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Transcript of press conference: Melbourne: 29 March 2011: e-health; NSW and health reform



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THE HON NICOLA ROXON MP Minister for Health and Ageing

TRANSCRIPT OF PRESS CONFERENCE MELBOURNE 29 MARCH 2011

E & OE

Topics: E-Health, NSW and Health Reform

NICOLA ROXON: Thank you very much particularly to George Savvides and Medibank for having us here today, to make a very exciting announcement about the Government's next investments in e-health.

I'm announcing today that there are nine new lead sites for the implementation of the personally controlled electronic health records, and the sites that we're announcing today include here at Medibank Private of course, one of Australia's biggest insurers, already providing a range of different health services, and as you just saw with our demonstration with Melissa and Renee and Emma, information that can be quickly made available, a test that can be done, can be uploaded onto the personal health record, information that will be able to be accessed by Medibank's members in their home, but also by clinicians providing different services across the country, so I'm sure George will want to talk more about that, it's one of the nine sites.

We also have investments that are commencing in Brisbane South, the Mater Hospital in Brisbane, St Vincent's in Sydney, a Western Sydney regional project, all of the Northern Territory is part of this range of implementation sites, a project being run out of Calvary Hospital in Canberra, a project in North Western Tasmania, and here in Victoria, a project by Fred IT, which has a particular focus on Geelong.

So these nine sites add to the first three sites that were announced last year, Brisbane North, Melbourne East and Hunter Valley, and these are the first parts of Australia that are going to benefit from our government's investments into e-health.

And through these sites you can see that we'll be working with public hospitals, private hospitals, GP divisions, GP practices, pharmacists, Australian Territory Governments, insurers and others, to make sure that these e-health records can

be implemented, and that every person will be able to access electronic health records, as the Government plans by 1 July, 2012.

Our 12 sites will target enrolling over half a million Australians ahead of that start date of 1 July, 2012.

So I want to thank George for allowing us here to Medibank, to see how e-health is already delivering for Medibank's customers, and how that can be significantly expanded through the new health book that you've had a sneak preview of today.

This project is going to help connect important health information, and allow people to have more control over their own health care.

I do want to flag in particular that Brisbane is becoming an e-health ‘super site’, with both Brisbane north and south, and maternity services at the Mater to be covered. Also of course they will benefit from projects like the national ones that Medibank is part of.

Importantly the Northern Territory was successful in their application, it means that often very remote members of the community in the Northern Territory, in the indigenous communities, will be able to access these services, and of course will be able to test and implement any different sorts of technologies that might be

needed, or techniques, to make sure that the access for those community members is able to be rigorous again for the start date on 1 July, 2012.

We had an independent selection process, and we received over 90 applications, so it's been very competitive, a lot of interest across the country in the implementation of a national electronic health record, and these sites will be funded now to undertake a detailed implementation plan before they receive the total funds for their projects.

So we believe this is another important step in progress that we're making towards our ambitious goal of connecting the health of Australians, and helping to reduce medical errors, and pharmaceutical errors. It's also, as I said, an important step in making sure consumers can control and have more information about their own health.

Other upcoming steps in the e-health implementation will be the release of our draft concept of operations, and of course the start of tele-health consultations being funded through Medicare from 1 July this year.

I'm also releasing today the outcomes of a very successful e-health conference that was held in Melbourne late last year, I see Mukesh Haikerwal is here, one of the clinical leaders for NEHTA, it was a very successful project, and conference, and there was important feedback that we received from consumers, clinicians,

and of course the IT industry, which has assisted in us being able to feed that into the design of our overall system.

So we're very excited that today we are getting over half a million Australians one step closer to having their health records on line and available for them, we're delighted that we've seen players across the health industry, apply for funding.

I think we shouldn't under-estimate the significance and importance of having players from public and private sectors, insurers, government, GP practices, pharmacists, this is - all of those organisations make up the health system, and our e-health investments are determined to link all of those parts of the system in a way that benefits patients.

So it's a very exciting time, I'm going to hand over to George, to make a few comments about Medibank's project, and then I'm happy to answer questions about this and any other issues that people want to raise.

GEORGE SAVVIDES: Thank you very much Minister and thank you for coming this morning, and being part of this really important launch for us, we really appreciate receiving the grant that makes it possible to be one of the sites.

At Medibank our world has been changing very quickly, just a couple of years ago we were a health insurer with 1700 staff, today our health services organisations, which we call Medibank Health Solutions, you're a part of it here today, has expanded our group to be over 4000 in staff in just that period of time, and we've moved from 30 health professionals as a health insurer to over 1500 now, operating over 60 clinics around the country, and over 800 nurses, taking 7 by 24 hours calls, and those triage calls here in Australia and New Zealand.

A vital component of the effectiveness of the services we provide to our customers, our members, is the ability to understand who they are, their health history, their health record, because we understand, once we have that view and that perspective, the health outcomes that they attain through the services we deliver, are much better, improved health outcomes, especially those who are involved in chronic disease programs, which we also offer our membership.

We have over 28,000 Australians in chronic disease management programs today, and we are developing a capacity to grow that to over 100,000 in the next couple of years. Critical in the effectiveness of those programs, is the ability to understand the health history of the person that we're treating, and so this initiative is very important for us, because it will improve the productivity of the services we offer, and the health outcomes of those who are part of the programs.

The Medibank health book will be available to the individual, controlled by the individual through their own web link, but also we'll move into portable devices,

like cellular phones over time, once the robust security and the NEHTA pathway for standards is established and firmed up, and we want to be part of that growing journey.

And also in the public health services that we offer, like nurse triage, be available to assist in the roll-out for all Australians to be a part of a personally controlled health record, which we are very much looking forward to.

And also in the virtual consultations that we'll start later this year, Medibank is already investing in the technologies to deliver virtual consultations, so we want to be a part of this new revolution of a health system that's opened not just for the single shift if you like, but three shifts a day, every day of the week, using that new innovative technology.

So Minister, thank you for making it possible for Medibank to be a part of this journey, we're working with our partners, IBM in this as well, and we're very much looking forward to delivering the desired objectives that this project has before

us. Thank you again for coming.

NICOLA ROXON: Okay, over to you, if anyone's got any questions. If we've answered all of them, we don't have to.

QUESTION: Could I just ask, if I have [indistinct] Medibank [indistinct].

NICOLA ROXON: Sure, well George might want to add to that, but basically there are two different stages that you need to also be aware of. At the moment, the project that's being funded and developed is for Medibank, for their customers, and for their service providers, and to be able to be accessed with the permission of the patient.

What we hope is that the development of all of this process and information being available for particular patients that are Medibank members is that that actually gives us the technology, the models, tested and proven screens that work well for consumers, which would have the potential to be translated into the electronic health world of the future.

We've got 9 different sites, a total of 12 now, when you add the first sites, all of them are working up proposals and services that we'll be able to link into the electronic health record that every Australian will have in the future.

So it's about testing up and developing the technology, the screens, the access to information, the systems to information that you need, so that different service providers can talk with each other, the systems you need so patients can access, using different types of technology, those lessons learned will be able to be translated into the establishment of the electronic health record, but I'm sure

George will want to be able to assure people that it is up to the patient who else

is able to access that information, and there's not a plan that Medibank will provide that information to the Government or to anybody else.

It is for the service providers that Medibank is currently engaged with.

Do you want to add to that George? Have I got that right?

GEORGE SAVVIDES: Yeah, absolutely. So it's patient control - or personally-controlled record, and we're starting with our 28,000 members who are in our own active programs, so they're daily engaged in telephonic and face to face consults with our Health Solutions staff, and that interaction creates for them an active build of their own health book, but that - the access of that book is controlled by the individual.

QUESTION: And so could a local hospital access it for example?

GEORGE SAVVIDES: No, not in our first phase of this e-health book. It has the capability over time to be developed into that kind of environment, but not for this particular phase of the cycle. It's an internal one. The 28,000 is a really lovely sort of size of sample where we could robustly test these claims and make sure that we've got the kind of capability technologically to be able to deliver the expectation of the individual.

NICOLA ROXON: Which is obviously an important point, but for example, each of these projects is different. The north Brisbane site which I've previously visited actually has a partnership with the local hospitals, the repat hospital and one of the other public hospitals. The patients that are enrolled in their system agree to be able to have that information accessed by the hospital, so last time I was there the GP was telling me a story of a veteran who was part of the system, who had turned up unexpectedly, needed to go to hospital.

They were able to access his information because he'd given permission for that - saw he was allergic to particular types of medication, and of course prevented what would have been a much more serious illness if he'd been prescribed the wrong medication which obviously can easily happen in hospital.

So each of the sites has got a different reach. Obviously the Mater Hospital is going to focus on their maternity consumers - to try to see how it can work particularly for young mothers and their families, children, to you know, we know that at that point in time people are high users of the health system, so each of the different projects is proving up different parts of the system, but it does mean that we'll have early adopters across the country up to about half a million who will be very familiar by the time we're at the 1 July 2012 start time with using electronic health records.

And I suspect will be some of our strongest advocates for why this is a benefit for the community to improve your own health outcomes.

QUESTION: Can you explain what's going to happen on 1 July for the patients outside of these projects, what are they going to get?

It's going to be much more basic version is it not?

NICOLA ROXON: So from 1 July this year the new steps that I flagged are that we will have access to tele-health items on the Medicare Benefits Schedule, so particularly for regional Australians, they'll be able for first time, potentially, to go to their GP in a rural community - hook up over the internet, various types of different technology obviously that can be used, to a specialist that might be in town.

They might have come to a major regional hospital for cancer treatment, but be able to do a follow-up appointment down the line. That will be available obviously from 1 July this year - also available from 1 July this year is our new after-hours

GP telephone service with both nurses and GPs available.

1 July next year is when the electronic health record will be available for all Australians. So there are many steps that need to be taken between today and 1 July 2012. But these lead implementation sites are essentially able to show both health service providers and consumers the benefits of e-health and help test which things work and which don't so by the time we're ready to flick that switch for everyone to, nationally, have an electronic health record, we know that we've got the best technology and the best links and strong clinical support, and strong consumer support to do it.

QUESTION: But what will people - what will everyone get on 1 July '12 in terms of the e-health record.

NICOLA ROXON: What everyone will get is the ability to be able to have an electronic health record that stores all their information, their blood type groups, their allergies, their medical history, and of course from that point on to be able to store information about the consultations that they have been part of.

So that's a big change from 1 July 2012. It is not compulsory for people to have an electronic health record so we don't imagine that from day one that we will have 20, 21 million entries and electronic records that people will actually gradually over time with the help of their GP will probably be the first port of call, or if they have a particular hospital presentation, to then actually adopt this system.

But we will be doing all we can to encourage people to take that up on 1 July - and these sites I think over the time will expand, will obviously be attractive to

many people. You can tell from the examples I've given that geographically we're actually covering quite a lot of the country when you have all of the Northern Territory that's going to be already a lead site, when you have all of the metropolitan area of Brisbane as a lead site, when you have the potential for 4 million Australians who are covered by Medibank to be able to link into a system which we want to be interoperable.

This is a lot of reach that will already be ready for the time we hit the 1 July 2012 guideline.

QUESTION: Will the nine new sites also be used as a way of measuring what works, what doesn't work, if there's any technical glitches?

NICOLA ROXON: Absolutely. I mean we have through this competitive process picked organisations that we think already have the capacity and the ability to make this work and for example with Medibank, they're actually investing a lot of their own resources into this as well so they've got a lot of leverage from the Government's perspective, that public money is being complemented by these other investments as well - and that of course when you have lead sites you want to learn from the way the system is implemented, but this isn't a pilot.

This is actually us introducing a system for those people. These are, you know, our front line that are going out and adopting and using this technology, and learning from that experience.

And of course we will be requesting that these organisations share that knowledge and information so that we know what works well can be applied elsewhere. And that's going to be important too.

QUESTION: It's pretty important though that it does work…

NICOLA ROXON: Absolutely.

QUESTION: And you said it's an example for [indistinct] 2012, so…

NICOLA ROXON: Yeah, absolutely, and we don't hide from the fact that we have a lot invested in each of these 9 organisations and the 3 that we've already announced, but I am very confident that there's a lot of exciting things already happening in the health sector.

People haven't been sitting still saying well we need the Government to work out how this happens - and then we'll do it.

Actually we're seeing the opposite. We want to help the Government make sure they're doing it in the most sensible way that will work for consumers - and it's why we've had so much interest across the spectrum. And I'm sure there were

many applications in those other 90 applications that were very good ones and I'm sure a lot of work will continue and I hope it does with those organisations as we get closer to the July 12… 2012 guideline.

And I know the work that Anita's doing is to keep encouraging the rest of the health sector to be ready for that switchover as well.

QUESTION: Well what about the support from the Coalition governments… the state governments. Do you find they're backing this?

NICOLA ROXON: Well unfortunately the federal Opposition, the Liberal Party has made quite clear they don't support e-health at all.

It was an item in the election that they clocked as a saving, $467 million that they said didn't need to be spent.

I think that is a major error of judgment, but we do have a Leader of the Opposition who was the Health Minister who when he first became Health Minister said if we didn't have e-health records well established in five years time

it would be a failure of his government, and of course his government didn't establish those records and it's been left to us.

And now in Opposition he is even saying they will pull away the money. I think he's just been left behind in this debate. There isn't time to wait longer when technology is providing these solutions for consumers - we want to make sure that they can access them, have more information and power to control their own health, and then to improve their health outcomes.

QUESTION: What about the state governments, [indistinct] in New South Wales? You've got a Coalition Government…

NICOLA ROXON: Ah yeah, look we haven't had any discussions yet with the New South Wales Government.

I'm very keen to do that as soon as the new Health Minister is announced and sworn in and ready to meet. We will certainly be lining up to be amongst the first to meet with her.

But obviously we need to give new Governments time to get their feet under the desk and settle. I haven't seen any public commentary from the New South Wales Government about e-health. There have been some suggestions that Mr

Davis here in Victoria is not going to continue with some of the Victorian, previous Victorian Government's investments, but they're really questions that you would have to put to them.

We think the value of every consumer being able to have information that they can control and their records - think of the benefit for families with a number of children who can't remember which one was vaccinated when or can't remember who had a particular illness, and you know, want to make sure that they've got all of their children equally protected. Just to have the information in one site, not have to have repeat tests because you can't find the results from your last test. It's actually going to be really convenient for consumers, and it will save taxpayers money, which means we will be free to invest in the growing health services that are needed for the community. So, it's a win all around.

QUESTION: So you'd describe it as a convenient move or will - is it a priority?

NICOLA ROXON: Oh, it's an absolute priority of our Government, but I think as well as having great potential to improve health outcomes, it is going to be very convenient for consumers. And that's important. Convenience matters, because if it's hard to look after your own health, then not as many people will look after

their own health.

If it's hard to make sure that you've given your children all your immunisations, well then you run the risk that you haven't immunised someone. We want to make it easier and more convenient for people to look after their own health, and we think these projects will allow that to happen.

QUESTION: What support [indistinct] the midwives, what support, training wise, that kind of thing are you going to give them so that they've got - they could [indistinct]?

NICOLA ROXON: Well, George might want to talk particularly about the very many nurses that are employed by Medibank and the nurse, Renee, who assisted in doing the tests, the blood pressure tests and the breath tests as well. Spirometry, is that the right…

GEORGE SAVVIDES: Spirometry, that's right.

NICOLA ROXON: So not really breath test, but…

GEORGE SAVVIDES: Lung function.

NICOLA ROXON: Lung function, that's a better terminology. But across the board, they're different projects everywhere.

So, in the general practice projects, the practice nurses, as much as the GPs themselves, are being trained in how you enter information into the system, and often you actually have the nurses being the ones who are setting up the system. It's going to be different in different parts of the country, and I can't tell you what

every sample will be like, but these projects are aimed to give us very broad coverage across the health professions.

We do know that your family GP is going to be the starting point for many people, so there is a focus on some general practice projects. But, of course, general practice these days does include nurses often playing a lead role in the way that people manage their chronic diseases.

QUESTION: [Inaudible]

NICOLA ROXON: Did you - do you want to say anything about your nurses or…

GEORGE SAVVIDES: Oh yeah. Look, on the nurse side, we certainly don't want the personally controlled health record to be an attempt to turn consumers into health professionals. That's not going to happen.

We want to be able to bring the history of the individual with them when they engage the health system. Whether it's a routine engagement or whether it's an unplanned one, or an emergency one.

In the two million calls we get every year in nurse triage, in Health Online and Nurse on Call, if we were able to view the history of the individual calling the nurse at that point in time, the outcomes would be even more powerful than they are today. The avoidance of unnecessary admissions would be stronger than they are today.

So, having that extra dimension of the history up to date and immediately available is the prize here.

The people that we're targeting in our programs, the 28,000, that will move to over 100,000 in the next few… three years, they consume 50 per cent of the $4 billion in claims that were paid out last year, because they are our high claims. Those that have that - 1 per cent of our members consume 50 per cent of our claims.

So, if we can engage that membership, and the broad Australian population, and have the same ratio, because we're a pretty good sample size at four million, in a health record, and the person who controls the health record, there's a significant benefit to the health system as well as to the individual.

NICOLA ROXON: Yes.

QUESTION: The Herald Sun today reported that the personal email [indistinct] federal MPs have been hacked by Chinese spies. Can you comment on those allegations?

NICOLA ROXON: Well look, I obviously can't comment on the allegations. I've seen the reports in the media and heard the reports in the media. I think people would be bitterly disappointed if they hacked into my email because they wouldn't find anything very interesting about - what time was that appointment and who's coming in next, and is somebody - you know, what flight am I on and has the car been booked. It won't - wouldn't really be massively interesting.

But, obviously, these allegations have been made. I'm sure they are being taken seriously. The Attorney-General is the person who has carriage of these matters for the Government and I'm sure that he will be answering any comments that it - you know, or making any comments that it's appropriate to, and I really don't want to get involved in speculation about these sorts of issues, other than to say that, of course, we expect people will respect the laws of our country and make sure that we have a secure system for the secure dealings that we have, whether it's Cabinet matters or others, and I'm pretty confident in those systems that are in place.

Okay, thanks for coming guys.

ENDS