Connecting for a health-e-Connecting for a health-e-futurefuture

Dr Brian RichardsDr Brian RichardsNational Director E-Health ImplementationNational Director E-Health ImplementationDepartment of Health and AgingDepartment of Health and Aging

Health environment – Health environment – service deliveryservice delivery

rapidly expanding medical knowledgerapidly expanding medical knowledgeincreasingly specialised and complex increasingly specialised and complex servicesservicesmultidisciplinary approaches to caremultidisciplinary approaches to carenew treatment modalitiesnew treatment modalitiesevidence based practiceevidence based practice

Health environment –Health environment –health systemhealth system

consumer empowerment and participation consumer empowerment and participation (information revolution) – rising expectations(information revolution) – rising expectationsfocus on efficiency and sustainability of health focus on efficiency and sustainability of health systemssystemsemphasis on outcomes (not just processes) of emphasis on outcomes (not just processes) of carecare

quality and safety quality and safety individuals and populationsindividuals and populations

increasing focus on health financing increasing focus on health financing arrangements (value for money) in light of arrangements (value for money) in light of growing health expendituregrowing health expenditure

Health care – Health care – an information industryan information industry

health care consumers are more active health care consumers are more active and informed participants in decisions and informed participants in decisions about their careabout their care

many now expect providers to be ‘on line’many now expect providers to be ‘on line’

Australian governments are investing in Australian governments are investing in better information systems to improve the better information systems to improve the efficiency and effectiveness of health efficiency and effectiveness of health service deliveryservice delivery

Health care – Health care – an information industryan information industry

common law duty of care is expanding to common law duty of care is expanding to include information management include information management standards standards

better record-keeping, with recalls, better record-keeping, with recalls, reminders, decision supportreminders, decision supportinformation sharing within care teamsinformation sharing within care teams

pressure is growing on health providers to pressure is growing on health providers to utilise information technologiesutilise information technologies

uptake has been patchy to dateuptake has been patchy to date

e-Health as an enablere-Health as an enabler

e-Health is a key enabler of health care e-Health is a key enabler of health care reforms, supporting:reforms, supporting:

new models of care (eg care planning)new models of care (eg care planning)greater autonomy for consumers of health greater autonomy for consumers of health services (consumer empowerment)services (consumer empowerment)new models of health care financing (eg new models of health care financing (eg enhanced primary care)enhanced primary care)better health service planning (population better health service planning (population health)health)

“Health information technology promises huge benefits, and we need to move quickly across many fronts to capture these benefits.

The nation needs to move closer to a national, interoperable health information infrastructure that would allow quick, reliable and secure access to information needed for treatment”

The need for investmentThe need for investment

Tommy Thompson, former US Secretary of Health, May 2004

e-Health: what is needede-Health: what is neededAppreciation of what has been achieved to Appreciation of what has been achieved to date date

Programs of this size and complexity Programs of this size and complexity take timetake timeManage expectations and scopeManage expectations and scope

Changes of this size and complexity Changes of this size and complexity evolveevolveOrganisational and individual change Organisational and individual change managementmanagementCollaboration, partnerships and agreementCollaboration, partnerships and agreementSustainability – systems approachSustainability – systems approachGood will – recognition of benefitsGood will – recognition of benefits

e-Health benefits e-Health benefits

reduce the cost of health carereduce the cost of health carereduce incidence of preventable illnessreduce incidence of preventable illnesstake pressure off hospitals / GPs / community take pressure off hospitals / GPs / community care care reduce duplication of treatment and testingreduce duplication of treatment and testingreduce hospital readmissionsreduce hospital readmissionsreduce medication errorreduce medication errorpeople take more responsibility for their own people take more responsibility for their own healthhealthmore responsive to community need (improved more responsive to community need (improved planning)planning)

Australian Health System Reform Environment Health SystemBenefits

OverallHealth System

Efficiency

ProviderEfficiencies

ImprovedConsumerOutcomes

Whole ofPopulationOutcomes

National Health Reform AgendaPriority Areas for Change – Governance and Structure

National Health PrioritiesPriority Areas for Care – Treatment and Prevention

Health System FinancingAustralian Health Care Agreements, Enhanced Primary Care, etc.

- Affordable and Sustainable

Safety and QualityReduce Errors andImprove Service Delivery Processes

Transformational andEnabling Initiatives

• Public HealthPartnerships

• Chronic DiseaseManagement

• Coordinated Care

• State Health ServiceDelivery Initiatives

• State eHealth Initiatives

• Workforce Development

• National HealthInfoStructure

• Broadband in Health

• and others…

• HealthConnect• Information Flow and Sharing• Service Coordination and Integration• Evidence Based Practice• Process Improvement• Connectivity and Access• Improved Research Capacity

e-Health in the bigger picturee-Health in the bigger picture

HealthHealthConnectConnect

a national system of electronic health a national system of electronic health recordsrecordsa joint initiative of the Australian, State and a joint initiative of the Australian, State and Territory governmentsTerritory governmentsbuilds on significant regional e-health builds on significant regional e-health activity (eg electronic discharge activity (eg electronic discharge summaries, pathology results etc)summaries, pathology results etc)based on agreed national standardsbased on agreed national standards

Trials

Implementationand Development

HealthHealthConnectConnect trials and trials and implementationimplementation

Townsville

Brisbane

Rural HunterWest Sydney

LauncestonHobart

Katherine

Victoria

Adelaide

HealthHealthConnectConnect: evaluation : evaluation lessons learnedlessons learned

technically challenging but possibletechnically challenging but possiblekeep consent simplekeep consent simplechallenge to change business process – challenge to change business process – adoption easier if it fits with existing processadoption easier if it fits with existing processneed a critical mass of consumers and need a critical mass of consumers and providers to efficiently deliver benefitsproviders to efficiently deliver benefitsgreatest value for providers in ‘new’ greatest value for providers in ‘new’ information to support coordinated careinformation to support coordinated care

HealthHealthConnectConnect: messages from : messages from stakeholdersstakeholders

focus on people, not just technologyfocus on people, not just technologybuild on existing processes, relationships, build on existing processes, relationships, capabilities and infrastructurecapabilities and infrastructureimplement according to regional prioritiesimplement according to regional prioritiespartnership approach to change partnership approach to change managementmanagementconverge towards common national converge towards common national standardsstandardsharvest benefits progressivelyharvest benefits progressively

HealthHealthConnectConnect stages stages

2000 2005 2010

Focus on benefitsFocus on benefits

2000 2005 2010

Not just a technical issueNot just a technical issue

Propensity of Providers to take-up HealthConnect

High

High

Low

Low

Unlikely to take-up

Will take-up but require a lot of persuading and

support

Will take-up with some

support

Will take-up and will overcome

most challenges

Target segments for take-up and demand

creation(The Early Followers)

Will followthe majority(The Sceptics)N

umbe

r of P

rovi

ders

Early pioneers and spokespeople

(The Enthusiastic Adopters)

Change managementChange management

E-health: recent developmentsE-health: recent developments

National e-Health Transition Authority (NEHTA) National e-Health Transition Authority (NEHTA) formed by Health Ministers in July 2004 to develop formed by Health Ministers in July 2004 to develop priority national e-health standardspriority national e-health standards

Dr Ian Reinecke appointed CEO (October 2004)Dr Ian Reinecke appointed CEO (October 2004)Ministers extended term of NEHTA (January Ministers extended term of NEHTA (January 2005)2005)

Standards Standards Physician & hospital buyers What to buy

Established vendors How to grow markets

Innovators What products to develop

Investors Where to invest capital

Policymakers How to protect public interest

HealthHealthConnectConnect: recent : recent developmentsdevelopments

December 2004December 2004

DoHA reviewed the HealthDoHA reviewed the HealthConnectConnect implementation approach and re-assessed roles and implementation approach and re-assessed roles and responsibilitiesresponsibilities

January 2005January 2005

National Director of e-Health Implementation National Director of e-Health Implementation appointedappointed

March 2005March 2005

Revised implementation planRevised implementation plan

Implementation philosophyImplementation philosophy

Investment strategy & Investment strategy & stakeholder relations stakeholder relations

(Governments)(Governments)

National standards National standards (NeHTA)(NeHTA)

Development & Development & marketing (Industry)marketing (Industry)

In summaryIn summaryHealth care is a complex, information-intensive Health care is a complex, information-intensive industryindustryE-Health is a key enabler for improving health E-Health is a key enabler for improving health care efficiency and effectivenesscare efficiency and effectivenessKey outcome measure is consumer benefit Key outcome measure is consumer benefit (better information, better health outcomes)(better information, better health outcomes)HealthHealthConnect Connect implementation is a change implementation is a change management issue, not just a technological management issue, not just a technological challengechallengeFocus on a standards-led approachFocus on a standards-led approach

Questions and DiscussionQuestions and Discussion

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