1 Towards a national eHealth strategy © 2009 Deloitte Touche Tohmatsu

National eHealth Strategy

The Way ForwardAdam Powick April 2010

eHealth – Building a wired health care system

Customer

Allied Health and Diagnostic Professionals

Private ProvidersNGO Sector

Family and Communities

Pharmacists

Clinicians and Nurses

GPs

Customer

Allied Health and Diagnostic Professionals

GP’s

NGO Sector

Family and Communities

Jurisdictions

Clinicians and Nurses

Private Providers

Jurisdictions

Personal HealthProfile

Consumer

Consumer

Current Environment

Future Environment

PharmacistsOnline

Information andCommunities

CustomerClinician

CustomerPolicy Maker

The key objective is to provide the right information to the right person at the right place and time to optimise health care outcomes

eHealth strategy and policy context

Why Now?

‘The Commission concluded in July last year that the health and hospital system is fragmented, is at a tipping point and is unable to cope with the challenges it faces in the years ahead. In the words of the Commission ‘now is the time to act’.

‘Treasury has concluded that by 2045-46, spending on health and hospitals would consume the entire revenue raised by state governments’.

Kevin Rudd, March 3rd 2010

eHealth should be a key part of the reform process• Heavily reliant on pen, paper and human memory

• Significant underinvestment in information technology

• Disconnected islands of information

Free Market

Guided Market

CentrallyControlled

Governance – what market model should we pursue?

National legislation

Nationally developed infrastructure & standards

Central funding / investments

Market driven projects and solutions

Establish the core foundations for electronic information exchange across the health sector

Foundations

Encourage health sector participants to adopt and use high priority systems and tools

Change and Adoption

Stimulate investment in high priority computer systems and tools

eHealth Solutions

Ensure the effective coordination and oversight of the national eHealth work program

Governance

So what do we need to do?

eHealth Implementation Roadmap

Connect and Communicate

3 Years

Establish eHealth foundations

Collaborate

6 Years

Focus shifts from basic communication to collaboration

Consolidate

10 Years

eHealth becomes part of business-as-usual

A journey of 10+ years is required to deliver a national eHealth environment

115 - By 2012, every Australian should be able to have a personal EHR

116 - Privacy legislation

117 - Unique identifiers and authentication (July 2010)

118 - National social marketing strategy

119 - Access to a national broadband network

120 - Payments to be dependent on sending and receiving personal EHR data

121 - National policy and open technical standards framework for e-health

122 - Funds for e-health teaching, training, change management and support

123 - Endorse the National eHealth Strategy

- strengthen government leadership, governance and resources

- support to public health organisations and incentives to private providers

- government should not design, buy or operate IT systems

Reform Commission Report (on 1 page)

• eHealth is recognised as one of the five key building blocks of the strategy and underpins each of the four identified priority action areas:

• Improving access and reducing inequity

• Better management of chronic conditions

• Increasing the focus on prevention

• Improving quality, safety, performance and accountability

• What will be different?

• Patients not having to repeat their medical history to each new provider

• Patients having information to help them to manage their own condition

• Health care providers able to set up virtual, integrated care teams, and having accurate and timely information to support best treatment

• Potential to outreach to hard to service communities with more innovative and efficient use of health workforce

• Improved quality and safety

‘Use of technologies including eHealth is falling behind consumer expectations, other service industries and progress in other comparable health systems.’

National Primary Health Care Strategy

‘It is necessary to strengthen Australia’s capacity to effectively monitor, evaluate and build evidence around preventative health. A number of ambitious targets relating to overweight and obesity, alcohol and tobacco have been set by this Strategy, and Australians will need to know how effective our preventative health programs are and whether we are on track to meet these targets.’

• Comprehensive national surveillance systems for obesity, tobacco and alcohol

• Development of national data linkage systems, for health and non-health data, in order to develop nationally representative and consistent baseline information

• Primary health care to have access to an electronic patient record and information systems that provide risk data on the practice population

National Preventative Health Strategy

• Health Identifier legislation before parliament

• Business case for the introduction of a national IEHR system being considered by AHMC

• Kevin Rudd and health reform - ‘now is the time to act’

‘Over the coming weeks and months, the Government will announce additional reforms that will build on existing investments and the structural reforms outlined in this document. These reforms will be made across a range of areas, including in:

• eHealth, to take further steps towards the introduction of a personally controlled electronic health record for all Australians.’

Kevin Rudd, March 3rd 2010

• But – no mention of eHealth in the ‘historic’ CoAG health reform agreement

Interesting Times

• Federal government to fund ‘60% of building, equipment, teaching and services in 762 public hospitals’

• Commonwealth Government takes full policy and funding responsibility for primary health care

• Introduction of case-mix or activity based funding right across the Commonwealth

• Responsibility for running public hospitals will be devolved to Local Hospital Networks

The CoAG Agreement

• Five key changes to health care:

• 1300 new hospital beds

• 2500 new aged care beds

• 6,000 new doctors

• Emergency / waiting list KPIs

• 20,000 young people to get access to mental health

The missing piece

In the Prime Minister’s words:

‘With (these reforms), we can finally deliver better integrated, better coordinated healthcare that is more responsive to the needs of patients’

‘With the structural reforms I am announcing today, we can go on to build and extend a health system for the 21st century’

Not without eHealth you can’t

Kevin Rudd, March 3rd 2010

The way forward – 5 key elements

• Leadership• Sponsorship, policy direction

• Governance• Board, leadership team

• Stakeholder Engagement• Care providers, consumers, funders, vendors, politicians

• National Infrastructure• Identifiers, standards, legislation, NBN, compliance

• Funding• Capital projects, recurrent expenditure, incentives

The vital ingredient – lead implementations

• Need tangible examples and evidence• Peer driven sector

• Means to engage vendors• Four conditions:

• High priority domains, compliance with national standards, cross sector connectivity, scalable

Defence

Medicare

DVA

Brisbane North

ACT

NT

CancerAged Care

Diabetes

‘Closed Systems’ ‘Communities of Practice’

Key Considerations

• Political support

• Engaging consumers

• Centrality of primary care (‘the network effect’)

• Encouraging vendor innovation

• Workforce skills

eHealth – change is now inevitable

Guided or free market change?

18 Towards a national eHealth strategy © 2010 Deloitte Touche Tohmatsu

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