Creating a Wired Health System


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A presentation by Adam Powick on how to create an eHealth system in Australia

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Creating a Wired Health System

  1. 1. 1 Towards a national eHealth strategy<br /> © 2009 Deloitte Touche Tohmatsu<br />National eHealth Strategy<br />The Way Forward<br />Adam Powick <br />April 2010<br />
  2. 2. eHealth – Building a wired health care system<br />NGO Sector<br />NGO Sector<br />Allied Health and Diagnostic Professionals<br />Private Providers<br />Allied Health and Diagnostic Professionals<br />GP’s<br />Personal HealthProfile<br />Jurisdictions<br />Pharmacists<br />Jurisdictions<br />GPs<br />OnlineInformation and<br />Communities<br />Pharmacists<br />Consumer<br />Family and Communities<br />Clinicians and Nurses<br />Family and Communities<br />Clinicians and Nurses<br />Private Providers<br />Consumer<br />Current Environment <br />Clinician<br />Policy Maker<br />The key objective is to provide the right information to the right person at the right place and time to optimise health care outcomes<br />Future Environment <br />
  3. 3. eHealth strategy and policy context<br />Why Now?<br />‘The Commission concluded in July last year that the health and hospital system is fragmented, is at a tipping point and is unable to cope with the challenges it faces in the years ahead. In the words of the Commission ‘now is the time to act’.<br />‘Treasury has concluded that by 2045-46, spending on health and hospitals would consume the entire revenue raised by state governments’.<br />Kevin Rudd, March 3rd 2010<br />
  4. 4. eHealth should be a key part of the reform process<br />Heavily reliant on pen, paper and human memory<br />Significant underinvestment in information technology<br />Disconnected islands of information<br />
  5. 5. Governance – what market model should we pursue?<br />Free Market<br />Guided Market<br />CentrallyControlled<br />National legislation<br />Nationally developed infrastructure & standards<br />Central funding / investments<br />Market driven projects and solutions<br />
  6. 6. So what do we need to do?<br />Establish the core foundations for electronic information exchange across the health sector<br />Foundations<br />Stimulate investment in high priority computer systems and tools <br />eHealth <br />Solutions<br />Encourage health sector participants to adopt and use high priority systems and tools <br />Change and <br />Adoption<br />Ensure the effective coordination and oversight of the national eHealth work program<br />Governance<br />
  7. 7. eHealth Implementation Roadmap<br />Consolidate<br />Collaborate<br />10 Years<br />Connect and <br />Communicate<br />6 Years<br />3 Years<br />Establish eHealth foundations<br />Focus shifts from basic communication to collaboration<br />eHealth becomes part of business-as-usual<br />A journey of 10+ years is required to deliver a national eHealth environment<br />
  8. 8. Reform Commission Report (on 1 page)<br />115 - By 2012, every Australian should be able to have a personal EHR<br />116 - Privacy legislation<br />117 - Unique identifiers andauthentication (July 2010)<br />118 - National social marketing strategy<br />119 - Access to a national broadband network<br />120 - Payments to be dependent on sending and receiving personal EHR data<br />121 - National policy and open technical standards framework for e-health<br />122 - Funds for e-health teaching, training, change management and support<br />123 - Endorse the National eHealth Strategy<br /> - strengthen government leadership, governance and resources<br /> - support to public health organisations and incentives to private providers<br /> - government should not design, buy or operate IT systems<br />
  9. 9. National Primary Health Care Strategy<br /><ul><li>eHealth is recognised as one of the five key building blocks of the strategy and underpins each of the four identified priority action areas:
  10. 10. Improving access and reducing inequity
  11. 11. Better management of chronic conditions
  12. 12. Increasing the focus on prevention
  13. 13. Improving quality, safety, performance and accountability
  14. 14. What will be different?
  15. 15. Patients not having to repeat their medical history to each new provider
  16. 16. Patients having information to help them to manage their own condition
  17. 17. Health care providers able to set up virtual, integrated care teams, and having accurate and timely information to support best treatment
  18. 18. Potential to outreach to hard to service communities with more innovative and efficient use of health workforce
  19. 19. Improved quality and safety</li></ul>‘Use of technologies including eHealth is falling behind consumer expectations, other service industries and progress in other comparable health systems.’<br />
  20. 20. National Preventative Health Strategy<br />‘It is necessary to strengthen Australia’s capacity to effectively monitor, evaluate and build evidence around preventative health. A number of ambitious targets relating to overweight and obesity, alcohol and tobacco have been set by this Strategy, and Australians will need to know how effective our preventative health programs are and whether we are on track to meet these targets.’<br /><ul><li>Comprehensive national surveillance systems for obesity, tobacco and alcohol
  21. 21. Development of national data linkage systems, for health and non-health data, in order to develop nationally representative and consistent baseline information
  22. 22. Primary health care to have access to an electronic patient record and information systems that provide risk data on the practice population</li></li></ul><li>Interesting Times<br /><ul><li>Health Identifier legislation before parliament
  23. 23. Business case for the introduction of a national IEHR system being considered by AHMC
  24. 24. Kevin Rudd and health reform - ‘now is the time to act’</li></ul>‘Over the coming weeks and months, the Government will announce additional reforms that will build on existing investments and the structural reforms outlined in this document. These reforms will be made across a range of areas, including in:<br /><ul><li> eHealth, to take further steps towards the introduction of a personally controlled electronic health record for all Australians.’</li></ul>Kevin Rudd, March 3rd 2010<br /><ul><li>But – no mention of eHealth in the ‘historic’ CoAG health reform agreement</li></li></ul><li>The CoAG Agreement<br /><ul><li>Federal government to fund ‘60% of building, equipment, teaching and services in 762 public hospitals’
  25. 25. Commonwealth Government takes full policy and funding responsibility for primary health care
  26. 26. Introduction of case-mix or activity based funding right across the Commonwealth
  27. 27. Responsibility for running public hospitals will be devolved to Local Hospital Networks
  28. 28. Five key changes to health care:
  29. 29. 1300 new hospital beds
  30. 30. 2500 new aged care beds
  31. 31. 6,000 new doctors
  32. 32. Emergency / waiting list KPIs
  33. 33. 20,000 young people to get access to mental health</li></li></ul><li>The missing piece<br />In the Prime Minister’s words:<br />‘With (these reforms), we can finally deliver better integrated, better coordinated healthcare that is more responsive to the needs of patients’<br />‘With the structural reforms I am announcing today, we can go on to build and extend a health system for the 21st century’<br />Not without eHealth you can’t<br />Kevin Rudd, March 3rd 2010<br />
  34. 34. The way forward – 5 key elements<br /><ul><li>Leadership
  35. 35. Sponsorship, policy direction
  36. 36. Governance
  37. 37. Board, leadership team
  38. 38. Stakeholder Engagement
  39. 39. Care providers, consumers, funders, vendors, politicians
  40. 40. National Infrastructure
  41. 41. Identifiers, standards, legislation, NBN, compliance
  42. 42. Funding
  43. 43. Capital projects, recurrent expenditure, incentives</li></li></ul><li>The vital ingredient – lead implementations<br /><ul><li>Need tangible examples and evidence
  44. 44. Peer driven sector
  45. 45. Means to engage vendors
  46. 46. Four conditions:
  47. 47. High priority domains, compliance with national standards, cross sector connectivity, scalable</li></ul>‘Closed Systems’ ‘Communities of Practice’<br />ACT<br />NT<br />Defence<br />Diabetes<br />DVA<br />Brisbane North<br />Cancer<br />Aged Care<br />Medicare<br />
  48. 48. Key Considerations<br /><ul><li>Political support
  49. 49. Engaging consumers
  50. 50. Centrality of primary care (‘the network effect’)
  51. 51. Encouraging vendor innovation
  52. 52. Workforce skills</li></li></ul><li>eHealth – change is now inevitable<br />Guided or free market change?<br />
  53. 53. 18 Towards a national eHealth strategy<br /> © 2010 Deloitte Touche Tohmatsu<br />General information only<br />This presentation is provided as general information only and does not consider your specific objectives, situation or needs. You should not rely on the information in this presentation or disclose it or refer to it in any document. We accept no duty of care or liability to you or anyone else regarding this presentation and we are not responsible to you or anyone else for any loss suffered in connection with the use of this presentation or any of its content.<br />About Deloitte<br />Deloitte provides audit, tax, consulting, and financial advisory services to public and private clients spanning multiple industries. With a globally connected network of member firms in 140 countries, Deloitte brings world class capabilities and deep local expertise to help clients succeed wherever they operate. Deloitte's 150,000 professionals are committed to becoming the standard of excellence. <br />Deloitte's professionals are unified by a collaborative culture that fosters integrity, outstanding value to markets and clients, commitment to each other, and strength from diversity. They enjoy an environment of continuous learning, challenging experiences, and enriching career opportunities. Deloitte's professionals are dedicated to strengthening corporate responsibility, building public trust, and making a positive impact in their communities. <br />Deloitte refers to one or more of Deloitte Touche Tohmatsu, a Swiss Verein, and its network of member firms, each of which is a legally separate and independent entity. Please see for a detailed description of the legal structure of Deloitte Touche Tohmatsu and its member firms. <br />About Deloitte Australia<br />In Australia, Deloitte has 12 offices and over 4,500 people and provides audit, tax, consulting, and financial advisory services to public and private clients across the country. Known as an employer of choice for innovative human resources programs, we are committed to helping our clients and our people excel. Deloitte's professionals are dedicated to strengthening corporate responsibility, building public trust, and making a positive impact in their communities. For more information, please visit Deloitte’s web site at<br />Confidential This document and the information contained in it is confidential and should not be used or disclosed in any way without our prior consent.<br />Liability limited by a scheme approved under Professional Standards Legislation.<br />© Deloitte Touche Tohmatsu, 2009. All rights reserved.<br />