This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Tuesday, April 16, 2013
The Evidence Free Nature Of the NEHRS / PCEHR Confirmed By Independent Research.
Dr Karin Garrety is a researcher at the University of Wollongong’s Centre for e-Health and is on a mission to uncover the worst eHealth decisions ever made – so that the next generation of eHealth implementations can be more effective.
"This is a really interesting time in the development of the internet and the development of information technology for use in health," she says.
“The people implementing these systems are coming up against problems that we haven’t encountered on this scale before. It involves very complex issues, and involves many different professional groups who have different information needs.”
Dr Garrety is part of a five-person team working on an Australian Research Council (ARC) funded Discovery project under the Human Society field of research.
Other researchers include Professor Ian P McLoughlin, a management expert from Monash University and Dr Rob Wilson from Newcastle University in the UK.
The project will document the policies and processes used by government employees who tried to bring in eHealth systems in both the UK and Australia and analyse the impact of these.
The result will be a retrospective, comparative study of five attempts to set up regional and national systems for sharing electronic health records in Australia and Britain.
“We’re looking at this from a socio-technical perspective,” she says.
Big System Failures
“The majority of people in England now have a summary care record,” says Dr Rob Wilson.
“But the program initially called National Program for IT and later rebadged Connecting for Health failed to deliver on the promise of modernising hospital IT in the UK, with just three installations in ten years.”
Dr Garrety says that Australia hasn’t made the same top-down approach that began with a big, outsourced system.
“We are going a bit more bottom-up here, which has been much better,” she says.
“There are still issues where for example, clinicians feel that NEHTA has not consulted enough with them and so they feel they are out of the loop.”
Dr Garrety says that the focus on the PCEHR came “out of the blue.”
“The idea to have personal control over your own health record didn’t come out of research into what are the current information practices in the health system,” she says.
“A better approach would have been to ask, what is it that would help people do their work better - and then to build something up from what people would find useful to help them to deliver health care.”
It is impossible to disagree with Dr Garrety’s conclusion and indeed, as is well known, NEHTA was planning for a much different Shared EHR before the NEHRS / PCEHR was suddenly, out of a clear blue sky, dropped upon them with a large budget but very little in the way of evidence support or indeed time to execute!
The last two paragraphs really say it all!
It does need to be pointed out that I made similar points a little while ago.