E-Health: Australia's $5bn black hole

Australia's health sector has made only "marginal" progress towards being able to exchange information electronically, despite governments investing more than $5 billion in the field over the last 10 years, according to a report released late last week.

The primary information tools used to manage health care in this country still revolve around pen, paper and human memory

Deloitte's e-health report

The report, which was developed by consultancy Deloitte Touche Tohmatsu earlier this year but only partially published last week, was endorsed by state and federal health ministers last week as a key strategy document outlining how the nation's outdated and dysfunctional health IT systems should be brought up to date.

"At its core, health is a knowledge industry with information being central to all aspects of care planning, management and delivery," Deloitte wrote. "Despite this, the primary information tools used to manage health care in this country still revolve around pen, paper and human memory."

Deloitte's findings come on the heels of a similar, but broader report released in November by New South Wales Health special commissioner Peter Garling. Garling found that while much of the work undertaking in NSW public hospitals was "high tech", its record-keeping (or e-health) system was a "relic of the pre-computer age", with most records being kept on paper; a situation that had implications for the level of care provided.

"The relative lack of maturity of information technology within the health sector has important implications for patient safety ... studies have found that up to 18 per cent of medical errors are due to the inadequate availability of patient information," wrote Deloitte.

Deloitte's report recommended the nation embark on a strategy of coordination and alignment across government jurisdictions, focused in four areas:

• Implementing the national "health information highway" (infrastructure and rules to allow information to be shared)
• Stimulating investment in high-priority IT systems and associated tools
• Encouraging the health sector to use the tools
• Establishing an e-health governance regime

Many of Australia's current e-health initiatives involve the National E-Health Transition Authority (NEHTA), a group set up several years ago by state and federal government to provide coordination in the area.

What was released is a classic case of bureaucratic 'box-ticking'

E-Health consultant David More

But Deloitte wrote that current governance structures weren't sufficient, and NEHTA needed to be replaced with a more powerful organisation that could be built upon its existing structure.

"In NEHTA, Australia has created and invested in a vehicle for the progression of the national E-Health agenda and, whilst the journey to date has at times been problematic, it represents the best foundation upon which to build momentum behind a national E-Health work program," the consultancy wrote.

But not everyone agrees that Deloitte's strategy is the right way ahead. E-health consultant David More wrote on his AusHealthIT blog that there were some very good principles and strategies to be found in Deloitte's report, but that in general it would not result in action due to a lack of funding.

"Actually, what was released is a classic case of bureaucratic 'box-ticking'," he wrote. "A country has to have a published national e-health strategy — so now we have one.

"Sad it is a total unfunded fraud on all those who have been waiting for some sign of change over the last four years since the bureaucrats last decided they would not invest in Health IT (when HealthConnect morphed from a real project into a 'change management strategy'). Frankly, I don't think the box has been ticked if you don't ensure action after planning."