Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Monday, January 19, 2009

Booze Allen Suggests a Sophisticated Approach to e-Health that Recognises the Complexity and Difficulties.

The following release appeared last week.

http://www.boozallen.com/publications/article/40808278?lpid=38218798&gko=50ac0

Toward Health Information Liquidity: Realization of Better, More Efficient Care From the Free Flow of Health Information

How health information and communications technology (health IT) can accelerate progress towards health reform and a genuinely patient-centered health care system.

Recognizing the challenges presented by the current state of our economy and national discussions about healthcare reform, Booz Allen Hamilton and the Federation of American Hospitals have collaborated to examine the ways that health information technology, in combination with communications technology (hereafter referred to simply as health IT), can accelerate progress toward the goal of a patient-centered healthcare system.

We engaged thought leaders from across the different segments of the healthcare industry to discuss ways to accelerate progress toward the free flow of essential electronic health information. This group of invested stakeholders from the provider community, academia, the technology industry, and government concluded that consumers, clinicians, and providers all derive greater benefits when health information flows faster and more freely, or becomes more “liquid.” Growing evidence indicates that liquid health information can facilitate improvements in healthcare access, quality, safety, efficiency, convenience, and outcomes. At the same time, it can open the door to innovation and provide a foundation for a new standard of patient-centered care through enhanced use of healthcare teams and informatics.

We conducted a series of interviews with these thought leaders and convened them to discuss the benefits of liquid electronic health information, as well as the barriers that inhibit the conversion from paper-based record systems to robust electronic health information and that discourage the sharing of appropriate data that is already electronic. Published reports, white papers, websites, policy blogs, trade newsletters, and other sources of information on early adopters of electronic health information informed the results of the discussions and our conclusions.

Health IT alone will not dramatically improve care and reduce costs. Even when information is electronic, it is not automatically shared outside of organizational or network firewalls, or across organizational boundaries. In the course of our inquiry, two accelerators emerged that combine policy and market changes to change healthcare delivery and improve the flow of information. First, focus on enhancing the flow of health information and communications among patients and providers, rather than focusing only on adoption of electronic health records (EHR). Second, take bold new steps toward realizing a consumer-centered healthcare system.

Booz Allen's Susan Penfield, Kristine Martin Anderson, Margo Edmund, and Mark Belanger are the authors of "Toward Health Information Liquidity: Realization of Better, More Efficient Care From the Free Flow of Health Information."

study posted January 12, 2009

Comment.

This study makes interesting reading and I do not disagree with the findings. However it is not really as simple as it seems. Booze Allen clearly recognise this I believe as they point out, among the key things needed are both a Health Information Exchange Architecture and Knowledge Management Framework as well as interoperation and communication standards (Section 1.3 to 1.6).

Under Accelerator 1 – Intensify the Focus on Information Flow and Communication we read

“1.3 Define and implement a national health information exchange and knowledge management architecture – make sure critical history data, such as pharmacy, lab and imaging date flow securely across organisational boundaries.

1.4 Create and maintain standards for information exchange: the Certification Commission for Health IT (CCHIT) could certify any system’s ability to meet health information exchange requirements.

1.5 Fast-track implementation of a national e-prescribing network with decision support at the time and place of care.

1.6. Assure availability of pharmacy, lab and imaging histories at the point of care and increase reliable and valid reporting for quality and safety.”

This is all going to require very serious work and planning! It is not at all easy or quick to get these things right.

There is a bit of a ‘cargo cult’ around in Australia that seems to think all you need to do is connect clinicians and it will all sort itself out. This is utter rubbish – Booze Allen know it – but some DoHA staff and some academics do not. They need to read the detail to see what is needed and just how hard it will actually be.

David.

1 comment:

Teki said...

There may be tension between Obama and his chief-of-staff, Rahm Emanuel, over Health IT. The recent article in the New York Times highlighted a brief comment from Emanuel that it was “essential” to protect personal health information.
For Obama, and from all of the non-white minorities, access to health care has been only one facet of discrimination based solely on a person's physical appearance. For all those millions, any improvement is worthwhile, even if privacy is breached, because the worst than can happen, mostly, if for someone else to find out that so-and-so is not Causasian, which would be hardly a revelation. On the other hand, Emanuel is Jewish and one of his parents is a medical specialist. So, he carries the history of how recorded information was used to actively discriminate (putting it softly) against minorities who were indistinguishable from other Europeans. On that alone, without the input of his father's working knowledge of medical data systems and the need for scrupulous confidentiality, I reckon Emanuel will have his best brains pulling any EHR apart, and he will fight with Obama until the privacy is right.
On another matter, someone should look into the innards of the Lance Armstrong Foundation (www.livestrong.org). There are strong links to information gathering software and clinical trials databases. Pharmaceutical companies have billions invested in chemotherapeutics and expect to make profits. That image of the Prime Minister in close association with the bicycle race will cost the Aussie taxpayer in costs of expensive chemo drugs.
Of relevance, then, was the call from a couple of oncologists for better access to the clinical trials data being gathered by drug companies. Another application of Health IT, but, at moment, the running and the investment is coming from global pharmaceutical corporations.