The Best Medicine

The Best Medicine

The health-care industry is learning how to cope with change, and so are the CIOs in that industry

The next time your doctor writes you a prescription, check out the state of his or her handwriting. If the script looks more like chicken scratchings than English it could end up killing you.

The US Institute of Medicine estimates as many as 98,000 Americans die from medical mistakes in hospitals each year - the equivalent, according to one Harvard researcher, of three jumbo jets filled with hapless patients plummeting to the ground every two days. One major cause is the appalling handwriting of some doctors, and there is no reason to assume Australian physicians write any more legibly than their US counterparts. As the practice of medicine advances, the situation only gets more critical.

"We have now many millions of drugs to be prescribed, and as they get more sophisticated the levels of toxicity become more important, and very small changes in dosage can lead to very bad outcomes," says Health Informatics Society chair Paul Cohen, currently at Geelong-based Barwon Health.

There's technology available to fix the problem - it involves creating automated linkages between GPs, hospitals and pharmacies - but Australia has yet to put it in place. The reason is simple - a lack of funding.

Cohen says while there are large numbers of projects under way around Australia focused on the use of informatics to support clinical delivery of health-care, not to mention improving health information infrastructure, all face the same major barrier. Australia-wide, health spending is under huge pressure, and although NSW Health alone spends in excess of $1 million per hour in delivering health-care to NSW residents, the portion of the money available for IT is positively minuscule.

"Across Australia we probably spend between one and two and a bit percent from state to state, on health IT," Cohen says. "And workers in the field, and clinicians in hospitals and GPs and others have reasonably poor infrastructure in place to start with. While there are some amazing things we can do in terms of managing information, bringing information together at the point of care to improve health-care, often they're working from sub-optimal infrastructures . . . There's not yet a culture where our industry just accepts that you have to have a good IT infrastructure to be able to run these organizations."

When CIOs are sitting on such tiny IT spends it can also be very hard to justify spending the amount of money required on data quality, Cohen says.

But that doesn't mean they aren't trying to find a cure.

The health industry is one of the biggest collectors of data in the world, and Denis Nosworthy, a board member of the Health Informatics Society, says it is finding more and more ways of turning that data into usable information. Over the past five years there has been a huge push towards the use of evidence-based information to affect the way health-care is delivered, he says.

"The thing with evidence-based medicine, is it is very, very, very reliant on the use of IM&T because a lot of it is based around what is published in journals gathered together and published on the Internet," he says. "Now the organizations and the people that have been publishing information and getting it on the Internet have become much more credible."

There are plenty of other issues that make delivering outcomes that use informatics and IT to improve delivery of clinical health-care one of the more knotty endeavours a CIO can undertake. For one thing, with both federal and state governments owning carriage of some aspects of health-care, complexity comes from the whole issue of ownership of health projects.

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