I Hope an Obvious Source of Funding for E-Health Is Actually Deployed.

The following appeared a few days ago.

E-health plans could be paid for by future fund

Siobhain Ryan | August 07, 2009

Article from: The Australian

THE expensive e-health ambitions of Canberra, from personal electronic health records to online consultations, could be bankrolled from the leftover $1.8 billion in the "nation-building" Health and Hospitals Fund.

Bill Ferris, chairman of the fund's advisory board, has backed the creation of electronic health records as "essential" to improving Australia's health system. "If we fund everything else and not this, it might result in lots of shiny engines and carriages rattling along different gauge health system tracks across the nation."

The shift away from paper-based records was one of the "obvious capital funding demands" that could be made of the fund, Mr Ferris noted. However, he made clear he was expressing his personal views and not those of the board or government. His first public statements on possible funding priorities come after Kevin Rudd's hand-picked health adviser last month threw its substantial weight behind a $1.1bn to $1.8bn plan to create an electronic health record for every Australian by 2012.

Progress towards digitising medical records, assigning them unique identifiers and giving patients control of the information has been slow, despite near unanimity about e-health's value in improving communication between health workers and reducing life-threatening mistakes.

Electronic prescribing and internet consultations are also no closer to reality, despite past Council of Australian Governments spending of $318 million on e-health projects.

The Prime Minister has given himself six months to respond to National Health and Hospital Reform Commission recommendations on e-health and other reforms. Mr Rudd has already warned that his cash-strapped government will not be able to finance all of the commission's proposals and will look for fresh savings to offset new spending.

More here:

http://www.theaustralian.news.com.au/story/0,25197,25894686-23289,00.html

This possibility was first flagged on the blog about 8 months ago. See here:

http://aushealthit.blogspot.com/2008/12/health-and-hospitals-fund-announcement.html

The key issue that will arise if indeed the funds are made available it that they be spent very carefully and wisely.

I think it would be fair to say there will only be one chance to get access to a sum of this scale to try and get Australian e-Health rolling, so we need to proceed calmly and deliberately.

In this spirit it seems to me to be vital we make sure we have the visionary leadership and appropriate and highly competent governance. It will also be critical to effectively communicate with the public, government and industry about goals, objectives, plans and evaluation of what is being done and why.

The way the e-Health initiative in Ontario went off the rails should be warning enough that considerable care is required!

See here for the grisly details:

http://aushealthit.blogspot.com/2009/06/amazing-goings-on-in-e-health-in.html

My personal preference would be that the funds be made available to an entity which was established by legislation with very clear cut roles, responsibilities and authority and that it report to the Australian Health Ministers Council who would be advised by an appropriately expert board (mixing technical, health sector, planning and commercial skills).

As recommended in the Deloittes National e-Health Strategy I would be keen to see this entity absorb NEHTA, while continuing the important ongoing functions and funding from NEHTA, and at the same time adding the capabilities needed for the larger task. I DO NOT see any place for handing the extra money to NEHTA and just hoping for the best!

The leadership group to progress this vital task will be absolutely critical and there will need to be great care taken to select the right people. (Essential will be in depth understanding of both the health system and where technology fits and a clear recognition that e-Health in not an end in itself but an enabler of improved safety and efficiency. Clearly there will also need to be highly developed capabilities in areas such as project management, public administration, government relations, stakeholder communication etc.)

I am pretty sure this will need to be a team – just one leader to do all this may just be too big an ask!

I look forward to being able to wonder just what the team might be who can deliver all this when the funds are nailed!

David.