Crowd-sourcing the cost of the PCEHR

A billion dollars is such a nice, round figure. It is also a nice, big figure. So big in fact that it seems to have attached itself to every mention of the PCEHR despite it being difficult to find evidence that it is in fact the true cost of the system.

A recent example is an article by News Corp's veteran health reporter Sue Dunlevy following a Senate Estimates hearing, in which Greens health spokesman Richard Di Natale asked a few pertinent questions about the hold up in the government's response to the Royle review into the PCEHR.

Ms Dunlevy calculated that if the PCEHR cost $1 billion to build, and there were currently about 42,000 shared health summaries on the system, then that would mean each shared health summary cost $24,000.

That sounds about right on the face of it, but that also means accepting that the $1 billion price tag is correct. There are some questions over this, despite it having become an article of faith.

In Senate Estimates, Senator Di Natale asked the Department of Health's first assistant secretary for eHealth, Linda Powell, how much both governments had invested in the system so far.

“It depends on what you count and when you want to count it from, Senator,” Ms Powell replied, rather mysteriously.

DoH CIO Paul Madden piped up to clarify that the total spend so far was “a complicated issue”.

“There was the investment in the personally controlled eHealth record to establish it, then there is the operation for the 2012 through to 2014 period, and now the 2014-2015 period,” he said.

Ms Powell said the budget in 2012-13 was $233m, and that between “2012-13 and 2015-16, in total, eHealth program funding was $538m,” she said. “That is all of eHealth, not just the PCEHR.”

So do we add the $466.7 million from the 2010-11 budget for the build of the PCEHR to Ms Powell's figure of $538 million, give or take a hundred million or so for non-PCEHR eHealth activities, or is it a little more complicated than that?

We have decided that it's time to finally answer that question and see if we can break down all of the figures that are on the record. We actually started this project last September when PhD student Urooj Raza Khan contacted us to double-check the numbers she could find. At the time, we couldn't get it all to add up to $1 billion, but we were certain we'd missed a few things.

So, we are going to have a crack at pulling together those figures, and we'd like your help. We have set up a series of spreadsheets hosted on Google Docs to detail as much as possible where and to whom money has been allocated, and whether it has even been spent. All expenditure will be listed chronologically and fully referenced.

Most of the figures have been extracted from federal budget papers, various ministerial media releases – made all the harder as we cannot find an archive for former Health Minister Nicola Roxon's press releases – and our own and other media outlets' reporting.

We also owe a huge debt of gratitude to Eric Browne, who has collected a lot of valuable financial information on his Healthbase Australia site.

We have asked the Department of Health to also double-check the figures, and with your help, hopefully we can come up with an accurate breakdown. If you see an error or think we have missed something, let us know.

We'll keep this resource live for the foreseeable future, as it will also allow us to do more than just our initial investigation into PCEHR costs.

We want to look at how much funding NEHTA has received – which by our reckoning has eclipsed the total cost of the PCEHR – the cost of the build and operation of the Healthcare Identifiers Service, and the costs and outcomes of the Wave 1 and 2 sites.

More importantly, it will allow for an appraisal of what was achieved – or not – with those initial investments. We would also hope to use this information to inform decision making on eHealth at a ministerial level.

We plan to open the spreadsheets for a read-only view later this week. If you are interested in taking part, email [email protected].


0 # B Robertson-Dunn 2015-03-10 11:07
What is even harder to identify is the value of the PCEHR.

A shared health summary is only of value if it contributed to improved health care.

It would be instructive to ask the Department of Health how many times the information in the PCEHR has been used as part of a significant (i.e. useful & where the data couldn't have been obtained from somewhere else just as quickly) health intervention. They may also wish to indicate the value of each intervention.

That way you can work out if the cost (whatever that may turn out to be) is less than the value achieved.
0 # Karen Dearne 2015-03-11 12:37
Um, aren't there official records of all spending on various health programs and initiatives? Why haven't you examined those? That's what I've done over many, many years.
0 # Simon James 2015-03-11 13:01
Hi Karen, for the most part that's what we have done, however a good number of relevant documents are no longer available online, and the ones that are don't always have the detail required to allow us to ensure we aren't double counting expenditure.
0 # Karen Dearne 2015-03-11 14:35
Sorry, Simon. Are you suggesting key financial and contract reporting documents are not available?

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