Reform Commission lays out e-health recommendations

There is increasing frustration and mounting cynicism with the pace of action on implementing a national e-health platform, the National Health and Hospitals Reform Commission report has found.

“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,” the A Healthier Future for All Australians, report says.

In addition to calling on the Commonwealth to assume responsibility for all primary health care policy and funding, the report argues that attempts to achieve a ‘liquid’ flow of essential health information among health professionals and patients have been fragmented and fraught with difficulty.

"Much like the state and private railways of the 19th century, Australia runs the risk of unlinked electronic health infrastructure," the report says. "There are already significant pockets of investment in electronic health data and information exchange across Australia...But much more can be gained by taking advantage of synergies and committing to a truly national effort to optimise the system."

According to the report, if Australia did not capitalise on the investments already made in e-health systems to date, then it risked incurring significant increased economic cost in the future to achieve a well-connected, useful and secure e-health system.

To capitalise on existing e-health roll outs, the report argues that the Federal Government must ensure that the national policy framework incorporates open technical standards which provide for interoperability, compliance, confidentiality and security.

These standards must also be developed with the participation and commitment of state governments, the ICT vendor industry, health professionals and consumers.

“This framework will be essential to the development of interoperable ‘feeder systems’, which will provide key data to populate the person-controlled electronic health record irrespective of the supplier of the system,” the report says.

The report’s recommendations also argue that the National Broadband Network, will be essential to allow the secure transfer of health information, whether voice, data, images, and video conferencing to the point of care.

“Ensuring access to a national broadband network (or alternative technology, such as satellite) for all Australians, particularly for those living in isolated communities, will be critical to the uptake of person-controlled electronic health records as well as to realise potential access to electronic health information and medical advice,” the report says.

The report also recommends that by 2012, every Australian should be able to have a personal electronic health record that will at all times be owned and controlled by that person. Each Australian should also be able to approve designated health care providers and carers to have authorised access to some or all of their personal electronic health record, and choose their personal electronic health record provider.

To ensure the privacy of a person’s electronic health data, while enabling secure access to the data by the person’s authorised health providers, the report recommends the Commonwealth Government create new e-health specific legislation and introduce unique personal identifiers for health care professionals, patients and professional organisataions by July 2010.

The report also outlines the need to strengthen the leadership, governance and level of resources committed by governments, as well as make available significant funding and resources to extend e-health teaching, training, change management and support to health care practitioners and managers.

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