This appeared during the week:
WA Health Digital Strategy 2020–2030
2 October 2019
The WA Health Digital Strategy 2020–2030 (the Digital Strategy) aims to take advantage of the innovations transforming healthcare to drive better health outcomes for all Western Australians.
The Digital Strategy presents an exciting opportunity for the WA health system.
There was commentary here:
WA Health plots decade-long IT systems overhaul in new digital strategy
State-wide e-health record to form foundation.
WA Health has laid out plans for a widespread overhaul of its clinical and corporate IT systems over the next decade as part of a new digital health strategy aimed squarely at improving patient care.
The ten-year blueprint [pdf], released on Wednesday, reveals an extensive program of work to transform the state’s health system through interoperable systems, big data, AI and data analytics.
Central to the strategy’s vision is the planned state-wide electronic medical record (EMR), which is considered the foundation for many of the patient-centric improvements WA Health hopes to introduce.
The department has already begun looking at its EMR options, having approached the market in August to gain an understanding of the “current market environment”.
The case for a state-wide EMR was established in the government’s sustainable health review interim report last year as a means to achieving better access to patient records.
The final report [pdf], released in April this year, urged WA Health to work towards “all health services having a functional electronic medical record or equivalent by July 2029”.
But in the 2020-2030 digital strategy, the department said it would look to begin implementing the planned EMR over the next two years.
The EMR is expected to provide WA Health with a “single source of truth” for patient information, including “integrated progress notes, clinical assessments and summaries, medication history, images and diagnostic test results”.
It is also slated to link to a planned state-wide electronic medication management (eMeds) system, which could be provided as part of the EMR or as a seperate integrated system.
While the department has not yet decided on the approach it will take for the EMR, the strategy points out that whatever approach is eventually decided on will “represent a significant improvement on the present combination of paper-based and electronic systems”.
WA Health said it plans to rollout the EMR over the course of the next decade, which - in a similar fashion to NSW’s e-health strategy - has been separated into four horizons due to the size and complexity of the shift.
The EMR is expected to help WA’s health system to become “increasingly virtual and personalised healthcare system”, partly because of the “seamless access to real-time comprehensive patient information”.
There is vastly more here:
The press release announcing the Strategy is here:
What to say other than this should have been a Strategy for 2010 – 2019! WA health has really had a decade or two of less than rapid progress in the Digital Health domain! The whole document seems like something that would have been leading edge 15 years ago to me,
This is rather made clear by the fact that the Strategy does not explicitly outline just what the system and technological base it is working from other than to mention some hospitals do not have Wi-Fi and similar infrastructure and that some systems are rather long in the tooth.
The Strategy seems in two minds about the #myHealthRecord suggesting its use will grow but then pointing out “In some ways the My Health Record could be considered a preliminary EHR for Australian citizens.” P14. Are they suggesting they plan to replace it with a ‘real’ one?
Lastly it seems to me there is hardly even lip-service paid to all the care that is delivered out of hospital by GPs and others. Integration of the holistic health system does not seem to have be a clear priority. The approach to benefits realisation also seems a little light and there are no budgetary estimates / investment plans I could see! Is it all smoke and mirrors with no substance – I wonder!
David.
10 comments:
As you say "Integration of the holistic health system does not seem to have be a clear priority."
Surely you understand that it never has been a priority. The States are responsible for hospitals, not primary care. The Federal Government is responsible for Primary Care, not hospitals. They each gaze at different navels.
This Digital Health Strategy is pretty much a Pied Piper reflection of the strategies developed by other jurisdictions. Their representatives go to the same conferences, listen to the same rhetoric and come away with the same ideas which they then diligently, assiduously and uncritically, put into practice. New ideas arising from creative, visionary, lateral thinking are foreign to their culture.
Sidebar page 14:
"In some ways the My Health Record could be considered a preliminary EHR for Australian citizens.
The WA health system does not have remit over external providers or systems, hence the focus on establishing EMR functionality rather than that of an EHR. Having said that, by ensuring the system with EMR functionality is compliant with national and international interoperability standards the WA health system will support the development of a national EHR."
I'd like to see the value proposition for a national EHR
"Surely you understand that it never has been a priority."
I understand precisely and disagree with that approach. Not looking at the whole health system when planning is plain stupid IMVHO.
David.
David re: "Not looking at the whole health system when planning is plain stupid IMVHO."
That hits the nail on the head.
AFAIK, all the state's digital health strategies only have the public health sector in scope. Nothing about private hospitals or GPs.
Yet the states go on about patient/person centric/centred. The words differ but the message is the same - and misleading.
.... but while they toss around patient/person centric/centred the unspoken truth is everything must be department centred lest control should be irretrievably lost.
Dr Ian Colclough - 100%. Seems a good week for hitting nails on the head.
The core question has been and continues to be: What is the likelihood that the knowledge and assumptions that underpin the current strategy are correct?
This question could be asked of all jurisdictions and all 'technology-driven' solutions to achieve the same effect. None of them will deliver anything other than more cost and in too many cases more dependence upon a digital technology vendor.
If we care about this sad situation, what avenues are available for a new idea and a different approach to gain a hearing?
IMVHO, the answer lies somewhere between Buckleys and None.
To remove the roadblock to progress government must first acknowledge and accept that it needs to get out of the way. That is the first conversation.
@ 12:10 PM It might be the first conversation Dr Ian and you and your colleagues are well equipped to have it with them. However, I'm willing to wager that neither you nor anyone else will be invited to have that conversation with the powers that be, and that if on the slim chance that you are invited, they will sit stoically mute in front of you and at the end politely say - "thank you for the conversation". That of course is not a conversation but that's not something they understand, because they have been inculcated and poisoned by the political imperatives of 'nothingness'.
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