E-health goes back to basics

By: Karen Dearne

FEDERAL bureaucrats are back in charge of the e-health reform agenda, with the Rudd Government allocating $60.6 million to solving the "challenges" of complexity, pace of technology development and lack of consultation with stakeholders.

E-health has taken a budget cut of $4 million to $60.6 million in 2008-09

Budget documents say the Government, through the Health Department, "will work with the states, professional groups and consumers, to address the aspects of e-health requiring national leadership and coordination. This includes the development of a national e-health strategy".

The declaration ends the arm's-length approach to e-health adopted by the previous government, which created the largely ineffective National E-Health Transition Authority (NEHTA) to manage the issue then cut existing projects such as the HealthConnect nationwide patient record-sharing system.

Underlining the shift away from NEHTA, the Budget statement adds that the department "will specifically oversee the development of national standards to enable compatibility of e-health systems across the national health network. The department is working to ensure health systems are interoperable, and can safely and securely exchange electronic health information between health professionals with patients' permission".

NEHTA founding chief executive Ian Reinecke resigned unexpectedly in late March, amid increasing calls for a clear strategy and state health departments embarking on their own, separate, health IT projects.

Andrew Howard, chief information officer of Victoria's Human services department, is currently acting chief executive while an international search is conducted for a replacement for Dr Reinecke.

A formal review by Boston Consulting found the authority had failed to communicate with health and IT industry stakeholders whose support was needed to resolve complex technical and workplace reform concerns.

In contrast, the new government has promised to consult with "medical groups, the software industry, other professions and the community to ensure the needs of all are taken into account" and the benefits of e-health properly communicated.

It's understood NEHTA will be required to report directly to department officials, who will "ensure work is delivered within agreed timeframes".

However, e-health has taken a Budget cut of $4 million to $60.6 million in 2008-09, compared with $64.6 million in the previous year.

In 2006-07, the Howard Government left $41.5 million unspent out of $79 million allocated to national health IT projects, as it lost interest in e-health reform.

Meanwhile, Medicare is developing the Unique Healthcare Identifier service needed to support the introduction of a national e-health record system.

Under a contract signed with NEHTA earlier this year, Medicare is working on a system that will generate individual identity numbers for patients, medical providers and healthcare locations such as GP surgeries, hospitals and clinics.

The Budget has provided $8.6 million over four years to streamline Medicare benefits claiming through electronic payments systems. GPs boycotted Easyclaim, introduced by the former government because it required practice staff to conduct Medicare claims functions and was difficult to use.

Human Services Minister Joe Ludwig said Easyclaim tied-up medical practices that wanted to do the right thing for patients in red tape. "This is the reason why, despite making $28 million available to drive take-up, the Liberals achieved rates of only 0.5 per cent of electronic patient claims".

And the Government has scrapped the Eclipse software system, originally developed by the Health Insurance Commission at a cost of $48 million to provide private patients with information about expected gap bills resulting from private health fund limits on doctors' fees.

The measure will save more than $20 million previously allocated to future development of the system, which is only used by a small number of private health funds.