It has been a good week or two for Australian e-Health.
A day or so ago we had the Nation Hospitals and Healthcare Reform Commission release an initial set of suggestions and benchmarks as to how Health Services should be changed and measured in Australia.
The Reform Commission can be found here:
Of most interest is the following.
Update
8 May 2008 - National Health and Hospitals Reform Commission
30 April: Minister Roxon receives Commission's first report –
Here is the full release of May 8, 2008
National Health and Hospitals Reform Commission
In keeping with the Terms of Reference announced by the Council of Australian Governments (COAG) in December 2007, the National Health and Hospitals Reform Commission (NHHRC) last week presented the Minister for Health and Ageing, Nicola Roxon, with a Report on the framework for the next Australian Health Care Agreements.
Beyond the Blame Game: Accountability and performance benchmarks for the next Australian Health Care Agreements represents the Commission’s views on key issues to be addressed in the Agreements and proposes robust and relevant performance indicators and benchmarks.
Chair of the NHHRC, Dr Christine Bennett, said today that the Commission’s Report highlights twelve health and health care challenges that must be addressed in the Agreements to enhance health promotion and wellness and to make the health system work better for the people who need it and use it.
The twelve challenges are:
- Closing the gap in Indigenous health status,
- Investing in prevention,
- Ensuring a healthy start,
- Redesigning care for those with chronic and complex conditions,
- Recognising the health needs of the whole person,
- Ensuring timely hospital process,
- Caring for and respecting the needs of people at the end of life,
- Promoting improved safety and quality of health care,
- Improving distribution and equitable access to services,
- Ensuring access on the basis of need, not ability to pay,
- Improving and connecting information to support high quality care, and
- Ensuring enough, well-trained health professionals and promoting research.
Dr Bennett said that while the Commission had identified these challenges for the Health Care Agreements, the Commission also recognises that there are other challenges facing the health system as a whole.
“The Commission is preparing to hear many views from the public, frontline health workers, professional and consumer organisations, Indigenous health providers, and other health groups through an extensive community engagement process,” Dr Bennett said.
“In coming months, the Commission will be travelling around Australia engaging with communities and people from the health sector to collect ideas on the future design of the Australian health system.
“This will complement the formal submission process that is already underway, with submissions being accepted up until the end of May.”
Dr Bennett said the Commission had developed a set of draft design principles for the Australian health system that will shape the Commission’s work to develop a long-term health plan for a modern Australia. The Commission’s proposed principles to guide reform and future directions of the Australian health care system are:
- People and family centred,
- Equity,
- Shared responsibility,
- Strengthening prevention and wellness,
- Comprehensive,
- Value for money,
- Providing for future generations,
- Recognising that broader environmental influences shape our health,
- Taking the long term view,
- Safety and quality,
- Transparency and accountability,
- Public voice,
- A respectful, ethical system,
- Responsible spending on health, and
- A culture of reflective improvement and innovation.
Dr Bennett said she is confident that the Commission’s principles and stated challenges will be debated and discussed in both the community consultation and formal submission processes.
“The Commission wants to be and needs to be a catalyst for debate on Australia’s future health system,” Dr Bennett said.
“We encourage individuals and organisations to make a submission to the NHHRC to help us shape a health system that is truly people and family centred to serve the Australian community well into the future.”
Submissions to the NHHRC can be made by email to talkhealth@nhhrc.org.au, by mail to PO Box 685 Woden ACT 2606, or by calling 1800 017 533. Submissions will be accepted until the end of May 2008.
Copies of Beyond the Blame Game: Accountability and performance benchmarks for the next Australian Health Care Agreements are available at www.nhhrc.org.au or by calling the NHHRC on 02 6289 8108.
----- End Release.
As readers would know my first instinct was to see what mention was made of information and e-health.
I was rewarded.
Challenge 11 had the pay dirt for me.
11. Improving and connecting information to support high quality care
The way health knowledge and information are created, stored, shared and accessed across health services significantly impacts not just on the efficiency of the health system, but also on the quality and safety of patient care. ‘Connected health’ allows health knowledge and patient information to move with the patient across the different parts of the health care system, improving patient care, helping people navigate their way through the system, supporting doctors in their decision-making, and improving productivity and efficiency.
To achieve this, information about a person’s health and how to optimise it needs to be readily available from reputable and respected sources in multiple and accessible formats, while appropriately managing privacy, security and confidentiality.
Currently, health information networks have been built by different public and private providers and are usually based on inconsistent and incompatible designs, which do not allow for interconnectivity. It is imperative to implement a robust and standards-compliant information management system that enables individuals to authorise access to their vital health details across all health care environments including hospitals, GPs and other health professionals, where they choose to do so, in an agreed privacy regime.
And better still we find in the benchmarks the following measures:
11. Improving and connecting information to support high quality care
11.1 Patient experience with being provided with adequate information: Jurisdiction relevant to service
11.2 Proportion of hospital discharge summaries that are provided electronically to the patient-identified general practitioner or other health service: State
11.3 Proportion of referrals made to specialists that are undertaken electronically: Commonwealth
Now there are a couple of comments I need to make.
First it is good that having defined the measures the report says:
“The emphasis on performance against benchmarks presupposes a capacity for managers to track and adjust policies and strategies in the light of feedback. Information technology and inter-operable systems will be a key technology and structure under-pinning such a system. Ease of use, data gathering and analysis, real time feedback of information to inform on the success or otherwise of interventions and meeting benchmarks and targets will be facilitated greatly by such technologies”
In “report speak” this is an admission that the information gathering infrastructure in the Health Sector might not be quite up to par – to put it mildly. Certainly work and investment will be required to measure some of these benchmarks at reasonable cost.
Second I am not sure that these are either the optimal or only measures we should apply to e-health progress.
Seven additional ones I would be keen to see (off the top of my head) would be:
- Proportion of diagnostic test results received electronically
- Data Quality measures of electronic clinical information
- Use of electronic prescription transmission
- Use of clinical audit software for clinical performance assessment
- Use of CPOE in hospital practice
- Use of electronic diagnostic test ordering in GP
- Proportion of systems offering and level of use of Level 4 Clinical Decision Support Systems
I suppose I should make sure I get a submission in!
Third is was good to see that the Commission recognised that there is more to ‘Connected Health’ than simple connections as some have stupidly suggested in recent times. E-Health is not easy and needs well considered and robust standards to be adopted to achieve the desired outcomes.
David.
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