Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Tuesday, October 16, 2007

The e-Health Initiative Shows How It Could Be!

This week we had a major blueprint released by the e-Health Initiative.


The following report on the release appeared a day or so ago.


E-Health Group Unveils IT 'Blueprint' For Health-Care Industry

The 107-page report recommends a "shared vision" and timeline to guide health-care players in how to improve quality and accessibility of health care.


By Marianne Kolbasuk McGee, InformationWeek


Oct. 10, 2007

Non-profit industry organization eHealth Initiative on Wednesday released a blueprint on how IT and information can be used for improving health and health care delivery.


The report represents agreement on several key issues among a varied group of 200 health-care industry stakeholders, including hospitals, clinicians, consumer groups, pharmacies, labs, health IT suppliers, health-plans, insurance companies, public health officials, government agencies and employers.


"The biggest accomplishment of the blueprint is reaching consensus across diverse stakeholders" to come up with a strategy and action to move forward in improving quality and safety of health care through IT, said eHealth chairman Janet Marchibroda during an event in D.C. to unveil the report.


The 107-page blueprint represents a "shared vision" and timeline to guide health-care players in how to improve quality and accessibility of health care through information and IT, and not how to implement IT, says Christine Bechtel, eHealth VP of public policy and government.


Entitled "Building Consensus For Common Action" the blueprint includes "principles, strategies and actions" focused on five key areas.


Continue reading here:


http://www.informationweek.com/news/showArticle.jhtml?articleID=202400982


On their web site the vision is outlined as follows:


Our Shared Vision



We envision a high-performing healthcare system, where all those engaged in the care of the patient are linked together in secure and interoperable environments, and where the decentralized flow of clinical health information directly enables the most comprehensive, patient-centered, safe, efficient, effective, timely and equitable delivery of care where and when it is needed most – at the point of care.


In our vision, financial and other incentives are aligned to directly support and accelerate all of the key elements of transformation — engaging consumers, transforming care delivery at the point of care, and improving population health — in a secure, private, and trusted environment.


Vision for Engaging Consumers:


Patients will be fully engaged in their own healthcare, supported by information and tools that enable informed consumer action and decision making, working hand-in-hand with healthcare providers. Tools that support consumer engagement are well designed and customized to the diversity of consumers. These tools are integrated into the delivery of care, and are conveniently available outside healthcare settings as well.


Vision for Transforming Care Delivery at the Point of Care:


Patient care is high quality, patient-centered, for a lifetime, and reflects a coordinated and collaborative approach. Complete, timely and relevant patient-focused information and clinical decision support tools are available, as part of the provider’s workflow, at the point of care. High quality and efficient patient care is supported by the deployment and use of interoperable health IT and secure data exchange between and across all relevant stakeholders.


Vision for Improving Population Health:


Electronic healthcare data and secure health information exchange are utilized to facilitate the flow of reliable health information among population health and clinical care systems to improve the health status of populations as a whole. Information is utilized to enhance healthcare experiences for individuals, eliminate health disparities, measure and improve healthcare quality and value, expand knowledge about effective improvements in care delivery and access, support public health surveillance, and assist researchers in developing evidence-based advances in areas such as diagnostic testing, illness and injury treatment, and disease prevention.


Vision for Aligning Financial and Other Incentives:


Healthcare providers are rewarded appropriately for managing the health of patients in a holistic manner. Meaningful incentives help accelerate improvements in quality, safety, efficiency and effectiveness. Quality of care delivery and outcomes are the engines that power the payment of providers.


Vision for Privacy, Security and Confidentiality:


In a fully-enabled electronic information environment designed to engage consumers, transform care delivery and improve population health, consumers have confidence that their personal health information is private, secure and used with their consent in appropriate, beneficial ways. Technological developments are adopted in harmony with policies and business rules that foster trust and transparency. Organizations that store, transmit or use personal health information have internal policies and procedures in place that protect the integrity, security and confidentiality of personal health information. Policies and procedures are monitored for compliance, and consumers are informed of existing remedies available to them if they are adversely affected by a breach of security. Consumers trust and rely upon the secure sharing of healthcare information as a critical component of high quality, safe and efficient healthcare.

----- end Vision.

Also of interest is that while all the broad principles of what is needed to move forward there were two areas where the detail was contentious. As the report states:

“The most challenging issues that arose during the development of the Blueprint centered on two key areas: the design of financial incentives to support improvements in healthcare and policies for information sharing.”

This is not unexpected since one of these goes to the question of “who pays?” and the other goes to the issue of “who will I share with?” and “how much can and will I share?”

Overall it is my view that to develop strategies and tactics to address the five areas identified here (as has been done in the full document for the US) would be an enormous leap in Australia as well.

It is fascinating reading the reasons the Initiative believed a Blueprint was needed.

“eHealth Initiative’s discussions with multiple stakeholders across the healthcare system at the national and local levels reveal that there is not clarity regarding the incremental steps that must be taken. With all of the change, and the multitude of activities taking place at the national, state, and local levels, healthcare leaders find that it is often hard to keep track and make sense of what is happen­ing, and understand the concrete actions for improving the quality, safety and efficiency of healthcare through information technology.”

They could have just as well have been writing about a place we all know much better! The analysis works as well for Australia as it does for the US as far as I am concerned. This is the reason we need a Plan!

The process used to develop this consensus document involving 200 or so major organisations is a model as to how things should be done – compared with the obsessive secrecy and lack of vision we see coming from the entire official e-Health leadership in Australia.

With examples of this quality available the time has come for a total revamp and a “falling on their respective swords” of the current crop of dismal bureaucratic dimwits. A whole new generation of leadership needs to be encouraged to emerge. The current lot failed us all and need to go!

To grasp just how bad it is just compare the e-Health Initiative document to the disgustingly pathetic strategic products produced by our Australian Health Information Council – they are clearly just a joke in comparison!

David.

Note: As part of a project to stimulate work on a similar project in Australia the Health Informatics Society of Australia (HISA) is conducting a survey of its members – asking their views of the applicability of this vision and strategic framework to Australia.

If you are not a member of HISA and would like to respond to the survey please contact the HISA CEO (Dr Brendan Lovelock) at brendan.lovelock -at- hisa.org.au and he will send you an e-mail invitation to participate in the survey.

Thanks

David.

5 comments:

Dr Ian Colclough said...

Perhaps the most significant statement made, among so many contained in the eHealth Initiative document, is “that there is not clarity regarding the incremental steps that must be taken.”

All too often great visions and big plans, fired-up with emotive language, urgency and zealous enthusiasm, overwhelm everyone - bureaucrats, politicians, stakeholders, technology vendors. When this happens, in the most complex and turbulent of industries - the health industry - everyone loses their way without a very good chart, roadmap, plan (call it what you will) that carefully plots the way through the minefield(s) to the other side.

Anonymous said...

The obsessive secrecy to which you refer reflects a high level of insecurity by those in charge of setting the e-health agenda in Australia. This has lead to the lack of vision to which you also refer.

People who don’t have sufficient knowledge and experience about a particular subject have only two options open to them. The first is as you describe - obsessive secrecy - the other is to admit we are not experts, we do not know, please help us, and please advise us. If their egos will not allow it - the latter will not happen. Insecurity and ignorance will block progress.

It is however unfair to suggest a “falling on respective swords by the current crop of dismal bureaucratic dimwits”. It is neither necessary nor fair to describe them so. They do not know what they do not know. They may well be decent, intelligent, competent people - but not competent in health IT, and not intelligent enough to know when to ask for help.

Dr David G More MB PhD said...

Hi,

Didn't you just make my case for generational change? Competence actually matters I think!

David.

Anonymous said...

Competence matters absolutely. No one should argue with that.

But ‘generational change’, what does that mean. Older people with experience, wisdom and maturity who understand the pitfalls or younger people more gung-ho, less experienced, less cautious and ready to have a go at anything?

I’m not sure ‘generational change’ is what you are really calling for. Perhaps you should be more specific about what sort of people, background, skills, experience, etc, you think are required to lead the way.

Dr David G More MB PhD said...

Its is simple!

Without trying to issue slogans it is time for 'new thinking'. The current bureaucracy has had a decade - got not far..

Time to clean all them out and start again. They have had a chance and IMVHO failed.

One or two for corporate memory and the rest out so people who really understand what is needed can assist. Sad there is not a decent course to train such people at a decent level anywhere in OZ now!

Being well meaning but incompetent does not cut it in my view any more!

David.