Wednesday, September 03, 2014

The Irish Have Identified Just How Hard National E-Health Can Be! And Seems To Have A Sensible Plan.

This appeared last week.

Ehealth plan designed to save money and patients

Hiqa is working on standards for a new ‘health identifier’ system that aims to simplify medical records

Elaine Edwards
First published: Tue, Aug 26, 2014, 01:00
One of the many challenges facing new Minister for Health Leo Varadkar will be to oversee the Government’s ehealth strategy, published by his predecessor, James Reilly, at the end of last year.
It will require investment not just in information technology but in new work practices and governance structures in the health service. It will be a slow process but, if handled properly, should pay big dividends for patient safety and for the healthcare system generally.
Ehealth is described as a fully integrated digital supply chain, involving “high levels of automation and information sharing”. In English, that means making consistent, accurate information about every patient available when and where it is needed, eliminating duplication, increasing patient safety and improving, for example, the management of chronic illnesses.
The strategy document claims investment in ehealth infrastructure has the potential to bring significant economic benefits.
Healthcare is changing radically as a result of demographic, organisational and resourcing factors, as well as the proliferation of new technology, it notes.
“These factors mean that future healthcare systems will need to be radically different in order to respond efficiently and equitably to forecasted demand.”
Prof Jane Grimson, acting chief executive of the Health Information and Quality Authority (Hiqa), says forecasts suggest healthcare will consume a large percentage of GDP in most developed countries by 2050.
All developed countries and many developing countries have ehealth strategies, she says. “They’re all investing in ehealth because everybody is convinced it can really offer benefits in terms of improved patient safety, as well as improved efficiencies.
“There’s plenty of evidence to suggest that this is true. However, the really good, strong evidence about benefits of ehealth tend to be mostly at local hospital level or a GP practice level.”
Prof Grimson says implementing ehealth solutions at a national level “has been a challenge everywhere”.
“A lot of countries have invested and wasted a lot of money and had to start all over again.”
Creating electronic health records, integrating information from multiple sources – including monitoring devices and sensors – as well as major changes in governance and work practices and a realignment of health budgets will all be part of the huge challenge.
Lots more here:
The caption for the picture for the article says it all.
Prof Jane Grimson: ‘We have the opportunity to learn from other people’s mistakes.’
I have to say what I read that Prof. Grimson is saying makes a great deal of sense. I hope she succeeds so there will be one decent example of things being done is a more sensible fashion - slowly, carefully, evidence based with decent leadership and governance.
I wish them the luck of the Irish with this!


Anonymous said...

"Prof Jane Grimson: ‘We have the opportunity to learn from other people’s mistakes.’ "

to be sure, to be sure!!

Talk about being spoilt for choice with NEHTA contending admirably for a position at the top of the global ehealth mistakes heap.

And such a shame NEHTA didn't make the most of the same historical opportunity and avoid running off the global ehealth lemmings cliff!

Anonymous said...

Ooops - I seem to recall Dr Ian Reinecke, NEHTA's foundation CEO, saying "NeHTA would be a fast follower" - how right he was - "able to learn from the mistakes of others" - how wrong he was.

Bernard Robertson-Dunn said...

re ' "able to learn from the mistakes of others" - how wrong he was'

another take might be that they did learn from the mistakes of others - they learned how to make the same mistakes, but differently.

To mis-quote Leo Tolstoy — 'All successful projects are alike; each failed project fails in its own way' cf Anna Karenina

Dr Ian Colclough said...

Bernard said "another take might be that they .... learned how to make the same mistakes, but differently."

Precisely so, and may I also add that they failed to understand the problem in the context of, indeed they neglected to pay any attention whatsoever to, the business processes and functionality needs and requirements of multiple disparate health care organizations. Their attempts to solve the problem with a technology mentality caused them to lose their way.

Andrew McIntyre said...

Well NEHTA have commissioned Deloitte to work out why SMD has not resulted in a major break out of messaging and interoperability between messaging providers. This is a perfect example of not understanding the problem. At a technology level interoperating is relatively easy, but the poor compliance with standards and variable quality of endpoint capability makes it a very risky error prone thing to do. They have been told that for years, but refuse to listen. I doubt they will listen now and I am sure they will just try and shoot the messenger. The lack of understanding of what the issues are is a major concern considering they have already spent > $1 Billion of tax payers money.