David More wrote: > Hi Tim, > > Let me try and answer your questions as best I can. ...snip... > Re Use of Medicare Number - it is not an adequate ID for medical records > nationally. > Remember there are more medicare number by about 20% than people in the > populations (see > recent productivity commission report - it mentioned that I recall)
Yes, yes, and if you re-read my post, you will noted that I said: "One has to ask the question: why not just jump directly to a national health care identifier, particularly when we are already 80% of the way there with the Medicare number. Yes, it would take some (minor) legislative change to allow the Medicare number to be used universally, yes, Medicare numbers would need to be made unique to each person, and yes, those not eligible for Medicare would need to be accommodated, but these are all feasible extensions to the current Medicare card/number. It all depends on timing. Hmmm, if left in the hands of HIC, it could take decades..." > Tim, it is simply not enough to do anything that will make a difference I > believe. And its > goes to 2009 - then what - no recurrent funds committed. No, but these NeHTA-led initiatives will supplant a lot of already-funded activity to do somewhat more limited versions of the same things (eg statewide or regional unique patient identifiers, health care provider directories). The task for NeHTA is to convince State and regional health authorities to disinvest in those and to re-invest the money saved into these national initiatives instead. If NeHTA succeeds in doing that, then there will be enough money. Wanting a confirmed budget beyond 2009 is unrealistic. If it works as promised, or looks like it will work, then funding will be continued. If it doesn't work (like just about every other national scale health IT project, or pilots thereof, that I can think of), then the funding plug will be pulled. I am sure you are familiar with the phenomenon of funding being pulled from large health IT projects which don't deliver results within a 3 or 4 year time frame, aren't you, David (what is that rattling sound?) > Note: I believe these are good things to do - just not much will really > happen with the > proposed funds - and the risk of underinvestment is that all of it will be > wasted like the > $49.5m spent on HealthConnect to date (largely) A little while ago you said in a New Matilda article (reproduced here: http://www.mail-archive.com/[email protected]/msg01136.html ): "...planned HealthConnect implementations have been drastically scaled back in both cost and likelihood to meet the goals of the original plan upon on which upwards of $100M has reportedly already been spent." David, which is correct, $100m or $49.5m? Tim C > On Sat, 11 Feb 2006 10:54:10 +1100, Tim Churches wrote: >> David More wrote: >> >>> Progress Towards Electronic Health Records >>> >>> To underpin the efforts in refocusing the health system to promote better >>> health and > community >>> care for all Australians, COAG agreed to accelerate work on a national >>> electronic > health >>> records system to build the capacity for health providers, with their >>> patient's > consent, to >>> communicate quickly and securely with other health providers across the >>> hospital, > community and >>> primary medical settings. The Commonwealth will contribute $65 million and >>> the States > and >>> Territories $65 million in the period to 30 June 2009. >>> >> That sounds less like the former HealthConnect vision of huge, shared, >> central repositories and much more like a vision of a far more >> distributed electronic health record (or rather, an "electronic health >> record system") enabled by quick and secure communication. OK, I have >> just restated the preceding paragraph - but my point is that the >> emphasis is on secure communication (implying between distributed >> clinical information systems or repositories), not on shared central >> repositories. >> >> Is that correct? >> >>> Comment - This is a funding of $43.3M p.a. >>> >>> From February 2006, governments will accelerate work on a national >>> electronic health > records >>> system to improve safety for patients and increase efficiency for health >>> care providers > by >>> developing the capacity for health providers, with their patient's consent, >>> to > communicate >>> safely and securely with each other electronically about patients and their >>> health. > This >>> requires: >>> developing, implementing and operating systems for an individual health >>> identifier, a >>> healthcare provider identifier and agreed clinical terminologies; and >>> promoting compliance with nationally-agreed standards in future government >>> procurement > related >>> to electronic health systems and in areas of healthcare receiving >>> government funding. >>> >> Goodness me, that actually seems like a sensible programme of work. Now >> if it can just be implemented in a sensible, cost-effective fashion... >> >>> Comment >>> >>> The best estimate of the cost of Patient ID, Provider ID and Terminology >>> Services Costs > when >>> operational is at least $100M p.a. to do it half way properly >>> >> David, where is this estimate published so we can examine its basis and >> assumptions? A great many cost estimates for health IT initiatives are >> produced by large IT consultancy firms who hope to pick up fat contracts >> to implement those same inititaives, and teh estimates are based on >> rather flimsy evidence or questionable (or at least highly arguable) >> assumptions. Thus all such figures need to be carefully scrutinised >> before being given any credence. >> >>> Again I believe we are being dudded big time! This is again tinkering at >>> the edges - > and of >>> course there is no public plan about what is intended other than these few >>> lines. > Anyone know >>> any more detail? >>> >> The key question is how this relates to existing and planned State >> health dept facilities and planned projects to create state-wide unique >> patient identifiers and health service provider directories, often by >> amalgamating existing regional medical record number systems and GP >> directories etc. One has to ask the question: why not just jump directly >> to a national health care identifier, particularly when we are already >> 80% of the way there with the Medicare number. Yes, it would take some >> (minor) legislative change to allow the Medicare number to be used >> universally, yes, Medicare numbers would need to be made unique to each >> person, and yes, those not eligible for Medicare would need to be >> accommodated, but these are all feasible extensions to the current >> Medicare card/number. It all depends on timing. Hmmm, if left in the >> hands of HIC, it could take decades... >> >> Tim C >> _______________________________________________ >> Gpcg_talk mailing list >> [email protected] >> http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk >> >> __________ NOD32 1.1403 (20060210) Information __________ >> >> This message was checked by NOD32 antivirus system. >> http://www.eset.com > > > ------------------------------------------------------------------------ > > _______________________________________________ > Gpcg_talk mailing list > [email protected] > http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
