Friday, April 05, 2013

This Certainly Looks Like A Useful Resource For Health System Improvement And IT. Looks Like The NEHRS Needs A Rethink.

The following appeared a little while ago.

VA, U.K. health service team up on IT

Posted: March 22, 2013 - 12:45 pm ET
The healthcare arm of the Veterans Affairs Department and the United Kingdom's National Health Service are teaming up under a three-year agreement to swap leaders, staff and ideas about the use of healthcare information technology by the two huge government-financed systems, according to a new joint report
The 90-page document, “Making Connections (PDF),” explores what its authors call a “transatlantic exchange to support the adoption of digital health” between the U.S.' Veterans Health Administration and the NHS. The report, produced by 2020 Health, a U.K. think tank with public and private support, was jointly funded by grants from the NHS and the Robert Bosch Corp., and starts with a side-by-side comparison of the two taxpayer-funded healthcare systems.
The VA serves a population of 23 million veterans, of whom 8.3 million are enrolled in the VHA, compared with 53.2 million people served by the NHS. The VHA's 2012 budget of $53 billion is around one-third that of the NHS' $160 billion budget, the report said. The average age of a VHA enrollee is 62, with more than 40% aged 65 and older. VHA patients are typically sicker than most Americans across a plethora of costly chronic conditions, including hypertension, diabetes, obesity, depression, congestive heart failure and chronic obstructive pulmonary disease. Many of the patients could be better served by various existing and emerging information technologies, according to the report. And while the NHS covers all ages of the population, providing care to all residents of the U.K.—“free at the point of delivery, irrespective of personal wealth”—including 11 million children under age 18, the proportion of the population in the U.K. age 65 and over is expected to rise 42% to 18 million by 2025, pushing up expected costs.
According to the report, with the collaboration beginning this year, both organizations expect to learn from each other in five areas: a general digital transformation of healthcare to improve patient outcomes; home telehealth, that is, the use of remote patient monitoring for chronic-care management; telemedicine and video conferencing between clinicians and patients to replace face-to-face visits; mobile health, using a range of devices to empower both clinicians and patients with the information they need to provide more effective care; and the use of secure messaging and personal health records to support provider/patient communications.
Lots more here:
There is a very useful amount of interesting material and forward looking ideas here - but in a coherent framework.
Here is a direct link to the report:
This from page 10 or so shows how are a little off course possibly here in OZ.
Secure Messaging and Personal Health Records – an online record accessed or owned by the patient, integrated with clinical providers’ health records, and supporting secure text-based communications between patient and clinician
 What the VHA can learn from the NHS
  • Patients overwhelmingly value on-line transactional support rather than record access on its own.
  • Specialised PHRs can be highly valued for patient groups with specific health needs (e.g. renal patients).
  • There is value to putting patients in control of their own record, allowing them to set personalised goals that matter to them rather than just being clinically orientated, and letting them decide who sees what.
What the NHS can learn from the VHA
  • Secure messaging and PHRs are essential tools in empowering patients and improving self-care.
  • A single record accessible to both clinician and patient supports integration and a co-created care plan.
Well worth a browse to see how thinking is moving overseas.

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