Prime Minister Kevin Rudd and Health Minister Nicola Roxon released a report on the nation's hospitals today by the National Health and Hospitals Reform Commission (NHHRC) which recommends a $1.2 to 1.9 billion spend on e-health.
(Surgeons at work image
by Salim Fadhley, CC2.0)
The report endorsed the recommendations of the National e-health strategy completed by Deloitte last year. Its figure for rolling out a National e-health agenda of $1185 to $1865 million roughly mirrored the consultant's original reported amount for implementing its national strategy.
In addition to Deloitte's recommendations, the NHHRC put out a plea for better leadership on e-health. "We urge the Commonwealth Government to take responsibility for accelerating and adequately resourcing implementation of a National e-health Action Plan which incorporates strengthened national leadership to direct and revitalise implementation and which values and actively seeks the expert guidance of key stakeholders," it said.
The report acknowledged that the work had been already completed but pointed out how far Australia had to go. "There is increasing frustration and mounting cynicism with the pace of action on implementing a national e-health platform. The lack of visible utility at the point of care has resulted in calls to stop the 'talkfest' and get on with setting a dedicated budget and definite delivery date with clear responsive and responsible governance for electronically enabling the health system: e-health."
There was still a "small window of opportunity" to capitalise on the money the nation had already spent on a national e-health system, it said. If that window were missed, the cost would be much higher.
The report called for every Australian to have an electronic health record by 2012, controlled by them so they could allow chosen providers access to their health information. Funding for this record could come from the patient, their health fund or employers. Governments could help fund those in need.
The report outlined milestones to reach this point, with the first being personal identifiers and health organisation identifiers to be in place on 1 July 2010. It also suggested a system to authenticating patient identity by this date.
The report recommended that hospitals, pathology and digital image providers be able to send key data by 1 July 2012. Other providers such as GPs and specialists would need to take up the baton by 1 July 2013. The authors pointed out that this would require incentives and training. The report suggested that the government make payments to health providers and organisations contingent on being able to send and receive patient's data in a format that can be put into an e-health record.
Electronic health records would only work where there was free flow of information and no little pockets of non-standard data, according to the report. Work on a national policy and technical standards framework needed to be accelerated so that they could be in place by 2011 or 2012.
The government will consider the report's recommendations over the coming months with input from the public.
"The report is clear — 'business as usual' is not going to be sustainable in the coming years and decades. We simply won't have the resources to keep doing things the way we are doing them in the future," Health Minister Nicola Roxon said.
"Some of the recommendations from the report are controversial, some will inspire robust debate. It wouldn't be a report worth its salt if it did not, as real fundamental reform will always generate conversation," she said.
One of the significant limitations is how we currently build information systems. There should only ever be a single national health record for an individual that can be accessed by - clinicians, dentistry, GP's, etc. It is now possible to overcome these limitations.
The current approach of trying to wire together a multiplicity of disparate health systems keeps consultancy, IT and SI companies happy but does not deliver information efficiency and the levels of security and cost required.
The other problem will be the State-by-State approach - the we are special and unique attitude and hence there will be divergence, delay and cost.