Section 2 – Department Outcomes – 10 Health System Capacity and Quality
Outcome10
Health System Capacity and Quality
Improved long-term capacity, quality and safety of Australia’s health care system to meet future health needs, including through investment in health infrastructure, international engagement, consistent performance reporting and research
Outcome Strategy
The Australian Government, through Outcome 10, aims to improve the long-term capacity of Australia’s health care system with a particular emphasis on quality and safety. To achieve this, the Department funds systemic improvement activities focused on management, performance, information, infrastructureand research.
The implementation of the Personally Controlled Electronic Health Record (PCEHR) system is playing a significant role in the Government’s long-term strategy to improve the capacity and quality of the Australian health care system. The PCEHR system enables key health information to be available for individuals when and where it is needed, while ensuring that records are private and secure. In 2013-14, the Department will continue to work with key stakeholders to promote awareness of the benefits of eHealth and to encourage take up of the PCEHR and other eHealth tools by consumers and providers.
The Department will also work with states and territories to further use technology to improve health and reduce healthcare costs. A key activity commencing in 201314 will be the rolling out, over three years, of the PCEHR in Tasmania’s hospitals and enabling allied health, pathology and diagnostic imaging services to connect to eHealth in Tasmania.
To further boost capacity, quality and safety of the health system, the Government is continuing its investment in health infrastructure through the renewal and refurbishment of hospital facilities, medical technology equipment and medical research facilities. The Australian Government will also provide education and support for health professionals and consumers topromote the exchange of health information between states and territories; oversee Australia’s health and medical research efforts, including supporting programs that translate research findings into clinical care;and engage with international organisations and participate in international, regional and bilateral forums on health issues.
The increasing prevalence of chronic diseases, already the leading cause of preventable death and disease in Australia, presents a major challenge for Australia’s health care system. The Government will increase the capacity of the health system to better manage and prevent chronic disease, including cancer, through continued support and investment in infrastructure and evidencebased best practice.
Outcome 10 is the responsibility of Acute Care Division, Pharmaceutical Benefits Division, Population Health Division, Portfolio Strategies Division, eHealth Division, Primary and Ambulatory Care Division, Regulatory Policy and Governance Division, and the Office of Health Protection.
Programs Contributing to Outcome 10
Program 10.1:Chronic disease – treatment
Program 10.2: e-Health implementation
Program 10.3:Health information
Program 10.4:International policy engagement
Program 10.5:Research capacity and quality
Program 10.6:Health infrastructure
Outcome 10Budgeted Expenses and Resources
Table 10.1 provides an overview of the total expenses for Outcome 10 by program.
Table 10.1: Budgeted Expenses and Resources for Outcome 10
2012-13Estimated
actual
$'000 / 2013-14Estimatedexpenses$'000
Program 10.1: Chronic disease - treatment1
Administered expenses
Ordinary annual services (Appropriation Bill No. 1) / 3,026 / 20,610
Special Accounts
Health and Hospitals Fund Health Portfolio Special Account2 / 211,642 / 163,304
Departmental expenses
Departmental appropriation3 / 4,138 / 4,411
Expenses not requiring appropriation in the budget year4 / 125 / 169
Total for Program 10.1 / 218,931 / 188,494
Program 10.2: e-Health implementation
Administered expenses
Ordinary annual services (Appropriation Bill No. 1) / 68,636 / 112,335
Non cash expenses5 / 18,309 / 18,309
Departmental expenses
Departmental appropriation3 / 18,263 / 17,601
Expenses not requiring appropriation in the budget year4 / 503 / 680
Total for Program 10.2 / 105,711 / 148,925
Program 10.3: Health information
Administered expenses
Ordinary annual services (Appropriation Bill No. 1) / 32,561 / 29,824
Departmental expenses
Departmental appropriation3 / 1,590 / 1,425
Expenses not requiring appropriation in the budget year4 / 49 / 66
Total for Program 10.3 / 34,200 / 31,315
Program 10.4: International policy engagement
Administered expenses
Ordinary annual services (Appropriation Bill No. 1) / 14,912 / 14,912
Departmental expenses
Departmental appropriation3 / 18 / 19
Expenses not requiring appropriation in the budget year4 / 1 / 1
Total for Program 10.4 / 14,931 / 14,932
Table 10.1: Budgeted Expenses and Resources for Outcome 10 (cont.)
2012-13Estimated
actual
$'000 / 2013-14Estimatedexpenses$'000
Program 10.5: Research capacity and quality1
Administered expenses
Ordinary annual services (Appropriation Bill No. 1) / 28,764 / 83,027
Special Accounts
Health and Hospitals Fund Health Portfolio Special Account2 / 36,205 / 30,095
Departmental expenses
Departmental appropriation3 / 9,204 / 7,953
Expenses not requiring appropriation in the budget year4 / 178 / 241
Total for Program 10.5 / 74,351 / 121,316
Program 10.6: Health infrastructure1
Administered expenses
Ordinary annual services (Appropriation Bill No. 1) / - / 4,500
Special Accounts
Health and Hospitals Fund Health Portfolio Special Account2 / 466,244 / 519,366
Departmental expenses
Departmental appropriation3 / 3,224 / 3,007
Expenses not requiring appropriation in the budget year4 / 97 / 131
Total for Program 10.6 / 469,565 / 527,004
Outcome 10 totals by appropriation type
Administered expenses
Ordinary annual services (Appropriation Bill No. 1) / 147,899 / 265,208
Non cash expenses5 / 18,309 / 18,309
Special accounts / 714,091 / 712,765
Departmental expenses
Departmental appropriation3 / 36,437 / 34,416
Expenses not requiring appropriation in the budget year4 / 953 / 1,288
Total expenses for Outcome 10 / 917,689 / 1,031,986
2012-13 / 2013-14
Average staffing level (number) / 194 / 182
1This program includes National Partnerships paid to state and territory governments by the Treasury as part of the Federal Financial Relations (FFR) Framework. National partnerships are listed in this chapter under each program. For budget estimates relating to the National Partnership component of the program, please refer to Budget Paper 3 or Program 1.10 of the Treasury Portfolio Budget Statements.
2The Health and Hospitals Fund is recorded as an expense by this department and by the Treasury. For more detailed estimates relating to this program refer Budget Paper 3.
3Departmental appropriation combines "Ordinary annual services (Appropriation Bill No 1)" and "Revenue from independent sources (s31)".
4"Expenses not requiring appropriation in the Budget year" is made up of depreciation expense, amortisation expense, makegood expense and audit fees.
5"Non cash expenses" relates to the depreciation of computer software.
Program10.1: Chronic disease – treatment
Program Objectives
Improve detection, treatment and survival outcomes for people with cancer
The Australian Government recognises the enormous impact that cancer continues to have on many Australian families. Through the Health and Hospitals Fund (HHF), the Government will continue to progress a number of cancer infrastructure projects to help improve access to cancer treatment and support.
In 2013-14, the Department will actively monitor the progress of cancer infrastructure projects including the world class cancer treatment and research facilities in Sydney and Melbourne: the Chris O’Brien Lifehouse at the Royal Prince Alfred Hospital in Sydney and the Victorian Comprehensive Cancer Centre in Melbourne. These centres will not only provide treatment and support to those with cancer and their families, but also undertake ground-breaking research in cancer prevention and treatment. By integrating the work involved in new discoveries and the people involved in treating and supporting patients and their families, these significant cancer projects will drive the next generation of improvements in the prevention, detection and treatment of cancer.
In addition, the Department will continue to monitor the 25 Regional Cancer Centre projects (24 from the HHF) which will help improve access to essential cancer treatment and support services (accommodation, counselling and/or education) for those living in regional, rural and remote Australia. Eight Regional Cancer Centre projects are complete (seven from the HHF) with a further 10 expected to reach practical completion in 201314.These projects will enable people with cancer to access the right care at the right time, as close as possible to home and family, irrespective of where they live or their social circumstances.
The Department will continue to oversee the purchase of a variety of equipment to completely replace BreastScreen Australia’s dated analogue mammography equipment with digital equipment. This project will see the final equipment upgrades in most states and territories achieved in 2013-14.
In 2013-14, the Department will fund the continuation and expansion of the specialist breast care nurse initiative through the McGrath Foundation. The McGrath Foundation will be funded to continue the employment of 44 existing breast care nurses, and will expand the program by 10 FTE nurses (approximately 13 employed nurses) to provide information, care, and practical and emotional support to women diagnosed with breast cancer, their families and carers.
In 2013-14, the Department will continue to fund CanTeen to improve coordination of care for young people (12-24 years) with cancer. This will include funding a national network of state-territory wide service hubs that will assist in identifying, informing, assessing and coordinating the care of young people with cancer. Funding will also assist multi-disciplinary teams to provide information and support to young people living with cancer and link them with appropriate services; facilities for treatment and support for young people, including social and emotional support; and facilitating participation in clinical trials to assess new cancer technologies.
Program 10.1 is linked as follows:
- This Program includes National Partnership Payments for:
-Health and Hospitals Fund - National Cancer Statement.
Partnership payments are paid to state and territory governments by the Treasury as part of the Federal Financial Relations (FFR) Framework. ForBudget estimates relating to the National Partnership component of the program, refer to Budget Paper 3 or Program 1.10 of the Treasury’s Portfolio Budget Statements.
Program 10.1: Expenses
Table 10.2: Program Expenses
2012-13Estimated
actual
$'000 / 2013-14
Budget
$'000 / 2014-15
Forward
year 1
$'000 / 2015-16
Forward
year 2
$'000 / 2016-17
Forward
year 3
$'000
Annual administered expenses
Ordinary annual services / 3,026 / 20,610 / 20,663 / 10,741 / 11,088
Special account expenses Health and Hospitals Fund
Health Portfolio¹ / 211,642 / 163,304 / 101,051 / 50,500 / 1,600
Program support / 4,263 / 4,580 / 4,402 / 4,437 / 4,530
Total Program 10.1 expenses / 218,931 / 188,494 / 126,116 / 65,678 / 17,218
1The Health and Hospitals Fund is recorded as an expense by this department and by the Treasury. For more detailed estimates relating to this program refer Budget Paper 3.
Program 10.1: Deliverables
Qualitative Deliverables for Program 10.1
Improving detection, treatment and survival outcomes for people with cancer
Qualitative Deliverable / 2013-14 Reference Point or TargetImprove the early detection of breast cancer through the installation of new digital technology / Continue upgrade from analogue to digital mammography
QuantitativeDeliverables for Program 10.1
Improving detection, treatment and survival outcomes for people with cancer
Quantitative Deliverables / 2012-13 Revised Budget / 2013-14 BudgetTarget / 2014-15 Forward
Year1 / 2015-16 Forward
Year2 / 2016-17 Forward
Year3
Number of full-time equivalent breast care nurses employed through the McGrath Foundation / 44 / 53 / 57 / 57 / 57
Program 10.1: Key Performance Indicators
QualitativeKey Performance Indicators for Program 10.1
Improve detection, treatment and survival outcomes for people with cancer
Qualitative Indicator / 2013-14 Reference Point or TargetEffective monitoring of HHF Cancer projects for compliance with agreed outputs / Progress reports are received for all projects in the required timeframe and remedial action taken as required
Quantitative Key Performance Indicators for Program 10.1
Improve detection, treatment and survival outcomes for people with cancer
QuantitativeIndicator / 2012-13 Revised Budget / 2013-14 Budget
Target / 2014-15 Forward
Year 1 / 2015-16 Forward
Year 2 / 2016-17 Forward
Year 3
Percentage of progress reports for cancer infrastructure projects (including regional cancer centres) that meet agreed requirements / 100% / 100% / 100% / 100% / 100%
Program10.2:e-Health implementation
Program Objectives
Provide national eHealth leadership
Every time a consumer visits a healthcare professional, hospital or other medical facility, important information about their health is created and stored at that location. Currently, it is hard to access and share this information with the health professionals involved with the consumer's care because the health sector is fragmented across public and private organisations, with many different approaches to managing health information.
The adoption of eHealth improves the quality, safety, efficiency and coordination of health care by reducing the fragmentation of information across the health care sector and increasing its accuracy and availability. The Australian Government is leading the national rollout of eHealth technology and services by partnering with state and territory governments to fund the National EHealth Transition Authority (NEHTA). NEHTA will maintain the standards necessary for eHealth, including clinically safe, secure and inter-operable eHealth specifications for adoption by public and private health care providers and secure joint projects on the exchange of clinical information.
The Australian Government, through NEHTA, has now delivered a number of key eHealth foundations: Individual Health Identifiers for eligible Australians; a system of identifying health care providers and their organisations; secure messaging, and technical specifications for inter-operability of clinical information systems.
The Australian Government in collaboration with Health Direct Australia have delivered a National Health Services Directory (NHSD). The NHSD is a consolidated and comprehensive national directory of health services and provider information. It covers all Australian jurisdictions with services across the public and private sector. The directory can be accessed via the web and a mobile application. The NHSD is being expanded to support finding healthcare provider end points that support telehealth and secure messaging.
Operate a national eHealth system
The introduction of the Personally Controlled Electronic Health Record (PCEHR) system for individuals allows them to register for their eHealth record either online at ehealth.gov.au, by phone, via Medicare shopfronts, by post or by assisted registration and eventually with their GP or at hospital. Once an electronic health record is created, individuals control access to information held within the record. People can track their health progress, and record their medications and allergies, while health care providers are able to create shared health summaries, upload event summaries or discharge summaries and view a record which accessesuptodate information at the point of care to improve clinical decision making.
The national eHealth system provides a better and more efficient health care experience for participating consumers, with a smoother transition of information between care settings, a reduction in the time spent repeating clinical history or waiting for test results to be located, and a reduction in adverse medical events.
As the PCEHR system grows, additional functionality will be added, beginning with the Child Electronic Health Record and the National Prescription and Dispense Repository (NPDR), which for the first time will facilitate access to prescribing and dispensing information for consumers and their authorised healthcare providers via PCEHR portals and compatible software. The NPDR will allow prescribers and dispensers to make more informed decisions regarding medications for their patients which in turn will improve the safety and quality use of medicines in the community.
The Department will continue to work with key stakeholders to promulgate the use of eHealth across the health sector. The ePractice Incentive Program (ePIP) will encourage the adoption of new eHealth technology to assist practices to improve administration processes and the quality of care provided to patients. The Department has funded the Royal Australian College of General Practitioners to assist general practices to participate in the PCEHR system, throughtraining and professional development.
Provide eHealth services
In 2013-14, the pilot program to promote the use of telehealth services in the home using the infrastructure of the National Broadband Network (NBN), will be implemented. Patient-centred telehealth services to the home will be provided to participants of this program. The focus of the program will be on aged care, cancer and palliative care.
Program 10.2 is linked as follows:
- This Program includes National Partnership Payments for:
-Cradle Coast Connected Care Clinical Repository.
Partnership payments are paid to state and territory governments by the Treasury as part of the Federal Financial Relations (FFR) Framework. ForBudget estimates relating to the National Partnership component of the program, refer to Budget Paper 3 or Program 1.10 of the Treasury’s Portfolio Budget Statements.
Program 10.2: Expenses
Table 10.3: Program Expenses
2012-13Estimated
actual
$'000 / 2013-14
Budget
$'000 / 2014-15
Forward
year 1
$'000 / 2015-16
Forward
year 2
$'000 / 2016-17
Forward
year 3
$'000
Annual administered expenses
Ordinary annual services / 68,636 / 112,335 / 26,888 / 12,859 / -
Non cash expenses1 / 18,309 / 18,309 / 18,309 / 18,309 / 18,308
Program support / 18,766 / 18,281 / 11,297 / 11,313 / 10,789
Total Program 10.2 expenses / 105,711 / 148,925 / 56,494 / 42,481 / 29,097
1"Non cash expenses" relates to the depreciation of computer software.
Program 10.2: Deliverables
Qualitative Deliverables for Program 10.2
Provide national eHealth leadership
Qualitative Deliverables / 2013-14 Reference Point or TargetFund the NEHTA to support the connectivity and interoperability of the eHealth system / Contract and funding agreements between the NEHTA and the Commonwealth executed. Deliverables outlined in the schedule/s and a process for performance reviews in place
Promote uptake of the PCEHR system through targeted awareness and training with key stakeholders representing both consumers and healthcare providers / Deliver consistent messaging about the PCEHR system and its benefits through key stakeholders’ organisations, including the Australian Medicare Locals Alliance, Medicare Locals, the Royal Australian College of General Practitioners and the Consumer Health Forum
Operate a national eHealth system
Qualitative Deliverable / 2013-14 Reference Point or TargetThe Department, as the PCEHR system operator, applies good practice principles and methods for the operation and support of the PCEHR system / The PCEHR system operations and practices are regularly reviewed by a specific governance committee
Provide eHealth services
Qualitative Deliverable / 2013-14 Reference Point or TargetTelehealth services are trialed in the home for aged care, palliative care and cancer care / The Department will evaluate the pilot program on the use of telehealth services in the home using NBN infrastructure
QuantitativeDeliverable for Program 10.2
Operate a National eHealth system
Quantitative Deliverable / 2012-13 Revised Budget / 2013-14 BudgetTarget / 2014-15 Forward
Year1 / 2015-16 Forward
Year2 / 2016-17 Forward
Year3
Number of telehealth services provided under the NBN Enabled Telehealth Pilots Program / 200 / 400 / N/A / N/A / N/A
Program 10.2: Key Performance Indicators