A 2010 federal budget commitment to provide universal e-health records in Australia is contingent on the states upgrading their core health information systems to connect with a proposed national eHealth system.

Treasurer Wayne Swan has committed $A467 million to establishing "the key national components to introduce a personally controlled electronic health record for every Australian who would like to use one, from July 2012."

Exactly what are those "key national components"? A database, a server, a new bureaucracy? The answer is not contained in the 2010 budget announcements.

The federal government envisions providing all citizens with easy access to information about their medical history, including medications, test results and allergies, as well as the power to control what is stored on their health records.

However it notes, "In order to fully realise the significant benefits of this Commonwealth investment, State and Territory governments will also need to continue their planned or expected investments in core health information systems. The States and Territories will also need to provide the complementary investments to build their capacity in readiness for connection to this national system."

A half-billion database of personal health records will "modernise our health system by providing a personally controlled electronic health record for every Australian who wants one," said Treasurer Swan.

"Patients will be empowered with easy‑to‑access information about their medical history, including medications, test results and allergies, allowing them to make informed choices about their health care."

According to the 2010 Budget statements, "This funding will provide the capability to produce nationally consistent patient health summaries from existing and compliant information sources. Patients who choose to participate will be able to securely access, and permit their healthcare providers to access, their health information.

"Personally controlled health records will over time be capable of incorporating a range of health information, such as a patents' general health history, pathology and radiology summaries and prescription information. This will support more informed clinical assessments and decision making, improve continuity of care for patients and introduce efficiencies in health care service delivery.

According to a report issued last week by consultants Booz & Company, 95 percent of Australia’s GPs are computerised versus 46 percent in the United States.

Although the report also notes that "Despite the relatively high adoption of IT amongst Australian GPs, connectivity between hospitals and community healthcare providers remains a key issue that only a handful of projects have begun to address. Furthermore, there is an overall lack of investment, accountability, and shared goals in Australia’s e-health programs. This is creating insecurity, confusion, and frustration among the healthcare system’s primary stakeholders, especially patients who expect clinicians to have access to meaningful information at the point of care.

"Although a national e-health strategy has been developed for Australia, a general reluctance to commit funding, resources, and political weight to the implementation effort remains. Missing key elements are a clear, shared understanding of the benefits e-health investments can bring and the quantification of the financial impact that e-health initiatives have on the system’s major stakeholders."

The report claims "a successful rollout and adoption of core e-health capabilities in Australia
[is] expected to be worth an estimated AU$7.6 billion annually by 2020" and "approximately two-thirds (AU$5.1 billion) of the quantifiable e-health benefits in Australia can be attributed to two benefit categories: reduced errors and enhanced adherence to best practices."

Booz & Company believe that "a commitment to a full e-health program now could help Australia avoid an estimated 5,000 deaths annually, more than 2 million primary care and outpatient visits, 500,000 emergency department visits, and 310,000 hospital admissions."

Shadow Minister for Finance Joe Hockey said, "The Budget confirms that Kevin Rudd’s health policies will be about more bureaucrats and not better services. The Government will spend around $A500 million to establish new layers of Commonwealth bureaucracy. In less than a month, Kevin Rudd has broken his promise of no net increase in health bureaucrats."