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Creating a Wired Health System


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

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

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  • 1. 1 Towards a national eHealth strategy
    © 2009 Deloitte Touche Tohmatsu
    National eHealth Strategy
    The Way Forward
    Adam Powick
    April 2010
  • 2. eHealth – Building a wired health care system
    NGO Sector
    NGO Sector
    Allied Health and Diagnostic Professionals
    Private Providers
    Allied Health and Diagnostic Professionals
    Personal HealthProfile
    OnlineInformation and
    Family and Communities
    Clinicians and Nurses
    Family and Communities
    Clinicians and Nurses
    Private Providers
    Current Environment
    Policy Maker
    The key objective is to provide the right information to the right person at the right place and time to optimise health care outcomes
    Future Environment
  • 3. eHealth strategy and policy context
    Why Now?
    ‘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’.
    ‘Treasury has concluded that by 2045-46, spending on health and hospitals would consume the entire revenue raised by state governments’.
    Kevin Rudd, March 3rd 2010
  • 4. eHealth should be a key part of the reform process
    Heavily reliant on pen, paper and human memory
    Significant underinvestment in information technology
    Disconnected islands of information
  • 5. Governance – what market model should we pursue?
    Free Market
    Guided Market
    National legislation
    Nationally developed infrastructure & standards
    Central funding / investments
    Market driven projects and solutions
  • 6. So what do we need to do?
    Establish the core foundations for electronic information exchange across the health sector
    Stimulate investment in high priority computer systems and tools
    Encourage health sector participants to adopt and use high priority systems and tools
    Change and
    Ensure the effective coordination and oversight of the national eHealth work program
  • 7. eHealth Implementation Roadmap
    10 Years
    Connect and
    6 Years
    3 Years
    Establish eHealth foundations
    Focus shifts from basic communication to collaboration
    eHealth becomes part of business-as-usual
    A journey of 10+ years is required to deliver a national eHealth environment
  • 8. Reform Commission Report (on 1 page)
    115 - By 2012, every Australian should be able to have a personal EHR
    116 - Privacy legislation
    117 - Unique identifiers andauthentication (July 2010)
    118 - National social marketing strategy
    119 - Access to a national broadband network
    120 - Payments to be dependent on sending and receiving personal EHR data
    121 - National policy and open technical standards framework for e-health
    122 - Funds for e-health teaching, training, change management and support
    123 - Endorse the National eHealth Strategy
    - strengthen government leadership, governance and resources
    - support to public health organisations and incentives to private providers
    - government should not design, buy or operate IT systems
  • 9. National Primary Health Care Strategy
    • 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. Improving access and reducing inequity
    • 11. Better management of chronic conditions
    • 12. Increasing the focus on prevention
    • 13. Improving quality, safety, performance and accountability
    • 14. What will be different?
    • 15. Patients not having to repeat their medical history to each new provider
    • 16. Patients having information to help them to manage their own condition
    • 17. Health care providers able to set up virtual, integrated care teams, and having accurate and timely information to support best treatment
    • 18. Potential to outreach to hard to service communities with more innovative and efficient use of health workforce
    • 19. Improved quality and safety
    ‘Use of technologies including eHealth is falling behind consumer expectations, other service industries and progress in other comparable health systems.’
  • 20. National Preventative Health Strategy
    ‘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.’
    • Comprehensive national surveillance systems for obesity, tobacco and alcohol
    • 21. Development of national data linkage systems, for health and non-health data, in order to develop nationally representative and consistent baseline information
    • 22. Primary health care to have access to an electronic patient record and information systems that provide risk data on the practice population
  • Interesting Times
    • Health Identifier legislation before parliament
    • 23. Business case for the introduction of a national IEHR system being considered by AHMC
    • 24. Kevin Rudd and health reform - ‘now is the time to act’
    ‘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:
    • eHealth, to take further steps towards the introduction of a personally controlled electronic health record for all Australians.’
    Kevin Rudd, March 3rd 2010
    • But – no mention of eHealth in the ‘historic’ CoAG health reform agreement
  • The CoAG Agreement
    • Federal government to fund ‘60% of building, equipment, teaching and services in 762 public hospitals’
    • 25. Commonwealth Government takes full policy and funding responsibility for primary health care
    • 26. Introduction of case-mix or activity based funding right across the Commonwealth
    • 27. Responsibility for running public hospitals will be devolved to Local Hospital Networks
    • 28. Five key changes to health care:
    • 29. 1300 new hospital beds
    • 30. 2500 new aged care beds
    • 31. 6,000 new doctors
    • 32. Emergency / waiting list KPIs
    • 33. 20,000 young people to get access to mental health
  • The missing piece
    In the Prime Minister’s words:
    ‘With (these reforms), we can finally deliver better integrated, better coordinated healthcare that is more responsive to the needs of patients’
    ‘With the structural reforms I am announcing today, we can go on to build and extend a health system for the 21st century’
    Not without eHealth you can’t
    Kevin Rudd, March 3rd 2010
  • 34. The way forward – 5 key elements
    • Leadership
    • 35. Sponsorship, policy direction
    • 36. Governance
    • 37. Board, leadership team
    • 38. Stakeholder Engagement
    • 39. Care providers, consumers, funders, vendors, politicians
    • 40. National Infrastructure
    • 41. Identifiers, standards, legislation, NBN, compliance
    • 42. Funding
    • 43. Capital projects, recurrent expenditure, incentives
  • The vital ingredient – lead implementations
    • Need tangible examples and evidence
    • 44. Peer driven sector
    • 45. Means to engage vendors
    • 46. Four conditions:
    • 47. High priority domains, compliance with national standards, cross sector connectivity, scalable
    ‘Closed Systems’ ‘Communities of Practice’
    Brisbane North
    Aged Care
  • 48. Key Considerations
    • Political support
    • 49. Engaging consumers
    • 50. Centrality of primary care (‘the network effect’)
    • 51. Encouraging vendor innovation
    • 52. Workforce skills
  • eHealth – change is now inevitable
    Guided or free market change?
  • 53. 18 Towards a national eHealth strategy
    © 2010 Deloitte Touche Tohmatsu
    General information only
    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.
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    About Deloitte Australia
    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
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