The following appeared last week.
- Karen Dearne
- From: Australian IT
- September 01, 2010
NEW Zealand continues to outpace on e-health Australia still grapples with key design, funding and planning issues.
Tom Bowden, chief executive of Auckland-based secure messaging and integration specialist HealthLink, said Australia had failed to do the hard work on building basic capacity, setting standards and improving data quality.
"All the really flash stuff has been worked on and there's been lots of bright ideas, but the real effort is still to be done and we won't see solid progress until that occurs," he said.
"Nowhere near enough effort has gone into getting the quality of GPs' electronic patient records up to scratch, and organising standardisation of the information that's to be exchanged."
In contrast, 100 per cent of GPs were using fully functional e-medical records by 2000; 100 per cent have been doing clinical messaging and 95 per cent of hospitals have provided e-discharge summaries over the same period. Because of this infrastructure, New Zealand has been able to build and release a raft of more sophisticated applications.
The latest is electronic referrals from a GP's office to hospital specialists. HealthLink has completed the rollout of a web services e-referral platform across half the country. New Zealand celebrates the 10th anniversary of its universal patient record system this year.
"A hospital offers a menu of referral types depending on specialty, the GP picks one and the GP's system automatically picks up all the required information with one click," Mr Bowden said.
"The referral is then submitted electronically to the hospital, where it becomes part of the patient's incoming record.
"Where the system is in use, some 80 per cent of referrals are being done while the patient is in the GP's room, during a 10-minute consultation.
"The specialists like it because they get all the information they need, and the inclusion of test results or digital photos cuts waiting time because they have a much clearer understanding of what's wrong."
Mr Bowden said New Zealand achieved its connectivity using the messaging standard HL7 version 2, while most labs in Australia still used the outdated pathology reporting format PIT.
"I'm sad to say PIT should have been replaced long ago by HL7v2, but its use for pathology messaging is still rising," he said. "This gets back to basic messaging not being properly run here.
"Every lab is supposed to go through testing with the Australian Health Messaging Laboratory to ensure their conformance with HL7v2.
If ever there was an example of ‘perfection being the enemy of the good’ in e-Health it is the comparison that can be made in progress in the basics between NZ and OZ. Even with a financially more constrained nation it has been possible, with some decent strategic leadership to more steadily, if not rapidly forward. Pity we have not been able to replicate the same here!
I leave it as an exercise for the reader to suggest how we might change things to improve our chances in the future.
This blog offers some of my thoughts.