Concept of Operations: Relating to the introduction of a Personally Controlled Electronic Health Record System
2.1 BackgroundRecent health reform reports [DOHA2009a, DOHA2009b and NHHR2009] recognise that the health system is facing a significant set of challenges, including:
- The increased prevalence of chronic disease.
- Discrepancies in health outcomes between advantaged and disadvantaged Australians.
- An increasing and ageing population.
- Increasing demand for more costly and complex procedures.
- A shortage of skilled health sector workers.
Together these challenges are driving increased healthcare service demands and costs, and call into question the very sustainability of the Australian healthcare system in the medium to long term.
In April 2010, the Council of Australian Governments (COAG) met to discuss the health reform agenda. These reforms will deliver better healthcare via eight streams of work around hospitals, primary healthcare, aged care, mental health, national standards and performance, workforce, prevention and eHealth. Additional COAG discussions in February 2011 have made further refinements to the health reform approach. The health reform approach is described in A National Health and Hospitals Network for Australia’s Future: Delivering the Reforms [DOHA2010c] and the National Health Reform Agreement [DOHA2011c].
As part of the eHealth stream within the health reform package, the Commonwealth has invested $467 million over two years into the key components for an electronic health record system, so that all Australians have access to a PCEHR if they choose.
This investment represents the next key step in the National E-Health Strategy [AHMAC2008] and builds on the foundations developed by NEHTA. These foundations include the Healthcare Identifiers Service (HI Service), National Authentication Service for Health (NASH) and Clinical Terminologies.
In order to fully realise the benefits of this investment, the states and territories will need to continue their planned or expected investments in core health information systems. States and territories will also need to provide the complementary investments to build their capacity in readiness for connection to the PCEHR System.
The Department of Health and Ageing and NEHTA are currently working with each of the state and territory health departments to implement a range of foundations, including Healthcare Identifiers, Discharge Summaries and Secure Messaging, all of which will be required for the PCEHR System.