Feds and states agree to develop business case for eHealth

The federal, state and territory governments have signed a memorandum of understanding (MOU) committing them to developing a nationally agreed business case for funding for eHealth beyond July next year.

Current funding for eHealth initiatives such as the PCEHR – provided by the federal government – and for the National E-Health Transition Authority (NEHTA) – which is jointly funded – runs out on June 30, 2014.

The MOU is dated November 9, 2012, but it was only given official sanction last month.

Queensland, SA and the ACT signed the MOU late last year, with WA signing off in February, NSW in May, and Victoria and Tasmania in June. Federal Health Minister Tanya Plibersek gave official sanction on June 25.

The governments have also committed to building a business case and migration plan for the transition of each jurisdiction to the National Health Services Directory (NHSD), which will be devised by the National Health Call Centre Network, also jointly funded by the Commonwealth and the states.

The outcome of these local business cases will determine when states and territories will contribute funding to the NHSD, the MOU states.

The national eHealth business case will be led by the Department of Health and Ageing's E-Health Working Group (EHWG), which reports to the Ministerial Council on health, now known as the Standing Council on Health.

The federal Minister for Health will also this year appoint an individual to review the operation of the PCEHR Act and its regulations, and to prepare a report on the review by December 29, 2014.

“The outcomes of the independent reviews will complement the nationally agreed eHealth Business Case to inform governments’ consideration of long term governance arrangements for the national eHealth system,” the MOU states.

The MOU is predicated by an agreement that the jurisdictions recognise that “some components of the national eHealth capability are transitioning from a developmental and early implementation phase and some aspects may move to an operational phase”.

“The Parties reaffirm their commitment to the implementation of national eHealth capabilities and agree to maintain the momentum created from investments to date and to continue a coordinated approach to implementation.”

The MOU also contains a long-term vision statement, which commits the jurisdictions to achieving for Australia an effective eHealth capability underpinned by national specifications, standards, services and infrastructure and providing for eHealth solutions and systems that:

• enable a person’s key healthcare information to be accessed electronically by their healthcare providers anywhere in Australia through sharing information securely across geographic and health sector boundaries;
• empower and inform healthcare consumers through giving better access to and control over a consumer’s consolidated healthcare information and improving the person’s own improved health literacy;
• promote the adoption of safe, effective and efficient clinical practices by the health workforce through the use of eHealth technologies;
• use consistent national standards and specifications, and clinical terminology to facilitate the inter-operability and connectivity of health information systems; and
• provide effective regulatory and compliance arrangements that ensure the system is trusted by participants as a secure source of health information.

It will do this by streamlining clinical processes such as access to diagnostic results and ePrescribing, delivering core elements of enabling national eHealth infrastructure, and building a long-term national eHealth capability in an “incremental and pragmatic manner, focusing initial investment in those areas that deliver the greatest benefits for consumers, healthcare providers and healthcare managers”.

It has also committed to considering the number of skilled health informatics practitioners available to support the delivery of the national eHealth strategy and build the general IT literacy of the health workforce.

In the interim, the federal government has committed to rolling out and operating national specifications, standards and infrastructure such as the PCEHR.

In return, the states and territories have committed to continuing to work on implementing health systems in public hospitals such as discharge summaries to be uploaded to the PCEHR, medications management systems, diagnostic testing systems, patient administration and scheduling systems, master indexes and implementing Individual Healthcare Identifiers into public hospital and healthcare services.

The parties will also collaborate in funding core national eHealth services including “a national authentication service for health care providers”. The commitment calls for them to implement “an appropriate authentication service over the next three years” and “working together to test and evaluate eHealth initiatives before they are implemented nationally, to ensure that they are fit for purpose and achieve the intended benefits”.

For the PCEHR, they have committed to “supporting the incremental connection of the health information, within the services they manage and fund, to the information held in the PCEHR system, including progressive uploading of clinical documents, subject to the approval of the Rapid Integration Project by the NEHTA Board”.

Pulse+IT has requested more information from NEHTA about the rapid integration project.

For telehealth, they have committed to agreeing to and adopting telehealth technical standards and to developing a National Telehealth Connection Service and Strategy for achieving national interconnectivity and interoperability of telehealth.

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