Tuesday, December 23, 2014
A Challenge: What Are the Five Things Australia Needs To Do To Develop A Transformative, Cost-Effective e-Health System?
In welcoming the appointment of the new Federal Health Minister the Consumer Health Forum raised 5 key points it wanted to see actioned.
The second point was as follows:
“2. Commit to eHealth: The revolutionary changes (and cost savings) possible in health care through the introduction of a robust, consumer-centred eHealth system cannot be underestimated. Funding commitments must be made beyond 2014-15 to realise the potential of this system.”
In a brief response to this point I suggested that I was keen to have some of what the authors were inhaling on the basis that I believed to imagine that such was possible, if the present directions and approaches were continued and funded, was rather unrealistic.
Here is the full link:
Hardly surprisingly I was challenged to say what I would do in five points - so here goes.
Recognise that there are two distinct clients for e-Health systems and services and that their needs are not by any means the same - meaning that different systems are required for each. The professional clients (doctors, nurses, allied health etc.) need systems that enhance their clinical capabilities, improve record keeping and facilitate their secure sharing of clinical information to improve patient care and safety.
The consumers need systems to allow them to record their own information while at the same time having access to, ideally, the live clinical systems so they can better engage with and understand and contribute to their care.
It is obvious the present PCEHR does neither of these things well.
We need to recognise we don’t need a single monolithic System but that we need an e-Health ecosystem where health information flows efficiently, accurately, securely and privately between appropriately credentialed actors within the health system and to and from consumers.
We need an updated National E-Health Strategy that consults all stakeholders properly and provides the governance, leadership, strategic technical, standards and managerial pathways to actually achieve the goals cited by the CHF for this domain. We then need the Strategy properly funded and led - as did not happen with the 2008 version.
Before anything more is done or spent actually undertake a proper in depth peer-reviewed evaluation of what e-Health in all its guises has achieved in Australia and what has been achieved in the rest of the world that might be applicable to Australia. This research should inform what comes next.
We need to understand that no-where in the world has a transition to e-Health been easy, uncomplicated, pain free or without missteps. As we increasingly realise, getting this right is a very considerable and some might suggest near impossible challenge that takes lots of time, lots of money and dedication - as well as quality leadership and governance for success. E-Health is not something for generalist bureaucrats and technicians to have repeated goes at and repeatedly fail at!
I could ramble on for ever on this - but it what is said above is taken seriously, actioned and funded there is hope. If not then the next 20 years will be the same as the past 20!
Posted by Dr David More MB PhD FACHI at Tuesday, December 23, 2014