A Vision for an Australian Healthcare System Transformed by Health Informatics

Transcription

1 A Visin fr an Australian Healthcare System Transfrmed by Health Infrmatics Nvember 2007 Health Infrmatics Sciety f Australia Dr Michael Legg, President Dr Brendan Lvelck, CEO 413 Lygn Street Brunswick East Victria Ph:

2 A Healthcare System Transfrmed by Health Infrmatics Page 2 f 49 Cntents Summary... 3 Intrductin... 6 Backgrund... 6 The Survey... 8 Findings... 9 Australia Rates the Visin Strategy Statement Lists Ranked by Imprtance, Perfrmance and Degree f Difficulty Detailed Methdlgy Survey Design Detailed Results and Analysis Demgraphics Overall Imprtance, Perfrmance, and Degree f Difficulty Results and Analysis by Fcus Area Cnclusin Appendix A Survey Instrument and Results Appendix B Mind Map f Affinity Themes frm Text Respnses... 49

3 A Healthcare System Transfrmed by Health Infrmatics Page 3 f 49 Summary In the issue f the Medical Jurnal f Australia 1 published just prir t the Nvember 2007 electin, a number f cmmentatrs including the Federal Minister and Shadw Minister reflected n the Australian health system and their plans fr its future. The members f the Health Infrmatics Sciety f Australia (HISA) 2 believe there is a yawning gap in this analysis bth in terms f the size f the prblem and hw it might be fixed. There is a lming crisis in the health care system frm an unprecedented simultaneus bulging in demand and reductin in wrkfrce. Ten-fld imprvements in prductivity will sn be required 3 and this can nly happen if the wrk f thse in healthcare is leveraged and healthcare cnsumers becme mre engaged in the prcess. Health infrmatics is critical t bth strategies. The need fr ehealth is mre than fr efficiency alne hwever, health infrmatics is nw seen as an increasingly imprtant weapn against disease in its wn right and there is munting evidence that when used prperly bth health utcmes and cnsumer satisfactin can be imprved 4. Health infrmatics is als an essential cmpnent f any quality and safety agenda fr Australia. HISA strngly hlds the view that Australia lacks a visin fr the health system and in particular hw it culd be transfrmed by health infrmatics. HISA believes it is bth essential and urgent that there be an agreed visin and an apprpriately resurced plan. In Octber this year the US based ehealth Initiative published their Blueprint: Building Cnsensus fr Cmmn Actin 5. The Blueprint appeared t accurately and succinctly articulate a desirable visin f a healthcare system transfrmed by health infrmatics which was apprpriate t Australia. HISA undertk a survey f its members and supprters t test whether this was s and t expand n the visin fr the Australian cntext. The survey had mre than 200 respndents and shwed verwhelming supprt fr the visin which in summary fr Australia was: 1. Engaging Cnsumers - Patients will be fully engaged in their wn healthcare, supprted by infrmatin and tls that enable infrmed cnsumer actin and decisin making, wrking hand-in hand with healthcare prviders. Tls that supprt cnsumer engagement are well designed and custmized t the diversity f cnsumers. These tls are integrated int the delivery f care, and are cnveniently available utside healthcare settings as well. 2. Transfrming Care Delivery at the Pint f Care - Australian patient care is high quality, patient centred, fr a lifetime, and reflects a crdinated and cllabrative apprach. Cmplete, timely and relevant patient-fcused infrmatin and clinical decisin supprt tls are available as part f the prvider s wrkflw at the pint f care. High quality and efficient patient care is supprted by the deplyment and use f interperable health IT and secure data exchange between and acrss all relevant stakehlders. 3. Imprving Ppulatin Health - Electrnic healthcare data and secure health infrmatin exchange are utilised t facilitate the flw f reliable health infrmatin amng ppulatin health and clinical care systems t imprve the health status f ppulatins as a whle. Infrmatin is utilised t enhance healthcare experiences fr individuals, eliminate health disparities, measure and imprve healthcare quality and value, expand knwledge abut effective imprvements in care delivery and access, supprt public health surveillance, and assist researchers in develping evidence-based advances in areas such as diagnstic testing, illness and injury treatment, and disease preventin HISA is a scientific sciety that was established in 1993 which has as its aim t imprve healthcare thrugh health infrmatics. It prvides a natinal fcus fr health infrmatics, its practitiners, industry and users. It advcates n behalf f its members and prvides pprtunities fr learning and prfessinal develpment in health infrmatics. See 3 Dr Peter Flett Pathlgy Wrkfrce in WA, Keynte Address AACB The Business f Pathlgy Cnference, Sydney Nvember Sir Muir Gray The Third Healthcare Revlutin, Keynte Address Medinf, Brisbane August Health Initiative Blueprint: Building Cnsensus fr Cmmn Actin

4 A Healthcare System Transfrmed by Health Infrmatics Page 4 f Aligning Financial and Other Incentives - Healthcare prviders are rewarded apprpriately fr managing the health f patients in a hlistic manner. Meaningful incentives help accelerate imprvements in quality, safety, efficiency and effectiveness. Quality f care delivery and utcmes are the engines that pwer the payment f prviders. 5. Managing Privacy, Security and Cnfidentiality - In Australia's fully-enabled electrnic infrmatin envirnment designed t engage cnsumers, transfrm care delivery and imprve ppulatin health, cnsumers have cnfidence that their persnal health infrmatin is private, secure and used with their cnsent in apprpriate, beneficial ways. Technlgical develpments have been adpted in harmny with plicies and business rules that fster trust and transparency. Organisatins that stre, transmit r use persnal health infrmatin have internal plicies and prcedures in place that prtect the integrity, security and cnfidentiality f persnal health infrmatin. Plicies and prcedures are mnitred fr cmpliance, and cnsumers are infrmed f existing remedies available t them if they are adversely affected by a breach f security. Cnsumers trust and rely upn the secure sharing f healthcare infrmatin as a critical cmpnent f high quality, safe and efficient healthcare. 6. Plicy and Implementatin - Plicy develpment and implementatin bdies, bth gvernment and private deliver clear and insightful leadership f ehealth prgrams within the health sectr. They have a deep understanding f the cultural and peratinal cmplexities f the area and ensure that prgrams are apprpriately structured and funded t be successful. Respndents scred ur current perfrmance against this visin prly but acknwledge that it will nt be easy t attain. HISA takes n issue with the list f challenges fr the healthcare system listed by Armstrng et al 6 in their MJA paper namely: The next Australian Gvernment will cnfrnt majr challenges in the funding and delivery f health care. These challenges derive frm: Changes in demgraphy and disease patterns as the ppulatin ages, and the burden f chrnic illness grws; Increasing csts f medical advances and the need t ensure that there are cmprehensive, efficient and transparent prcesses fr assessing health technlgies; Prblems with health wrkfrce supply and distributin; Persistent cncerns abut the quality and safety f health services; Uncertainty abut hw best t balance public and private sectrs in the prvisin and funding f health services; Recgnitin that we must invest mre in the health f ur children; The rle f urban planning in creating healthy and sustainable cmmunities; and Understanding that achieving equity in health, especially fr Indigenus Australians, requires mre than just prviding health care services. The search fr effective and lasting slutins will require a cnsultative apprach t deciding the natin s pririty health prblems and t designing the health system that will best address them; issues f bureaucratic and fiscal respnsibility can then fllw. 6 Bruce K Armstrng, James A Gillespie, Stephen R Leeder, Gerge L Rubin and Lesley M Russell, Challenges in health and health care fr Australia, MJA 2007; 187 (9): ,

5 A Healthcare System Transfrmed by Health Infrmatics Page 5 f 49 Indeed many f the written cmments frm the survey reprted here supprt these views. There is hwever the implicatin by the absence f cmment in their paper, and the papers by Abbtt 7, Rxn 8 and Caplingua 9, that health infrmatics is seen merely as an enabling technlgy with the presumptin that if yu get the ther plans in place, ehealth will smehw srt itself ut. We, n the ther hand, believe this t be a majr and cmplex engineering prject f the scale f a Snwy Muntains Scheme that can nly happen prperly with a gd plan and the resurces t implement it. This paper cntains a visin that is strngly supprted fr applicatin in Australia by thse wh have an understanding f health infrmatics. While it shuld be tested mre widely, this shuld nt delay the urgent develpment f a natinal resurced plan that wuld get us t a visin like this ne. That plan shuld include strategy develpment, a business case, an implementatin plan and a benefits realisatin plan. T ften in the past there has nt been a gd understanding f what needs t be dne and the cnstancy f purpse that is required t get it dne. Australia needs plitical champins wh can prvide the necessary leadership in cllabratin with the healthcare cmmunity t mve us quickly t a new healthcare system transfrmed by health infrmatics. 7 Tny Abbtt, Gd health systems, getting better, MJA 2007; 187 (9): Nicla Rxn, Taking leadership tackling Australia s health challenges, MJA 2007; 187 (9): Rsanna Caplingua, A mandate t strengthen the health system, MJA 2007; 187 (9):