The following appeared today!
Roxon lost in e-health maze?
Karen Dearne | October 22, 2008
THE word e-health is yet to pass federal Health Minister Nicola Roxon's lips but the fact she is looking at healthcare that works across different parts of the system means that she has to get there soon.
For some months now, industry observers have been anxiously waiting for federal Health Minister Nicola Roxon to mention e-health
For some months now, industry observers have been anxiously waiting for Ms Roxon to mention e-health in one of her many - well-received - speeches on health sector reform. They point out that her plans rely on having a robust and reliable health IT infrastructure that presently doesn't exist.
But we still we wait for the penny to drop.
Last week, Ms Roxon said that while some medical providers may have resisted consumer participation in the past, "it's now widely accepted that consumers should have a central role as the users and beneficiaries of healthcare - and, ultimately the ones who pay for it".
Ms Roxon told the Consumers Health Forum in Canberra that while the dedication of health professionals could not be doubted, "still too often we only hear from organisations arguing that they speak for their patients, not the true voice of the patients themselves".
Much more here:
http://www.australianit.news.com.au/story/0,24897,24535256-5013046,00.html
Go to this URL and post you comments, suggestions or whatever!
Now I know there are strategic processes off and running to formulate the way forward for e-Health. That’s fine – but what a great opportunity to have a say directly on such a large and important media platform. as to what the ‘grass-roots’ are keen on and desire!
Go for it! - And why not copy the same comments here as well?
David.
Well, that comment box for the article left my Firefox hanging. I know other commenting facilities work properly at news.com. The failure may be another example of failure to apply universal standards. BTW, David, have you seen the paper on unique identifiers from RAND?
ReplyDeleteWell, here is what I submitted:
ReplyDeleteI fully support the CHF push for shared communications and greater involvement of community organisations (including GPs - who should count as part of the community). Some concerns about representation - it is the government who is supposed to be the elected body representing the community. Organisations like CHF can provide input, but at the end of the day the government needs to take the best advice available and make some decisions. Advice from the dedicated people who have been working as case managers, carers, allied health professionals, home helpers and so on should not be ignored either. By helping them we can help their clients. There have been some interesting projects using IT to benefit this group, look at http://www.s2s.org.au - despite continuing attempts to find resources, there has never been a proper evaluation of that system.
Whatever is done, there will be issues to confront, the biggest is certainly privacy and security. It is simply not practicable to give the consumer full control of all their information. The principle of consumer control is sound and should be built into every system at some level, but it is simply impossible to administer a system where the consumer must agree to every specific transaction before it occurs. This is where some government leadership is required. Not everyone will like or agree with some decisions, but they need to be made if progress is to be made.
There are other bodies that represent different stakeholders that should be listened to here also. One problem is that the "community health" sector is incredibly fragmented and it is difficult to find a clear voice that represents the people who have been working in that area for a long time, and may have some idea as to what would help them most. Another example is IT professionals who have been struggling for years with the issues of how to apply IT in community based health care. They are represented by the Health Informatics Society of Australia - I am Vice President of that organisation.
There are also various groups representing community care organisations and professionals that, with a little effort, could be involved in a meaningful discussion about what would be of most benefit to their clients. These are dedicated people who generally enjoy the trust of the consumers they work for. I am also on the board of Uniting Care Community Options, which is an organisation dedicated to providing community support, and one of the biggest issues for that organisation is the need to collect and report information to fundholders. Such collection is disjointed and the information required is generally not focused on the actual needs of the consumer - but rather on the need of the fundholder to justify and account for funding. As a result, the systems used to collect collate and submit the information to fundholders are of little or no use in supporting the carer and consumer with useful and relevant information. I think with a little effort, these needs could be much better aligned.
I could go on, drawing on more than 20 years of using IT to try and make a difference in the area of community based health care, but I am on leave at the moment and my wife is keen to get outside and enjoy the beautiful Tasmanian countryside.
I used Firefox too.
ReplyDeleteHere is the response that I tried to make:
The Health Informatics Society of Australia is definitely among those anxiously waiting for eHealth to become the subject of Government attention and it is true that there are important and urgent decisions to be made in regards to eHealth policy.
The solution to the problems that eHealth looks to address is far from simple and requires a well thought out and widely supported plan. As we can see from experiences in the US, UK and other European countries, the quality of the planning and strategy process has a major bearing on the success of the implementation.
Our interactions with Minister Roxon suggest that this has not passed her by and she has supported the development of a National eHealth Strategy Plan through the Australian Health Ministers Advisory Council (AHMAC) and no doubt the National Health and Hospitals Reform Commission will have to consider eHealth if they are to achieve any of the reform proposed in submissions and at their consultations.
Both these processes are close to conclusion, and we would support waiting until they are completed. Their conclusions need to be carefully considered and the potential plan for change well canvassed amongst both consumer and professional communities before being finalised. It is our hope that this process will begin in the near future and will generate a balanced consensus plan that will allow us to address the quality and workforce issues that it will be impossible to do without effective consumer- focused health information systems.
Take the results of the study, in the media this week, that concluded many parents are unaware that their child is overweight. Is that an opportunity to lobby the merits of health information technology (HIT)? I hope not, and following from that opinion, I suggest Ms Roxon chooses the benchmarks for measuring success of HIT applications very carefully. I mean, in the case of obesity, the time and place for intervention is in the supermarket. So, to make a general observation, trying to make technical targets for a community with woefully poor health literacy is inviting failure.
ReplyDeleteI see a small number of clients and when taking them on try to remember to ask their height and weight. A few will have the numbers at their disposal, many do not know or will take a guess. A few will look around, spot the deluxe bathroom scales in the corner, and offer to measure up. I will encourage those that are much under- or over-weight to let me record their numbers at each visit. My point is that people who expect their doctors to weigh them, and tell them whether or not they are over-weight, are lost causes. And a system that panders to dysfunction is risking corruption through perverse incentives. We have read about people who are so obese that they cannot leave their homes, and when they have a mishap, it takes a crane, trucks and team of paramedics to get them evacuated to a hospital. In a time of scarcity of trained personnel we should not risk the consequences of tying them up on a growing list of procedures on the morbidly obese. But that's the way we are headed, by medicalising obesity.
Back at the shop front, it bedevils me why the front-end software cannot ask clients to add the values for their height and unclothed weight, and then have those and any other relevant physical constants, like eye colour, passed through to the other applications in the practice. I would have no hesitation, then, in insisting to clients that it is their responsibility to supply the values. My fear is that health-care paternalism has rendered impotent any tendency for people to measure themselves and keep their own health data. A community that has little need, in their minds, to keep their own records is not likely to pay more to have us do it for them.
Just for the record, the comment box for the article in The Australian works in MS Internet Explorer.
ReplyDelete