Budgets go big in eHealth bonanza

We must admit to being momentarily gobsmacked when we received a joint press release from the NSW Treasurer and Minister for Health last Saturday proclaiming that the state was spending $536 million on eHealth over the next eight years, with a portion of the money starting to flow this year. We double-checked the figures on Monday morning just to be sure there was no double counting, but right it was.

When added to the approximately $400 million shelled out by the Coalition since 2011, we're looking at close to a billion dollars, and that's just from the current government. Granted, that money is spread over 16 years, but it's still a massive number, even among the eye-popping overall annual budget for NSW Health of $23 billion.

We were pondering this while also taking note of the terrible trouble that the New Zealand director general of health Chai Chuah has found himself in due to a misallocation by the beancounters at the Ministry of Health of just $38 million to the district health boards in this year's budget. New Zealand has a pretty big eHealth program but it has a habit of keeping its costs well – some would say too well – contained so it's hard to gauge how much is being spent.

It seems likely that the final format of its national EHR will not require a huge spend on new technology but we'll have to wait to see the results of its detailed business case to find out, its indicative business case having been approved just recently. Auckland DHB reckons it will have to spend $NZ90m as part of its share of the planned Northern EHR, which involves the implementation of an Epic EMR in its hospitals that may cover primary care as well.

Would the overall spend for NZ come close to Queensland's $1.26 billion over 20 years, considering the similar population? Added all up, probably yes. Looking around the rest of Australia, it's hard to gauge how much Victoria is spending on eHealth as it operates on a devolved model with each health service deciding what to do with its budget. It did allocate $30m last year for a real-time prescription monitoring system but unfortunately the Victorian Department of Health and Human Services is steadfastly refusing to tell Pulse+IT what it is doing with it.

South Australia is spending $422m on EPAS, $30m on EPLIS and about $20m on ESMI – News Ltd was having its usual conniptions about the latter just this week – along with other odds and ends. The NT is spending $259m on its core clinical systems renewal program, while Tasmania isn't spending much at all on eHealth, it having almost broken the bank on the $689 million redevelopment of Royal Hobart.

Let us not discuss WA, where terrible things have happened in the past. It may spend some money in the future, with news this week that former NSW Health director-general Robyn Kruk is to head up a review of the WA health system and how it can embrace innovation and technology. However, this review comes hot on the heels of an inquiry into the big spending of the Barnett government, recently dethroned in a landslide for somehow sending the state almost broke in the middle of a resources boom. Health ICT spend will get a going over yet again.

The question of course is whether this money is justified in terms of better patient care, patient safety and clinical efficiency. Some figures from the digitisation of Brisbane's Princess Alexandra Hospital, which we'll report on next week, show there are measurable improvements. However, the large sums must be torture to the cash-strapped primary care sector, where most healthcare is delivered. One of our popular stories this week was about a survey of GPs and their views on technology. Many of them would love to use more digital tools, if only the money was available to pay for it.

This leads us to our poll question for the week: Do you think the big sums being spent on hospital eHealth are justified? Sign up to our Weekend Edition to take part in our poll or leave your comments below.

Our poll last week asked: Will the My Health Record be rendered redundant by interoperable systems? 70 per cent said yes, 30 per cent no.


0 # WA Primary Health Alliance staff member 2017-09-04 13:27
No it won't be made redundant because not all health providers capture and use the same information. Even if you can move patient information around, how would consent work in releasing that information? What if providers don't know who their main GP is etc? Where should test results etc be sent if no regular GP? These are all solved by having a central repository that holds this information

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