Another day and we have another of the Rudd Government’s trio of papers on Health Reform.
Building a 21st Century Primary Health Care System
The draft of Australia’s first National Primary Health Care Strategy has been released by the Australian Government.
31 August 2009
The Rudd Government today released the draft of Australia’s first National Primary Health Care Strategy.
The Primary Care Strategy focuses on what Government can do to improve the frontline health care that Australians depend on, including the care delivered by GPs and other frontline health professionals like physiotherapists, psychologists and pharmacists.
Australia’s health system is facing a number of key challenges including:
- an ageing population
- rising rates of chronic disease
- the need to address the health needs of rural, remote and Indigenous communities.
The Strategy has a strong focus on meeting these key challenges of the future.
The strategy reinforces and builds on the work of the National Health and Hospital Reform Commission - providing the next level of detail that sits below the Commission’s broad priorities.
It provides us with a draft roadmap to guide future policy and practice in primary care in Australia, ensuring we are building a system that cares for the most vulnerable in our community and a system that is connected with the patient at the centre.
The Government is determined to get health reform right.
Stakeholder input has been crucial in developing the draft strategy, with more than 260 submissions received in response to the discussion paper.
Following the recent release of the National Health and Hospitals Reform Commission’s landmark report the Government has begun a national conversation on health reform with the Australian people.
Today’s consultation at Sir Charles Gairdner Hospital in Perth is the tenth consultation held by the Government. Over 18,000 hits have been received on the Government’s yourhealth.gov.au website – around 600 per day since the site was launched.
The three most popular topics explored on the site to date are hospitals and emergency departments, e-health, and primary care/general practice.
The release of the draft strategy today will further inform that discussion.
Development of the draft strategy has been assisted by an External Reference Group (ERG) with membership comprising primary health care experts from around Australia, including a pharmacist, a midwife, a physiotherapist, a psychologist, a general practice nurse, a consumer representative, primary care academics and strong representation from general practice, including those with Indigenous, rural and remote experience.
The Government thanks Dr Tony Hobbs, who chaired the ERG, and all members of the group who gave so generously of their time, experience and knowledge to inform the development of the draft strategy and its supporting report.
The release is found here:
http://www.health.gov.au/internet/ministers/publishing.nsf/Content/nr090831
There are two documents that were made available yesterday.
First we have:
Building a 21st Century Primary Health Care System: A Draft of Australia's First National Primary Health Care Strategy
Found here:
http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/nphc-draft-report-toc
The actual report is here:
Second we have:
Primary Health Care Reform in Australia - Report to Support Australia’s First National Primary Health Care Strategy
This is found here:
http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/nphc-draftreportsupp-toc
The download is here:
In the draft strategy we find the following under the Strategy Building Blocks:
2. Information and technology, including eHealth
eHealth and other technologies are key enablers for change in primary health care. eHealth will allow information to be available when and where a patient needs care, can drive communication and partnerships between providers and with patients, will reduce the risks of adverse events for consumers and, with it, reduce costs and improve patient outcomes.
Electronic information exchange, particularly individual electronic health records (IEHRs), are a strong support for multi-disciplinary primary health care collaboration and enable efficient exchange of information between the primary health care, community and specialist health care settings.
This would be a significant improvement on the current situation for clinicians and consumers, particularly those with complex or chronic health conditions and those who need to move across the service system – from a general practice to a specialist service provider or allied health professional to a hospital and back.
As Australians increasingly access online information and services through mobile and e-technologies, they expect that the health sector will operate as does other sectors, affording them similar access, efficiencies and ease of information and connection.
Consumers expect to be involved and active in their health care management, and should have access to tools to enable self-care in a structured and informed way, and assist them to navigate the health system maze effectively.
Released in December 2008, the National E-Health Strategy provides an appropriate basis to guide the development of eHealth and proposes the incremental adoption of IEHRs.
The National Health Call Centre Network, a Council of Australian Governments (COAG) funded initiative, provides a good infrastructure base for other innovative uses of technology, such as proactive telephone-based self-management support of patients and online health information.
What will be different?
Patients not having to repeat their medical history to each new provider. Patients having information to help them to manage their own condition. Health care providers able to set up virtual, integrated care teams, and having accurate and timely information to support best treatment. Potential to outreach to hard to service communities with more innovative and effi cient use of health workforce. Improved quality and safety.
In the Supplementary report we have information on e-Health in a major section, as well as comments it is important in pretty much anything.
This section covers pages 90 to 100 and is what I am much less than happy with.
Essentially these 10 pages say that e-Health is a good thing, the public want it and so we need to get on with the National E-Health Strategy and implement the notorious NEHTA Individual Electronic Health Record (IEHR)
Reading the 10 pages one gets the distinct impression the authors of this section have absolutely no idea just what the implications of what they are suggesting are, but that this is the latest buzzword and we think we should have one.
What they should have been saying is that what General Practice needs is broadband, connectivity, powerful, clinically useful provider systems for those in GP to use and standardised messaging capabilities to facilitate information flows between practices and within practices and with the various service providers and hospitals.
We also then need to exploit these systems to provide all the secondary benefits of information enabled practice.
If we can get there maybe then we can – as the National Strategy suggests - dip our toes carefully into clinical information sharing.
If you want an idea of just what a minefield this is download and read these documents from here:
Shared Record Professional Guidance (SRPG)
The purpose of the Shared Record Professional Guidance (SRPG) project was to develop a set of professionally led guidelines that would consider the governance, medico-legal and patient safety consequences of Shared Electronic Patient Record (SEPR) systems in primary care.
More here:
http://www.rcgp.org.uk/get_involved/informatics_group/shared_record_professional_guidance.aspx
The project report is presented in three documents:
SRPG final reference report (140 pages)
SRPG quick reference guide (8 pages)
I am sure you will conclude, as I have, we have a zillion miles to go to get to first base before we go down the IEHR path. The issues and complexity make the problems around the IHI seem like a cakewalk!
Sorry but they really should have come up with a push for getting the basics right and have not over-reached as I think they have with this.
David.
As Davis says, here is yet another report that says e-health is a good thing, but makes no useful contribution towards it. I have seen enough reports now telling me that e-health is ro would be a good thing, including reports from NEHTA. I would now like some concrete sensible achievable plans to make it happen.
ReplyDeleteConcrete, sensible, achievable plans will not happen. Face the facts, understand why and accept reality - it will not happen. The system has been set up to fail. Read the Privacy commissioner's report (Karen Curtis) in this blog August 31) and you will see why. The cross jurisdictional goals of NEHTA will continue to be undermined by the jurisdictions each intent on feathering their own nests. The Board of NEHTA has not changed despite multiple calls and the strongest recommendations to do so. And even as late as yesterday, it was reported in The Australian, that another wacky-do project has been set up by the The Australian Commission on Safety and Quality in health care in conjunction with NEHTA and KPMG to produce a uniform electronic medication management system. The future for ehealth was succinctly summed up in the Deloitte presentation at HIC-09 with the dire warning "the national agenda could easily fragment into 1000 moving parts". The words "Could easily" should be replaced by "will" - market forces at every level will ensure that is so.
ReplyDeleteHow does one access the Supplementary reeport on IT you refer to?
ReplyDeleteIt is not a separate report. It is 10 pages on the topic in the second document I list - the provides the evidence base for the shorter Draft Strategy.
ReplyDeleteDavid.