The NHHRC Final Report will be Released Soon. What Must it Say About E-Health?

The Final Report of the National Health and Hospitals Reform Commission is due out in the next couple of weeks.

As soon as I spot it I will provide a link. I assume it will be found from this front page:

http://www.nhhrc.org.au/

For the e-Health component of that reports to be seen as being in anyway useful and positive I believe it will need to make the following points.

First that leadership and governance of the e-Health space are crucial for success. The report should recommend how a satisfactory level of leadership, governance and accountability is to be achieved for the needed investment. Within the governance framework there has to be total clarity as to what the ongoing role of NEHTA should be and how the critical things it either does not or cannot do can be delivered. Clearly I believe just ‘business as usual’ or handing it all over to NEHTA and hoping they will ‘fix it’ is utterly flawed and idiotic. Also flowing from the need for governance and leadership is a deep requirement to ensure e-Health governance is clear that implementation of systems must be conducted in ways that understand, and are sensitive to, the culture of the health sector. Lastly in this area is a crucial need to learn from experience overseas to get the balance of local versus national implementation approaches correct.

Second it should be quite clear that as the health system is about patient care and patient safety that the emphasis on technology deployment should be in those areas where those outcomes can be improved.

Third it should recognise that in the times of Web 2.0 and individual interest by patients in their health records that Personal Health Records will have an important supplementary role to the provider health records.

Fourth it should recognise that Health IT provides the capability to provide far more efficient and connected care for patients and that any re-engineering of the health system should fully and properly take advantage of these capabilities. Just automating a broken or inefficient manual system is just not good enough.

Fifth the report needs to reflect a version of this basic truth:

“Every industry except healthcare has figured out how to become more efficient by replacing administrative work with information technology, he said. Nurses spend a third of their time documenting – a procedure Cutler said often involves printing digitized information and re-entering it into another IT system.”

See here:

http://www.healthcareitnews.com/news/saving-healthcare-industry-emrs-are-beginning-not-end

In a nutshell – Information Technology can do a lot for efficiency and effectiveness in things like administration, human resource management, supply chain management and billing – as well as clinical safety, performance and so on. – Both need to be properly addressed

Sixth there needs to be a clear realisation that without a significant investment in Health IT any hope for long term sustainability of the health system, especially in the era of the ageing population, is out the window.

Seventh there has to be an overall plan and vision for how e-Health and the other proposed reforms are going to interact. Neither can be planned, or successfully realised, in isolation. This needs to be recognised clearly and each needs to move forward assisted by the other.

Eight it needs to be clearly articulated that we need a nationally funded system for the provision of both consumer and professional health information to optimise both patient understanding an clinical care.

Ninth there needs to be a recognition that we have an e-health skills and capability deficit and that this needs to be formally addressed.

Last the report has to either strongly recommend implementation of the Deloittes developed National E-Health Strategy or offer an obviously more cogent and appropriate plan.

These ten points I rank pretty much equally. They all have to be in place.

When we see the report I will provide my view of the quality of the report and the e-Health outlook based on what is provided by the NHHRC and the Ministerial Response to the NHHRC report.

I am hoping I will be a happy camper - but somehow I doubt it.

David.