But the health department cannot yet provide any details of NEHTA's forward work plan allocated $67.4m in the recent budget -- a sum to be matched by the states and territories under Council of Australian Government funding arrangements.
Health chief information officer Paul Madden says NEHTA has "delivered" specifications for all foundation capabilities, including infrastructure and services.
Mr Madden said The Australian was wrong to suggest $1 billion had been spent on the national e-health program since former health minister Nicola Roxon unveiled her personally controlled e-health record vision in mid-2010.
The department insists the PCEHR program has been completed on time and within the original $467m budget, despite the slow launch and lack of many key components.
Mr Madden said $380m in COAG funding for NEHTA's work program during the period included e-health foundations that were "leveraged" for the PCEHR but would have been developed anyway, so this sum should not be included in any accounting of costs.
"The money that's gone to NEHTA historically and NEHTA's e-health activities started well before any announcement of the PCEHR," he said.
"They've been working on a whole range of things that were not necessarily (aimed) towards a specific individual e-health record (the original concept endorsed by COAG) and certainly not the PCEHR.
"These include the Healthcare Identifiers, the Australian Medicines Terminology and secure messaging.
"So, even if we hadn't developed the PCEHR, those expenses would have continued because COAG had decided to develop them."
Separately, the Gillard government has spent $777m on specific PCEHR-related activities since July 2010, including $352m in new forward funding.
Mr Madden said of the $234m allocated in the budget over the next two years, $161.6m was "operational funding for the PCEHR".
"It shouldn't be categorised as development, (our position is) we will operate this system and gain experience with it; there are no functional additions, there's no catch-up (included) -- it's to operate the PCEHR," he said.
This allocation will also finance NEHTA to provide some "specific support and testing arrangements" for PCEHR, on top of the COAG funding for its new work agenda.
Health lowered its targets for the number of consumers registered for a PCEHR in the budget to 500,000 by the end of the current financial year and 1.5 million by the end of 2013-14; originally, it targeted half a million participants by June this year through the lead site programs, but these have not eventuated.
Meanwhile, the National Partnership Agreement on E-Health, under which COAG funds NEHTA, expired at the end of last month.
Mr Madden said a new intergovernmental agreement was "still being developed".
NEHTA's role was to develop the specifications and standards needed to support e-health systems under a COAG program set more than three years ago, he said.
"They don't develop clinical software and put that in the hands of practitioners to use, but the jurisdictions are using products based on their work," he said.
He rejected concerns that many of these were as yet not ready for mainstream use.
"Secure messaging has been delivered in terms of the national guidelines and specifications," Mr Madden said. "There was a media release from a consortium of vendors a couple of months ago that's got an implementation of secure messaging based on those specifications."
Mr Madden also referred to NEHTA's specifications for e-referrals, specialist letters, e-pathology, and e-procurement, saying these were developed as part of its core work program, rather than for the PCEHR.
And he pointed to the delivery of "final" specifications for the electronic transfer of prescriptions -- released in December 2010 and placed on hold in February pending revision sometime this year.
"I understand that the ETP specification (is not current) but NEHTA did write a standard which is on hold pending revision, they will revise it and they’ve got the money to do it," he said.
"The standards wouldn't be up for debate and discussion if nobody did the development work."
The department did not respond to follow-up requests for further information on NEHTA's proposed work plan, and despite repeated requests is yet to provide details of its revised timeline for the PCEHR rollout.
According to Health statements to the Senate Community Affairs committee in June 2010, the $218m COAG funding from July 2009 to end of June this year covered "the essential foundations required to enable e-health, which include healthcare identifiers, secure messaging and authentication, and a clinical terminology and information service".
The original commitment for the Healthcare Identifiers service, by COAG in February 2006, was $98.2m over four years to "develop, implement and operate systems to manage" the individual and healthcare provider identifiers.
In late 2008, COAG agreed to a further $52m to fund Medicare's operation of the HI service from July 2010 – it is still essentially in pilot mode due to a lack of compliant provider software.
NEHTA abandoned its efforts to build a National Authentication Service for Health in 2010, instead awarding IBM a $23.6m contract for the work in March the following year.
But the PCEHR launched on July 1 without the NASH, and a date for its delivery is subject to negotiations between IBM and Health. Previous COAG spending on NEHTA, from its establishment in 2005 to June 2009, totalled $148.4m.
NEHTA had committed to "completing and implementing" clinical terminologies; discharge summaries; conformance, compliance and accreditation specifications; secure messaging; healthcare identifiers; supply chain identifiers; referrals and medication management by December 2009.
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Autor(en)/Author(s): Karen Dearne
Quelle/Source: Australian IT, 18.07.2012
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