Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Friday, November 10, 2017

HISA Checks Up On Health Informatics In Australia. Interesting.

This appeared last week:

Clinical Informatics in Australia: A temperature check

Clinical governance emerged as a key priority in our recent survey of the HISA Clinical Informatics Community of Practice. More than half of the respondents said clinical governance for implementing systems or process changes was a priority for the coming year. The survey was a temperature check on the state of clinical informatics and organised by HISA for the Community of Practice.
  • Nearly half of the 150 members of the Community of Practice responded  (48.7%)
  • Around 80% were mid to late-career, primarily working in public hospitals (50.94%) and 33% of respondents had a clinical background. Most live on the east coast of Australia (NSW, Qld, VIC)
  • Nearly half (49%) of respondents were from organisations that already had an EMR in operation, with another 37.3% progressing towards it (in either procurement planning or implementation mode)
  • Not surprisingly, digital health is spawning a new member of the C-Suite, the Chief “X” Information Officer (CXIO). Around half (51%) of organisations had someone in this role. For those with a CXIO, there was some variation in the clinical discipline of the incumbent which in turn influenced the role title. The most popular CXIO was the CMIO
The survey had a list of informatics topics for respondents to consider and prioritise for the next 12 months:
  • Clinical governance for implementing systems or process changes
  • Education of informatics to practicing clinicians
  • Access to university level programs in clinical informatics
  • Development of digital health policies and models
  • Introducing precision medicine into our facility
  • Knowledge of current and emerging technology (AI, blockchain, IoT, etc)
  • National/international eHealth standards conformance/ adoption (HL7, SNOMED etc)
  • Staying current with industry trends
  • How to do change management
  • User centred-design
  • Interoperability
  • WIFI
  • Data analytics
  • Cybersecurity
  • Patient engagement
  • Information sharing
  • Other
The three that came out on top were:
1. Clinical governance for implementing systems or process changes (55.6%)
2. Education of informatics to practising clinicians (47.2%)
3. Interoperability (41.7%)
More here, including a very useful summary infographic.
Here is the link to the infographic:
“This survey information may be shared with credit to HISA – download the infographic and share with your health workplace.”
It’s good to see HISA providing such useful feedback to the community.


Bernard Robertson-Dunn said...

At the risk of offending the informatics community, my view is that Health Informatics is only part of the health care problem space.

The real objective is making better health care decisions. This involves two things:

1. The process of decision making
2. The information required in order to make those decisions.

From the perspective of an enterprise architect, this is a no-brainer, it's what we do all the time.

Looking at the AHIMA’s Pocket Glossary of Health Information Management and Technology, it says this:

'health information management (HIM) (i)s “an allied health profession that
is responsible for ensuring the availability, accuracy, and protection of the clinical information that is needed to deliver healthcare services and to make appropriate healthcare-related decisions.”'

So far so good, we are in agreement. Unfortunately, in that document, that's about as far as it goes with respect to decision making processes.

IMHO, there needs to be a lot more work and investigation into how health and medical information is used and what health and medical information is needed to better deliver health care. An information/data view, on its own, is not sufficient.

This is one reason why the MyHR is such a total failure - there is no obvious clinical use for the data in it. Neither will gathering more data help, it's mostly useless, unreliable and confusing; all it will do is make the MyHR less usable (if that's possible)

Anonymous said...

"One reason why the MyHR is such a total failure - there is no obvious clinical use for the data in it."

I agree, and I would add that HISA seems more comfortable skirting around the periphery of this fundamental reality. In so doing it is avoiding any confrontation with ADHA thereby encouraging it to continue doing more of the same.

john scott said...

Bernard, I absolutely agree.

Health informatics and health information management are only part of the problem and solution space.

We need to better understand how information is used to inform, guide and execute health care decisions. You won't obtain these insights and resolve the necessary normative issues absent a clear separation of the human and the technology spheres.

Anonymous said...

and automating a manual process like medical record keeping will only act as an anchor to progress.

Andrew McIntyre said...

What I would really fear in a MyEHR with "lots" of data. The referral process includes a referral which is a summary of the important points. Faced with a repository of potentially thousands of useless documents what do you do? Are you liable for not reading every document, one of which contained a Piece of critical information? Are you liable for not reading "every" document? There is such a thing as to much information, especially when its a pdf. Its fine to look at 5 years of LFTs in a cumulative atomic form to pick a trend but 30 pdfs with LFTs is a nightmare. It puts you back to what started me on eHealth journey, to avoid having to construct your own date ordered cumulative results, with pencil and paper, to make sense of a pile of paper results. I want atomic data, not a pile of virtual paper!

john scott said...

Andrew, I totally agree with your concerns about how a doctor is to go forward with any kind of confidence.

What continues to amaze / bewilder me is the silence of the medical profession. When I say this I don't mean in regard to their relationship with government. Rather, I mean it in regard to their relationship with the citizens and residents of this country. HOW can they stand idly by? Where is their Duty of Care? Where is their acknowledgement of the social contract?