Little for health IT in capital-intensive Victorian budget

The Victorian government has invested $560 million in capital and equipment in today's state budget to build new facilities and redevelop existing infrastructure, but little has been set aside for health IT.

The big-ticket items include $200 million for a dedicated Western Women’s and Children’s Hospital and $106.3 million to expand Casey Hospital, along with $200 million to open and staff new beds under the Hospital Bed Rescue Fund, $60 million for an elective surgery boost to cut waiting lists and $99 million to solve Victoria's long-running dispute over ambulance services.

There is also money for the establishment of extended hours Super Pharmacies, a pre-election commitment, which will be set up in metro and rural areas with a nurse present for face-to-face advice between 6pm and 10pm. The idea is to take some pressure off hospital EDs.

However, despite some lobbying by the Victorian branch of the AMA and some screaming headlines, there is no money for new health IT initiatives beyond a small amount to evaluate the introduction of the Electronic Recording and Reporting of Controlled Drugs (ERRCD) prescription drug monitoring system and $10m for a clinical services hardware replacement program.

The AMA, patient groups and several Victorian coroners have long been calling for the introduction of ERRCD or a similar system, but this year's budget only sets aside $300,000 “to evaluate and plan for the implementation of a real-time prescription monitoring system,” the budget papers say.

“This will enable pharmacists and prescribers to access a patient’s dispensing history of Schedule 8 medications (e.g. oxycodone and methadone) at the time of consultation.”

The AMA, which in its pre-budget submission called for $15 million over three years for a full roll-out of ERRCD in addition to $50 million over three years to improve secure messaging between hospitals and general practices, said it was pleased with the budget but that the lack of investment in health IT was a “glaring omission”.

AMA Victoria president Tony Bartone said the AMA was pleased to see significant growth in health expenditure, especially for the acute care sector, along with the elective surgery blitz, the public hospital beds fund and the commitment to admit an additional 60,000 patients a year.

It also welcomed the commitment to real-time prescription monitoring. “The misuse and abuse of pharmaceutical medications (often via "doctor shopping") is a major problem across the state and we are very pleased to see an initial $300,000 investment for the planning and implementation of this monitoring system,” Dr Bartone said.

"Although this is a small amount, we are ecstatic that this problem is finally being addressed and we are looking forward to working with the government to see this system implemented.”

However, he said it was disappointing there was no investment in health IT systems.

"There is zero investment in public hospital and general practice IT systems,” he said. “It is paramount that GPs have access to timely and secure patient discharge summaries, medication charts and relevant information relating to a patient’s hospital stay.

“This can't be put in the 'too hard basket' – health IT is a vital investment and it is a glaring omission in the budget.”

The Victorian branch of the Australian Nursing and Midwifery Federation (ANMF) said it was particularly pleased to see the transparency around the $200 million Hospital Bed Rescue Fund, which outlines exactly how many beds, or points of care, will be opened this year, as well as estimations of the number of patients to be treated annually as a direct result of the funding.

New funding initiatives include:

  • $200 million for a dedicated Western Women’s and Children’s Hospital, with 237 beds, 39 special care nursery cots and four theatres
  • $106.3 million to expand Casey Hospital, including four new operating theatres, a surgery recovery centre and 96 extra beds, inclusive of beds in a new ICU
  • $85 million to expand the Werribee Mercy Hospital, delivering six extra operating theatres and 64 new inpatient beds
  • $20 million for an intensive care unit and short stay unit at the Angliss Hospital in Melbourne’s outer east
  • $10 million for a new cardiac catheterisation laboratory at Ballarat Base Hospital
  • $15 million for the planning and development of the new Victorian Heart Hospital at Monash University
  • $200 million to increase hospital capacity (hospital bed rescue fund)
  • $60 million for an elective surgery boost to cut waiting lists
  • $28.7 million for 15 metropolitan and five regional Super Pharmacies, to stay open 24 hours a day, seven days a week
  • $99 million to improve ambulance services, including $40 million to upgrade ambulance branches across the state and provide new vehicles and equipment, and $59 million to cut emergency response times and speed up the transfer of patients to emergency departments
  • $118 million for mental health, including $88.2 million to provide 80 adults and up to 500 older people with intensive, specialist support.

The government has also announced $200 million to establish a Future Industries Fund, offering grants of up to $1 million to companies working in six industries, including medical technology and pharmaceuticals. There is also $60 million for a start-up initiative.

Posted in Australian eHealth


0 # John Lowry 2015-05-06 11:28
Part of the problem is that government departments are very slow to look for alternative options to deliver health services integrations. They tend to prefer, understandably, the comfort of the biggest multi-nationals and their agents, but the premium is very high and in many cases (a.k.a. Queensland health payroll) are a miserable failure. Queensland Health recently opened the door to all potential health IT innovations through an "ideas" portal. It will open the health market to developers and start-ups with great products that will deliver health services integrations at a fraction of the cost of the big multi-national agencies. Victoria could try it. The $300k for "planning" would be far more effectively applied to a pilot for new integration products.
0 # Berne Gibbons 2015-05-06 16:06
Perhaps Vic is starting to embrace new technology, believing they have spent enough on the big systems.The Qld 'ideas' portal is a good initiative.
0 # David Wrede 2015-05-07 08:38
Perhaps the hard lessons about secondary and tertiary care IT both at home and abroad have been learned? We do need digital data collection and communicatrion innovation in specialist medicine, but not the promise it all, cost a fortune, fail to deliver solutions that have been tried in Australia, the UK and the States thus far. If we make the users central to development and move into webnative & mobile technologies we might see some rel progress.
0 # John Lowry 2015-05-07 10:20
I agree David. We developed a platform pretty much along your "thought path" that started life as a mobile business communications system. We quickly realised that we could use similar technology to integrate people, systems, machines and sensors in a workflow. I provides for communication between multiple / legacy systems, machines, environmental sensors and people in a way that large ESB's can not. It also allows for low-cost incremental implementation and retention of legacy systems until new systems are proven. It also means that perfectly good systems (that people like and are trained on) or that may perform discrete tasks very well, can be easily linked into wider networks.

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