A Bad Week for E-Health Leadership in Australia

It seems the leadership of e-Health in Australia is close to falling to bits.

We started out badly when the transcripts of a Senate Estimates Committee showed we had a major disconnect between the senior management of the Federal Department of Health and Ageing and those responsible for the actual delivery of health IT.

These comments were reported here:

E-health is on its way

Karen Dearne | October 28, 2008

HEALTH Department secretary Jane Halton says work on basic e-health standards is nearing completion.

Ms Halton told a Senate Estimates committee that the "nerd-relevant things which the public do not have any interest in but which are needed to make the system workable" were now getting "pretty close".

The Health Department was working towards the first version of a universal health record, which would be available in the short to mid-term.

"People will start to see the benefits of the investment and the tangible difference it makes in the near future," she said. "Until now a lot of e-health has been invisible to patients."

Ms Halton said the National E-Health Transition Authority's work on infrastructure meant messages could be sent securely and interpreted reliably.

"We are now talking about the beginnings of moving messages around the system so that business is conducted electronically," she said.

More is found here:

http://www.australianit.news.com.au/story/0,24897,24561094-15306,00.html

Then we moved on to the introduction of a discussion paper for a new Primary Care Strategy. which pointed out there was still a long way to go.

Roxon and e-health: close but no cigar

Karen Dearne | October 30, 2008

HEALTH Minister Nicola Roxon has signalled better management of health information as a concern just one day after an alarming report into medical mistakes was issued by the Australian Commission on Safety and Quality in Health Care.

The report found the nation's hospitals operate on, X-ray or carry out other procedures on the wrong patient or body part every second day, with 187 cases of mistaken identity in private and public hospital operating theatres, laboratories and radiotherapy units in 2006-07 - up from 79 a year earlier.

But Ms Roxon is still yet to address the issue of e-health publicly.

Launching a consultation paper, Towards a National Primary Health Care Strategy, at the Australian General Practice Network Forum in Darwin today, she said the key challenges were preventing avoidable disease, and managing chronic disease well.

…..

Ms Roxon said the consultations on primary health care reform would mesh with other elements of the federal Government's health agenda, including the development of a national e-health strategy.

The discussion paper, prepared by a Ministerial Reference Group chaired by GP Dr Tony Hobbs, says that while almost 98 per cent of GPs use a computer at work, there is only limited e-health readiness in hospitals, allied health, medical specialist and aged care facilities.

"Better management of health information and the systems to support it are fundamental to enhanced primary care delivery," the paper says. "There has been significant investment by all Australian governments in e-health, particularly in the development of enabling infrastructure and standards, and in the private sector, particularly in radiology and pathology.

"However further investments are still required in improved connectivity, interoperability and scalability, and in strengthened partnerships across providers and care settings through effective information exchange and referral supported by functionality, and security standards to protect patient privacy."

The primary health care strategy paper ranks e-health sixth out of 10 key priorities, even though it notes the lack of information sharing results in the "limited ability to provide co-ordinated care to patients, lack of collaboration over multi-disciplinary care, poor referral pathways, potential for patient misadventure related to delayed or non-arrival of referral information, and the lack of support tools to assist patients in the self-management of their health and well-being".

http://www.australianit.news.com.au/story/0,24897,24576455-15306,00.html

Then we find out that even the paltry sums that are available are not being spent

Some e-health funds unused

Karen Dearne | October 31, 2008

THE federal Health Department has once again underspent its e-health implementation budget, spending only $42.5 million out of $53.8 million allocated for 2007-08.

Spending on e-health had crashed during the previous year, with $41.5 million left unspent out of $79 million allocated to national projects, including the now defunct HealthConnect.

But even the heavily trimmed allocation for the past financial year was underspent by $11.2 million, the Department's annual report reveals.

The department also funded half the National E-Health Transition Authority's annual budget from the e-health allocation, but the funding amount is not reported.

Despite a number of high-profile e-health reviews, few IT consultants profited from the federal Health purse. KPMG took the largest share, at $335,358 for its advice on implementing a nationwide system for the electronic prescribing and dispensing of medications. The KPMG report is yet to be released.

Much more here:

http://www.australianit.news.com.au/story/0,24897,24580759-15319,00.html

There are a couple of things that really need to happen here:

First we really need to have public review and discussion of the Deloittes developed National E-Health Strategy, the Nation Health and Hospital Reform Commission E-Health Paper and the DoHA E-Health Business Case which is due to be submitted to the Council of Australian Government in a couple of weeks. (We have waited 10 years so far – another 1 month of review won’t matter).

Secondly I think we really need to consider whether there is a place for a proper Government enquiry to clear the air, get the best ideas from all this work on the table and build some true consensus on what needs to be done.

Right now we seem to have a lot of interested parties defending various bits of turf to the detriment of the nation as a whole. The time for a genuine ‘circuit breaker’ has arrived I believe.

Maybe the Coalition for E-Health could be prevailed upon to put to the Government a case for a considered public review of the work to date and what now needs to be done to move us forward?

David.