Is everything above board at the agency?
In what was a highly charged week in Australian politics featuring the final sitting of the 45th Parliament and big numbers being boasted in budget speeches, the appointment of a few new faces to the board of the Australian Digital Health Agency flew very much under the radar.
The announcement doesn't seem to have made any waves anywhere else apart from Pulse+IT, where we reported it the day before the official announcement was released, having been told by a very officious type at the Department of Health's media unit to mind our own business when we inquired about it earlier in the week. That of course just confirmed what we suspected.
In fact, the announcement appeared on ADHA's website alone and Health Minister Greg Hunt didn't bother to take any time out of his busy week announcing other things to announce this. That's a far cry from the inaugural board appointment in 2016, when then Health Minister Sussan Ley did the honours. The timing is interesting too. Mr Hunt did have a busy week of budget boosting but he may also have been in a hurry to confirm the board to his liking before the federal election was called.
We may never know, but what we do know is that there is a great deal of disquiet, both inside the agency and out, about the potential conflicts of interest it throws up.
On one hand, the new chair of the board is Elizabeth Deveny, who along with new member Learne Durrington is involved in an executive role with primary health networks, Dr Deveny as CEO of the South Eastern Melbourne PHN and Professor Durrington as CEO of the WA Primary Health Alliance, which runs the commissioning functions for the three WA PHNs. On the other hand are Medical Software Industry Association CEO Emma Hossack and GP Sam Heard, who is the chair of software vendor Ocean Health Systems, owned since last year by Pen CS.
While we welcome the refreshing sight of people with actual clinical software and health service commissioning expertise on the board, it does raise the question of how involved they can be in overseeing the agency's activities, particularly when it comes to project funding and strategy. The agency has quite deep pockets, a big work program and the ability to dole out money to the public and the private sectors so it is going to be a very fine balancing act making sure everything looks above board when half of its members have to excuse themselves every time these things are discussed.
Surely some would have been better placed with appointments to advisory committees rather than the actual board, with more independent people doing the board honours. That said, we are not sure exactly what the board does, as it hasn't updated its public minutes since August last year.
Elsewhere, it was a busy week with the federal budget and its alternative in the news, where healthcare as always was one of the top priorities. There wasn't any new money promised for eHealth in the budget but that was to be expected considering the billions allocated over the last eight or nine years. However, the government's $448.5 million scheme for flexible care models in primary care sounds very interesting and if Labor does win the next election, it should seriously take a look at adopting the policy.
HISA's Australian Telehealth Conference was on in Brisbane this week and was chock-full of good stuff. We particularly enjoyed geriatrician Len Gray's thoughts about a new strategy for telehealth, which hasn't been seriously considered for some years now. Again, a new government should seriously consider this, and finally take the plunge and allow GPs to bill telehealth just as they would a face-to-face consultation. They are already moving down this track with Health Care Homes, mental health in rural areas and the government's new announcement on Tuesday, so it's probably time to go the whole hog.
Somewhat lost in the fuss this week was Tasmania's announcement that it was taking its first steps towards a statewide eReferral system. Queensland is doing this too, with Victoria doing it on a regional scale and some LHDs in NSW also running their own local programs.
At the end of the week, a new front in the regulatory field blew up with the MSIA's response to proposals by the Therapeutic Goods Administration to move towards regulating software as a medical device. This has been brewing for a couple of years now as software, apps, AI and machine learning become more sophisticated and both the Europeans and the US FDA are active in discussions about regulation. While we see a role for the TGA in regulating or at least monitoring clinical software, we reckon they'd do more for Australia's good health by taking a stronger line on the dodgy claims that proliferate about complementary medicine before stumbling about in the world of health IT.
Speaking of regulation, our poll question last week asked: Do you think the use of secure messaging services should be mandatory? This one was overwhelming – 86 per cent said yes, with just 14 per cent saying no.
This week, our poll question is: do you think there are conflicts of interest on the ADHA board?