is said to be $200 Million spent, to demonstrate a single improved clinical outcome.
It is really quite serious when a government publication is so carefully crafted to conceal the lack of progress and to provide quotes and commentary which are frankly untrue.
David.
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