Wednesday, December 01, 2010

Wrap Up of the E-Health Summit. Was it Worthwhile?

Well the e-Health Summit has just wrapped up. This morning we had two formal presentations and a demonstration of telehealth working quite reasonably despite the fact we have not actually built the NBN yet! (Not that the NBN - when it comes - won’t make a pretty big improvement).

First - Senator Conroy gave us an e-Health focussed discussion of how important the NBN is. No real news there except for a grant of some funds to trial telehealth.

Second Mr Shane Solomon, Head of Healthcare, KPMG Australia gave a really useful presentation on the near two decade journey the Hong Kong Health Authority has undertaken to a presently pretty impressive - but still evolving - e-Health system.

It was fun to hear Shane point out that much of the progress happened by fiat of the CEO of the Health Authority. He decides and the HK Health System does! Might not quite work here.

His examples of what you can do once you have EHR systems in place in terms of use of information to assist care delivery and care quality were just excellent.

The presentations and slides will be available, I am assured by DoHA, real soon now.

In the early afternoon there was a forward looking discussion with a group of experts that explored the blue sky that might be possible for 2025.

We are now seeing some press coverage of the proceedings.

Examples are here:

http://www.computerworld.com.au/article/369816/nbn_first_release_sites_trial_telehealth/?eid=-6787&uid=25465

NBN first release sites to trial telehealth

Federal Government provides $4 million in funding to NSW Health to trial high-speed health monitoring

Two of the first mainland release sites under the National Broadband Network (NBN) will receive telehealth monitoring units in coming months, as part of a $4 million trial conducted by NSW Health.

As part of the trial, telehealth monitoring units and videoconferencing systems will be installed in homes and primary healthcare clinics of veterans with chronic diseases and those aged over 65 in the sites of Armidale and Kiama Downs. Under the rollout of the NBN, each of the sites are expected to encompass up to 6000 premises connected to speeds of up to one gigabit per second (Gbps).

The federally funded project was announced by communications minister, Senator Stephen Conroy, this week at an e-health conference hosted by the Department of Health and Ageing and is expected to determine the benefits of greater bandwidth afforded by the NBN for telehealth and other e-health systems.

And here:

http://www.theaustralian.com.au/australian-it/government/private-sector-key-to-e-health-rollout-says-roxon/story-fn4htb9o-1225963698809

Private sector key to e-health rollout, says Roxon

  • Karen Dearne
  • From: Australian IT
  • December 01, 2010 8:36AM

THE National E-Health Transition Authority will be contracted to deliver the $467 million patient e-health record system with private sector help, Health Minister Nicola Roxon has confirmed.

"We will be asking NEHTA to ensure the national infrastructure is delivered to a high quality standard and in a timely manner and to set the standards for how the system will work," she told the E-Health Conference in Melbourne yesterday.

"But we want the best available expertise so there will be an open approach to the market for key elements of the program."

Ms Roxon said the government was not looking to run the whole system.

"Our job is to contract partners to build the infrastructure and the linkages, and to set the standards and regulations," she said.

"It will not be our job to deliver all of the technological advances – that’s what we’re looking for from the innovators in industry."

And here:

http://www.theaustralian.com.au/national-affairs/ama-attacks-e-health-record-plan/story-fn59niix-1225963522922

AMA attacks e-health record plan

THE Gillard government's $466 million e-health record "won't work" , the Australian Medical Association says.

The AMA says it could be dangerous if patients were able to hide information about abortions or their use of anti-depressants.

AMA vice-president Steve Hambleton told an e-health conference doctors would not trust the new record if it did not contain all relevant patient information, and there was a risk of serious medical mishaps if information was kept secret.

And he says only doctors should alter information in the e-health record, which will be offered to patients from July 1, 2012.

"It should only be able to be changed by doctors who understand the implication of what is recorded, and this can certainly be done in consultation with the patient," he said.

----- End Quotes.

Summary impressions.

1. We have been warned this is a long term - decade + - process - so funding that runs out in 18 months is not smart. The costs are also much larger than presently admitted and this was raised repeatedly on the second day.

2. I think all I have seen from the conference misunderstands the level of complexity and the barriers that will be faced. Attempting to have something working and useful in 19 months is fanciful in my view.

3. I think the program governance plans are inadequate as presently framed. It is hard to believe the community will be keen on the present ill-defined plans. The AMA is right to demand a single Government Entity to run all this - as recommended in the National E-Health Strategy.

4. I believe the Department developing a central infrastructure and expecting the rest of the Health Sector to just ‘hop on board’ and pay their own costs is nonsense.

5. Until more information on the plans from DoHA / NEHTA is properly formulated, documented and widely discussed and reviewed all the optimism expressed by attendees is pretty premature.

6. The PCEHR concept is very likely to be opposed by the AMA in the way it is presently being talked about and if that is the case it is a ‘dead duck’. Refinement to make the plan acceptable to most of the doctors is an urgent issue!

7. At the last panel discussion it was clear that the key barrier to success of the PCEHR will be utility to both clinicians and consumers. At present none of the plans have addressed these issues in any realistic or sensible way.

8. The Department chattering on about sustainability and how the private sector will need to contribute to make this work mis-understands just who is hoping to benefit and it is not the providers!

9. Amazingly the Deputy Secretary closed saying they were starting serious planning and consultation on the PCEHR next year. Runway is looking a bit short!

Sorry we have had a lot of noise but little light! I fear the PCEHR might just need a major rejig to be made even half of what is naively hoped for by its proponents.

David.

3 comments:

Matt Hopkinson said...

As an attendee, i agree there was little new information. However time will tell if information from the breakout sessions and the web feedback forms is taken notice and acted upon.
There seems to be a concerted effort on PCEHR, however it is my view that this alone will not work. In order to have a successful product, it needs to be matched with pateint education as well as many of the health tools to implement change. Only addressing one part will cause the product to be incomplete and not achieve the goals of creating a patient centred product that will assist in managing chronic disease in the community.

Anonymous said...

There seemed to me to be a significant mismatch between the audience and the various messages the Conference sought to convey. Much of the material presented was focused on 'selling' the benefits of e-health. That's certainly a worthwhile thing to do, but most of those in attendance weren't people who needed to be convinced. We know what e-health can deliver.
In contrast there was really very little by way of new insights into the practical 'what', 'how', 'when' and 'who' of e-health implementation, which I suspect many participants hoped/expected would emerge.
So, it was arguably a good Conference pitched at the wrong audience. Maybe next time we can get some real details of the route we're following rather than the joys that await us when we reach the destination we're aiming for?

Bert said...

Very helpful information. Thank you!