eHealth and the Private Health Industry

The AHIA has been working with it member funds through the Industry eHealth Strategy Committee which was formed in 2000 and is a ‘voice’ for the Industry on eHealth. One of the key issues of dicussion at teh moment is eHealth.

The Australian Government is investing $467 million over two years to develop the critical national infrastructure for eHealth records as a key element of the national health reform agenda. This project is aimed at giving all Australians from July 2012 the option to sign up for a personally controlled eHealth record. The objective of the Personally Controlled Electronic Health Record (PCEHR) is to enable better access to important health information currently held in dispersed records around the country. It will mean that patients will no longer need to unnecessarily repeat their medical history every time they see a doctor or other health professional.

For the first time, all Australians who choose to participate will be able to see their important health information, when and where they need it. They will be able to share this information with trusted healthcare providers.

The system is being built on the foundations laid by infrastructure such as the National Healthcare Identifier Service that launched in July 2010 and  it is hoped that eHealth records will improve accessibility to health services and patient information, which over time will significantly enhance health outcomes.

The PCEHR is a significant change in health care management in Australia and the AHIA is very interested in the next iteration of the PCEHR Draft Concept of Operations– Relating to the introduction of a PCEHR system as Health Industry Funds want to ensure that they are well positioned to provide good services to their members who take up a Personal Health Indicator.

The PCEHR_Legislation Issues Paper was recently made publicly available for comment and the AHIA submitted feedback to the Department on the key issues for the Private Health Insurance Industry. The key issues for teh Industry include:

• Private Health Insurance Industry was not specifically addressed as a key participant nor was PHI participation addressed within the PCEHR Draft Concept of Operations document
• If the Minister’s desire to have the Funds participate in an expansion of Broader Health Care provision is to be facilitated, an inability to utilise the PCEHR to the fullest may well prevent such a desirable outcome
• Funds that do not qualify as a Healthcare Organisation and do not receive a HPI-O identifier will be at a disadvantage to those Funds who do receive an HPI-O identifier
• There is not currently a coordinated approach to complaints handling regarding PCEHR and want to to ensure the issue behind the complaint is correctly addressed so that PHIO is not dealing with complaints about the eHealth System
• PCEHR implementation focus has been on primary care rather than acute settings and therefore the implications for the private health sector are not well understood at this stage or top of mind of those driving implementation
• Under the Healthcare identifier legislation 2010, health funds are excluded access to the IHI for certain purposes however access by Funds to the IHI would help streamline hospital provider payments of benefits
• Funds have considerable amounts of information relating to their individual members health history and this information should be included in the PCEHR so that individuals have a complete picture of their health records
• It is noted that in order to be consistent with the overall existing record management requirements across jurisdictions, a minimum requirement is for PCEHR records to be stored for 15 years. This would/could place strain on IT capabilities and capacities.
• The requirement to store data in Australia places limitations on potential data warehouse options. It precludes emerging and potentially more efficient and cost effective technologies such as cloud or virtualisation of servers

The AHIA submitted its feedback to the Department on the 3rd of August 2011 and  looks forward to working with the Department as it continues through the planning and implementation phases of the PCEHR project.

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