I Seem To Think There Is A Key Aspect Of The NSW E-Health Journey Missing.

This appeared last week:

eHealth NSW nears completion of electronic medical records system

Aimee Chanthadavong

16 August, 2019

eHealth NSW has announced that by the second half of next year, all New South Wales public hospitals will have access to electronic medical records (EMR), as part of the agency's wider effort to make the state's health system more citizen-centric.

During his keynote address at an Australian Information Industry Association event on Thursday, eHealth NSW CIO and CEO Zoran Bolevich outlined the EMR system is already live at 177 public hospitals across the state.

"It is important for us to start looking at how we can link disparate electronic medical records databases so we can have a more continuous flow of patient information, and that's what we're trying to do with this piece of work," Bolevich said.

"We're trying to create a more consistent patient and clinician experience, especially for junior doctors and nurses who travel around the state and work in different types of hospitals … so there is a consistent look and feel everywhere."

With an EMR system in place, Bolevich said there was now a foundation for eHealth NSW to accelerate its data analytics journey where data models can be standardised and local innovations can be seamlessly rolled out across the state.

The EMR system will be used to support the eHealth's strategy to develop a Single Digital Patient Record (SDPR) that will be designed to give a holistic, state-wide view of a patient's healthcare information.

Earlier this month, eHealth issued a Request for Information to seek input from industry, solutions providers, and healthcare professionals to support the development of the SDPR initiative. An industry briefing on this is scheduled to take place next week.

A similar system known as My Health Record was designed by the federal government, although it was not particularly well-received by some patients. Over 2.5 million Australians opted out of the government's online medical file, after their records were automatically created for them.

Getting to know the patients

In addition, Bolevich announced phase one of the agency's patient reported measure project will go live in a few weeks' time, which will enable clinicians to invite patients to provide feedback through a survey portal, which will then be available to clinicians to inform patients' preferred process of care.

"Like most other systems in the western world, NSW Health is reframing and rethinking our value proposition," Bolevich said.

"Health systems have been very good traditionally at counting inputs and outputs of volume, but we haven't been particularly successful and or systematic in the way we collect outcome information so that we can truly understand the value the health system provides to community, and the impact we're making on people's health and wellbeing.

"We've focused a lot of the clinical outcome defined by the health system, but the idea here is the staff will systematically collect feedback on patient experience and outcomes of care in terms defined by patients."

Bolevich said eventually the patient experience outcome surveys will progressively be integrated with the EMR and GP systems to deliver a holistic process of care. 

Lots more interesting material here:

https://www.zdnet.com/article/ehealth-nsw-nears-completion-of-electronic-medical-records-system/

What I reckon I missing is the hard evaluation of both clinical, clinician and financial measures of impact.

Have we seen improved clinical outcomes, fewer clinical and medication errors, less clinician stress and has there been at least a reasonable return on the investment been made for the NSW public.

I have had a look at the last year or two of press releases and while a lot of systems have been installed there is not much discussion of the evidence for the difference they are making.

If there are some useful reports I would love to read them, or is all this just based on blind faith that more systems equals better clinical and financial outcomes?

David.