Wednesday, May 11, 2016

NSW Announces A 10 Year Health IT Plan - Will Be Fun To See How It All Goes.

NSW Health announced a 10 year e-Health Strategy at CeBIT last week.
Here are a couple of reports with links to the actual plan.

NSW govt to finish e-health records rollout within four years

Mobile, data analytics focus in 10-year strategy document.

By Andrew Sadauskas
May 3 2016 1:45PM
The NSW state government has committed to completing the rollout of electronic medical records within the next four years as part of its latest e-health policy. 
The e-health strategy for NSW Health 2016-2026 [pdf] was released by state Health Minister Jillian Skinner at the CeBIT conference in Sydney this morning. 
The core of the strategy is "maturing" NSW Health's core digital systems to create a consistent IT environment over the next four years. 
This includes completing the rollout of electronic medical records, which are currently implemented in 35 percent of facilities, across the state within the next four years. 
While just 29 percent of health facilities are currently connected to the Health wide area network (HWAN), the policy committs to all local health districts being connected within the next three years. 
The ongoing consolidation of NSW Health data centres is also scheduled for completion by late 2019.
"We continue to build a secure statewide broadband network – the NBN of health – which currently connects 150 health centres and hospitals across NSW, including those in rural and remote locations," Skinner said. 
"This enables our clinical and health systems to be used in hospitals across the state and in ambulatory care." 
More here:
Here is another report:

NSW Government announces 10-year eHealth strategy at CeBIT

The NSW Government will finish the rollout of e-health records within four years and complete connections of its health facilities to the Health wide area network within three years.
These are just some highlights of its eHealth strategy announced by The Hon. Jillian Skinner MP, Minister for Health, NSW Government at CeBIT Australia today. If you are interested the 40-page document is a good read and outlines a huge range of initiatives.
The Minister promised a “Digitally enabled and integrated health system with a focus on delivering patient-centred health experiences with quality health outcomes; giving attendees an insight into the journey the NSW Government has taken as it builds on its existing blueprint and outlines the direction for NSW investment over the next decade.”
"We continue to build a secure state-wide broadband network – the NBN of health – which currently connects 150 health centres and hospitals across NSW, including those in rural and remote locations. This enables our clinical and health systems to be used in hospitals across the state and in ambulatory care,” she said.
"It [the strategy] is a ten-year program of innovation, investment and implementation which identifies key short, medium and long term goals for eHealth NSW. It’s a policy that outlines the direction that we will take using the latest advances in technology policy and also including integrated care and ongoing enhancements to performance, quality and safety in our health system.”
More here:
There is a great diagram which summarises the present state and where work is planned.

We can all now sit back and watch to see how things progress! Will be fascinating to see how well they go.


Bernard Robertson-Dunn said...

Not directly relevant to NSW eHealth, but they will face the same problem.....

NEHTA tweeted this today:

Data cleansing prior to using the #MyHealthRecord system ensures accurate, up-to-date information:

Firstly, no amount of data cleansing (as they define it) will ensure the data is accurate or up-to-date. What they are promoting is the use of a "recognised disease classification or terminology system"

Secondly, the specialised skills they expect clinicians to have and the overheads they are suggesting is amazing.

Under "Developing a clinical coding policy for your practice" they say:

Achieving consistent disease coding requires the entire clinical team to be on board, so it's important to get all staff engaged in the process. A practice policy for clinical coding will need to address the roles and responsibilities of each team member.

Some steps to consider in developing this policy for your practice are:

1. Determine how your clinicians are currently disease coding. Clinicians may be doing it differently, with some using the free text field in the clinical software.

2. As a team, decide on what codes will be used as standard across the practice. You may find it easier to discuss and agree on the codes for one or two disease areas at a time through regular team meetings (possibly targeting specific high volume diagnoses). Ensure that all clinicians are aware of and are able to use the drop down 'condition list' in the clinical software.

3. Monitor and review the system. This could include providing training for clinicians as part of orientation, and providing regular updates and reminders of the system to all staff. In particular, it is important to acknowledge the efforts of your health service team when coding improves. This will help to ensure these changes are sustained.

4. Agree on a process to ensure that the majority of diagnoses for your active patients are, where relevant, coded and recorded appropriately.

The act of systematically recording a diagnosis is a clinical responsibility rather than an administrative function.

In all cases, any coding or re-coding of a patient's clinical record should be led by a clinician. Often this will be straight forward and, providing that clear rules and guidelines are established, other health professionals can assist in patient coding or re-coding. However, where there is doubt about coding a diagnosis, a clinician should be consulted to make the final decision.

Ensuring that patients have the correct diagnosis recorded within your clinical software may be tackled at particular times in the patients 'cycle of care'. For example, it may be practice policy that a patient's summary diagnosis list is checked for accuracy at the time of a GP Management Plan, Health Assessment or Medication Review, at regular check-ups and at the time of referrals to confirm that the patient's health information is accurate and up to date.

To locate patients who may be missing a coded diagnosis within the clinical software, you may try one or more of the following examples:

Search for patients who are listed as taking a medication that is generally indicative of being diagnosed with a specific chronic condition, but where that diagnosis has not been coded. For example, search for patients on bisphosphonate medications who do not have a diagnosis of osteoporosis recorded.

Search for patients who have had a pathology test indicative of being diagnosed with a specific chronic condition, but where that diagnosis has not been coded. For example, search for patients that have had a regular HbA1c blood test who do not have a diagnosis of diabetes type 1 or 2 recorded.

Check with your clinical software provider if there is a search function that enables you to identify and clinically code unstructured data.

Anonymous said...

Any data analyst knows that this is not 'data cleansing' - which is a rigorous process that looks for obvious errors in the data, impossible values, unwanted statistical noise etc. Its a complex process. Coding data is not 'cleansing' data. But hey, its *sounds* cool right, no need to know what it actually means ....

Terry Hannan said...

Bernard and Anonymous, your comments are very relevant. In particular I see no clear citing of "measures" of the existing model in terms of costs, quality and outcomes.
I am not sure how much this current 10 year plan will cost but I wrote a comment on the NSW Health plan in the 1990s and was brought into the NSW Health Minister's office like a naughty school boy and told to stop writing reports because it was upsetting too many people!!!
10 years later was the 'new' $1Bn NSW Health plan!
My understanding of what is occurring in NSW is likely to be very inadequate so I can expect some scolding however it would be nice to see some clinical health care measures posted in the public space.