Friday, February 21, 2014

The Irish Seem To Have Some Good And Not So Good Ideas On E-Health - Interesting Read.

This appeared a little while ago.

Identifying Ireland’s eHealth Needs

Friday, 31 January 2014 13:13 Paul Mulholland
PAUL MULHOLLAND examines the Government’s new eHealth strategy and Health Identifiers Bill
Given the increasing importance of information technology within the health sector, the lack of a national IT health strategy has been seen as a fundamental gap that has prevented the Department of Health and the HSE from running a fully modernised service.
Also, while the Government had been working on a Health Information Bill for the last number of years, which would facilitate the much heralded unique patient identifiers, there was little sign that this legislation was being progressed. These two factors combined meant that Ireland was far from leading the way in the area of eHealth.
Finally, however, things have changed.
Before the end of last year, Health Minister James Reilly published the eHealth Strategy for Ireland, as well as the Health Identifiers Bill 2013 and announced the recruitment of a Chief Information Officer (CIO) for the health service.
eHealth, as defined in the strategy, involves the integration of all information and knowledge sources involved in the delivery of healthcare via information technology-based systems, including patients and their records.
Examples of standard eHealth systems include electronic prescribing (ePrescribing) whereby patients can order repeat prescriptions online, online patient scheduling and referral systems and telehealthcare systems whereby patients with for example, diabetes or heart failure, can manage their own healthcare from the home environment. eHealth systems also include newer technologies such as ambient assistive living systems, robotic surgical systems and body-worn sensor devices.
The new strategy states that the development of a coherent eHealth strategy is an important strand of tackling the budgetary and demographic challenges that are facing the health service.
The strategy admits that the healthcare sector has lagged behind other sectors in adapting information technology.
“I think that eHealth has the potential to transform health systems, very much in the same way that ICT has transformed many other sectors such as finance and travel,” Director of Health Information Directorate in HIQA, Professor Jane Grimson, told IMN.
“It really does have the potential to support a healthcare system that is genuinely patient-centred that delivers personalised healthcare, tailored to the individual and delivered to the most appropriate place, whether it is in the community, or the acute sector or wherever. So eHealth has that real potential, and I think that the strategy recognises its transformational and disruptive potential. That is a firm statement of intent that Ireland is going down the eHealth route. We were rather late coming to the table, but that is not necessarily a bad thing. Because we really have an opportunity to learn from what has happened in other countries, and what hasn’t worked. I don’t think it is necessarily a bad thing to be a later adopter of this technology.”
Prof Grimson points to the UK as an example of a country who got it wrong by trying to do too much, too soon. The rollout of the National Summary Care Record was hampered as companies involved in the tendering process felt the implementation timeframe was too ambitious, while local trusts complained of a lack of consultation on the project.
The British Medical Association asked the UK Government to suspend the roll-out of the database in March 2010 as it was an “imperfect system” being rushed into service prematurely, with accusations that data had been uploaded without giving patients the opportunity to opt out a primary concern.
“Denmark had a similar problem. It tried to deliver a national  electronic health record in three years or something, and they only realised after a couple of years that this was far too complicated,” Prof Grimson explained.
“It really comes down to the fact that eHealth is very much a transformative, disruptive technology and if you start introducing electronic records, which is usually the ultimate goal of most national eHealth programmes, to have ultimately some kind of shared record, it is major change. It is every bit as major a change as having online bookings for airlines and so on, it is a very significant change, and if you ignore that whole change management piece you will run into difficulties.”
Under the strategy, a new entity called “eHealth Ireland” will be established, initially on an administrative basis within the System Reform Group (SRG) of the HSE. Over time, as the HSE is dismantled, this new organisation will be formed as an independent entity within a new institutional framework for shared services for the health sector as a whole.
eHealth Ireland will be headed up by a new CIO who will work closely with all of the key business organisations within the health service, in order to drive forward the eHealth strategy and ensure that key IT systems are implemented on time and to budget.
Lots more detail here:
This paragraph especially caught my eye.
“Prof Grimson welcomed the formation of the authority to lead the strategy as it will pull different work strands together and fix the current fragmented system. She cites Canada Health Infoway and the National eHealth Transition Authority in Australia as two of the best examples of similar eHealth organisations.”
It seems to me the good Professor needs to read a little less of the public propaganda from these two organisations and ask a few at the coal face just how both these two organisations have been experienced. She may just find the actual outcomes don’t quite fit the press releases!
This on the other had seems pretty good!
“Priority projects include: The development of appropriate health informatics skills and/National Health Identifier Infrastructure; ePrescribing Systems; online referrals and scheduling; telehealthcare – particularly relating to the management of chronic diseases; development of patient summary records; online access to health information; and a national patient portal.”
As also does the actual CIO appointment and a sensible Board to run the effort. The final plan will allow us to form a firm view on how well this may all play out!


Anonymous said...

Australia spent a bomb on change management with McKinsey and PwC cleaning up. What they did was outsource it to another firm to run around the hospitals and the shopping malls signing up registered users and expressions of interest on paper-based forms.


Anonymous said...

They don't call us "The Smartest Guys in the Room" for nothing...

Work "smarter" not "harder" and you too can indulge in a greater share of the taxpayer funded trough!

"Money for nothing... you get your chicks for free..."