Wednesday, August 04, 2010

This Seems Like Very Good News - But Is It?

The release referred to below has attracted a lot of attention.

91% of Australians Want All Their Healthcare Data Stored in One Place, in an Electronic Health Record

Wednesday, July 28, 2010 - CSC

CSC (NYSE: CSC) today launched the results of an independent research project on Australians’ views of electronic health (e-health) records. CSC’s report, A Rising Tide of Expectations, found consumers are ready and waiting for the government to deliver an individual e-health record – what they see as a basic Australian right.

In March 2010, CSC commissioned an independent, national Newspoll phone survey of 1208 Australian consumers to understand how important they believe it is to have an individual e-health record. The results showed that 96 percent of Australians in favour of e-health records believe that common medical data should be stored on a shared electronic record, despite only 46 percent being aware of the proposed introduction of e-health records.

The report also found that almost 90 percent of participants actively make an effort to improve and maintain their health already while 86 percent personally keep a record of some type of medical information. Ninety-one percent of participants want to see their healthcare data in one place. Ironically, Australians also feel they are effectively maintaining or improving their health despite increasing rates of chronic disease and obesity.

An additional insight gained by CSC’s research is that Australians want individual e-health records, as long as they do not have to pay for them.

Eighty-eight percent of Australians felt that it was either the Federal or State governments’ responsibility to contribute financially to the cost of individual e-health records.

The CSC report found that 27 percent of respondents are willing to pay on average almost $50 annually for an individual e-health record. However, a startling 70 percent of Australians are not willing to pay anything.

An unexpected finding was that in addition to Federal and/or State government funding, 63 percent of Australians regard private health insurers as also having some responsibility for financially contributing to the costs for e-health records. This is despite the fact that less than half of Australians have private insurance.

“Consumers now expect e-health records and expect the basic foundations to be funded as part of the health system, primarily, and convincingly, by governments, with contributions from others such as health insurers,” said Lisa Pettigrew, director of health services for CSC in Australia.

The research also found Australians want to be able to exercise control over their e-health records, specifically what data is stored and who has access to it. Results indicated that among Australians who are in favour of an individual e-health record, there is significant consensus on what data should be included in such a record. Further, 89 percent want the ability to select which healthcare providers view their information.

Australians are ready and waiting for an e-health record as long as they can choose who has access to the information that they elect to include in their health record.

In response to why CSC commissioned the independent research, Pettigrew explained, “E-health records are a core enabling platform for a modern, sustainable health sector. It is time for Australia to engage in a comprehensive discussion on what this means - for consumers, for patients and carers, for healthcare providers and for government. Part of this discussion must include a better articulated consumer voice. There is a rising tide of expectation and frustration that we and our doctors do not yet have basic online access to our full health record information.”

Pettigrew further said, “The recent Federal Government budget announcements about funding of $467 million for the start of e-health records is timely, and if spent on appropriate activities, will be an important investment for national health infrastructure. Based on CSC’s global experience in healthcare, a logical next step for the Australian Government would be to define a pragmatic plan for rapidly developing basic e-health records for patients and consumers to access which also delivers benefits to clinicians in terms of access to the right information about their patients at the right time.”

CSC is the world’s largest health systems integrator and has helped many governments implement national and regional e-health record programs. Through this investment in research and a related program with clinicians, CSC seeks to promote and contribute to a mature and informed national dialogue about e-health and to understand the perspectives of consumers and clinicians.

The CSC research report, A Rising Tide of Expectations, is accessible at


The respondents were randomly selected and a quota was set for capital cities and non-capital areas. Within each of these areas, a quota was set for groups of statistical division to reflect the overall population distribution.

About CSC

CSC is a global leader in providing technology-enabled solutions and services through three primary lines of business. These include Business Solutions & Services, the Managed Services Sector and the North American Public Sector. CSC’s advanced capabilities include system design and integration, information technology and business process outsourcing, applications software development, Web and application hosting, mission support and management consulting. The company has been recognized as a leader in the industry, including being named by FORTUNE Magazine as one of the World’s Most Admired Companies for Information Technology Services (2010). Headquartered in Falls Church, VA., CSC has approximately 94,000 employees and reported revenue of $16.1 billion for the 12 months ended April 2, 2010. For more information, visit the company’s Web site at

The release is here:

Commentary is found here:

E-health records given the thumbs up


July 30, 2010

Australians favour the idea of an electronic health record - with a significant minority even prepared to pay for it - according to a survey of 1200 people.

But patients and doctors are divided over how much control individuals should have over the contents of the record and whether they should be able to add to it themselves.

So-called e-health records - intended to improve the quality of patients' treatment by ensuring the health workers who treat them have access to all relevant information - are central to health reforms proposed by the federal government and are set to be implemented with the states.

But the finer details of the health plan have still to be determined, and previous attempts to unify health records have been frustrated by technical complexity and privacy concerns.

The new survey, conducted by Newspoll for the computer systems company CSC, found two-thirds of respondents were in favour of e-health records and 27 per cent would be prepared to contribute financially.

More here:

and here

Survey proves e-health demand: NEHTA

By Josh Taylor, on July 29th, 2010

The National E-Health Transition Authority (NEHTA) has welcomed the findings of a recent e-health survey conducted by CSC showing that Australians want an e-health record, despite the results also revealing that over 50 per cent of Australians surveyed were in the dark about the government's e-health initiatives.

At the Australian Information Industry Association National Broadband Forum held in Melbourne today, NEHTA CEO Peter Fleming said a CSC report released yesterday backs the organisation's own findings that the vast majority of Australians want electronic health records.

"Some research we did indicated that 80 per cent of Australia support the push to electronic health records [and] I notice last night that CSC released some findings from their recent research that tends to support that view," said Fleming.

However, the results of CSC's survey of 1208 Australians also showed that many Australians were unaware of the government's e-health plans. The survey — conducted in March prior to the $466.7 million federal budget investment in e-heath — revealed that just 43 per cent of people were aware of the government's plans for individual electronic health records.

The report also found that once the concept of an electronic health record was explained, 64 per cent of those surveyed were in favour of the records, while 24 per cent were opposed.

More here:

There are a lot of issues raised in this report and some, as clearly indentified in the document, will need considerable work (e.g. the large number opposed, the costs for government etc)

It is also clear there is a huge educational task.

For me, however, the biggest issues is the failure to distinguish between patient and clinician functionality.

The quotes on page 35 get to it pretty clearly.

“ What layers of bureaucracy are going to stand between me and a medical record? Do I have to justify to the patient every time I need to access their record? Is the patient the one to decide that I get access so that I can treat them?” Clinician

“ The sharing of patient clinical information is beneficial only if it was collected in a clinically appropriate way.” Clinician

“ It’s saving hours and hours for every patient. It’s reducing the tests that they order.”

Clinician – talking about an existing Shared Electronic Health Record program

“ You need to have access to all of the bits to know what’s going on.” Clinician

“ Those healthcare providers who need access should have access... for example, the act of referring to a Specialist should grant the Specialist access to the relevant electronic health record.” Clinician

“ You need to acknowledge that limiting access may well impede that patient’s care.” Clinician

“ O f course patients should have control over their records.” Clinician

----- End quotes.

It really worries me that a global company like CSC could not be clear with the consumers and clinicians regarding what it is talking about. Treating e-Health records as an amorphous lump really is not good enough.

My view is that this is because no-one else does and we are all stuck in some nonsensical word and acronym salad.

Let us be utterly clear about all this. Where the evidence lies for e-Health making a difference is in providing systems that support the work undertaken by clinicians and providing information and real-time decision support. It is in this area that investment is needed first.

Of course we need to allow patient / consumer involvement in their care – and provide them with the electronic tools to assist this where it makes sense.

Perhaps the distinction is best made by comparing Personal Quicken or MYOB with the information systems used by professional traders (IRESS and the like). Each does its job well – but the jobs are essentially different. Equally I do not need Adobe Photoshop (at x thousand dollars) to touch up my happy snaps but the Women’s Weekly sure does!

The sooner we get clear on a ‘horses for courses’ evidence based approach to electronic health and patient records the better, and I am really not sure I know what this report really means. It might have helped if the interview scripts used with the consumers were an appendix to the report.



Anonymous said...

One should also note that as reported in the Australian, CSC has a vested interest in talking up e-healht in Australia, as it has already benefitted from a NEHTA and DOHA contract, and I'm sure would dearly love to get a nice big chunk of the $476 million. Did they declare their conflict of interest in the report? I know academics have to, when they publish their research.

zeeclor said...

An issue for doctors, patients and bureaucrats is who will be responsible for maintaining the patient's electronic data. Options include general practitioners , local hospitals, Divisions of General Practice, State or Federal Departments of Health, local private enterprise or multinational information technology companies like Amazon, Microsoft and Google.

It would be interesting to know what patients felt about these various options. I suspect there is inverse relationship between their their enthusiasm for ready access to their data and the geographic distanceof the data centre from their home address.

David Guest

Steve Hards said...

You have to wonder who in CSC thought it a good idea to spin the headline the way they did (and use the rest of the release to try and justify it) when it should be obvious that it could be pulled apart (as ZDnet and David have) and thus undermine its credibility.

Anonymous said...

CSC's health marketing spin machine, like all big vendors, have one key focus - keep the name up there in the spotlight - capture mindset - be seen. The merits of the content is relatively inconsequential because of the multiplicity of conflicting viewpoints on the topic and the fact that the decision makes at the top won't read the report they will simply flick the pages, note the contents, enjoy the pictures and conclude that the 'big' organisation must know what it's talking about. Mindset captured and cemented in the memory.

Jon Patrick said...

Convincing the public that electronic records is only a part of the wider e-health task which includes universal identifiers, building communication methods, and determining access processes for clinicians and patients. However the issue that gets the least attention which is the biggest gorilla in the room, is the method of data collection, that is the clinical information system. This is the heart of the system that everything else survives on yet it rarely gets mention in any discussion on e-Health.

Until we get support to produce studies, research and development of systems of high quality that satisfies the needs of clinicians and fulfils the requirements of health management we will continue to exist in the world of Garbage In Garbage Out (GIGO) for the clinical record.