There has been a recognition in Australia for a number of years of the importance of electronic decision support (EDS) in improving the quality and safety of healthcare services. This recognition lead to some significant national work being undertaken in the late 1990’s and early 2000’s which cuminated in the creation of a very comprehensive national strategy entitled “Electronic Decision Support for Australia’s Health Sector - Report to Health Ministers by the National Electronic Decision Support Taskforce” which was published in November 2002. This report provided a comprehensive review of the then state of the art and a comprehensive set of recommendations.
Implementation of the recommendations was passed to the National Electronic Decision Support Steering Committee which is a subcommittee of the Australian Health Information Council (AHIC). Since that time an evaluation methodology for EDS has been developed and published by AHIC in 2003 and a work plan for 2004 has also been published.
However, after that, as best as can be determined nothing of consequence has happened and indeed only one of the fourteen high priority recommendations appears to have been actioned (the evaluation methodology) in the last three and a half years.
This is an amazing example of the ball simply being dropped due to what can only be stupidity and the inability to understand what benefits could be derived from following the roadmap.
Four years later we see the US produce, via the American Medical Informatics Association (AMIA) a similar plan. AMIA brought together experts from all over the US and convened a number of workshops and conferences in the following twelve months leading to the development of “A Roadmap for National Action on Clinical Decision Support” which was published on June 13, 2006. I can sadly report the US document reaches the same conclusions and suggests similar actions to the earlier Australian report.
Wake up Australia! You are being very badly served by the present crop of e-Health bureaucrats.
AHIC should either get on with it or resign in protest!
David.
1 comment:
I'm hoping that we're close to some critical mass regarding the congruence of each of these NEHTA workplan items.
One being the Australian Catalogue of Medicine which has required the mapping of clinical concepts, which in itself has required the a move to implementing SNOMED-CT within the Australian context. Next is the narrowing of the potential EHR information model; using EN13606 (albeit more for sumamtive data) but which in itself embraces the openEHR standard and archetype model.
These two significant yet currently invisible activites (at the GP clinical desktop) may act to be the driver of DSS within a 'standardised' landscape.
Is it now the turn of the MSIA and their respective software houses to do the heavy lifting, but under what pressures - certainly not the market...
Somedays I feel that I lean optimistically but then the next to pessimism... I'm holding out hope.
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