Australia’s peak health industry bodies have warned of the Federal Government’s e-health solutions becoming “siloed” without greater attention to standards surrounding implementation of technology for doctors and practitioners.
Both the Australian Medical Association (AMA) and the Royal Australian College of General Practitioners (RACGP) expect there to be little in the way of further funding for e-health initiatives in Tuesday’s federal budget, following the government’s $467 million pour in to personally controlled electronic health records (PCEHR) last year. The government has also committed nearly $400 million to subsidising telehealth services from 1 July next year.
[See the complete coverage of ICT spending in Computerworld Australia's Federal Budget 2011 section]
Any health funding announced by federal treasurer, Wayne Swan, is expected to be put toward mental health schemes.
However, AMA federal vice president, Dr. Steve Hambleton, told Computerworld Australia that even without additional funding, the industry required a greater, whole-of-sector approach to the looming initiatives.
“E-health has grown up in isolation, we’ve got to start talking about protocols we can communicate to each other nationally,” he said. “NEHTA [National E-Health Transition Authority] is trying to do that, but hospitals have different software in each state and only recently have we started getting a single unique healthcare identifier.
“GP [general practioner] software, which we’re all going to rely on ultimately to communicate, is all different and the way GPs use the same software is different so standards are really important otherwise we can’t get up and running.”
E-consultations with GPs were particularly important, as they required standardised software and hardware at both ends.
Royal College of General Practitioners (RACGP) e-health spokesperson, Dr. Nathan Pinskier, said standards were also required for implementation, change and adoption of the technology required. He warned a lack of protocols could ultimately silo e-health outcomes.
“Medicare Australia for example struggled to roll out its initiatives for a number of years until it adopted a more broad focus on a whole sector approach,” he said.
For the PCEHR program to have utility it must be embedded into existing software programs, Pinskier said, even once technical requirements have been locked down.
“If it requires practitioners to log out of one system and into another and then copy and paste information or transcribe information it’s not going to fly, if it’s embedded into existing technology so it’s one push at the end of a consultation subject to the patient consent we’re much more likely to have uptake.”
According to Pinskier, a history of using siloed networks to implement and communicate e-health initiatives to doctors and the wider public were examples of this.
The PCEHR rollout has progressed since announcement at last year's federal budget, with two waves of implementation sites underway and the health department publicly releasing its concept of operations around the project.
But Hambleton said there was a clear need for the forthcoming PCEHR to be implemented effectively, in order to prevent “jumbo jet loads of patients crashing into the ground through poor communication”. The need for accurate medication lists, hospital discharge summaries, diagnostic imaging and pathology were essential requirements to getting off the ground and ensuring the project’s success.
“The personally controlled elements are concerning in that the patients will be allowed to add, remove, subtract parts of the record and we say that’s fine in the section the patient controls but there needs to be a section that is medically moderated that’s accurate otherwise doctors aren’t going to use it.”
The Australia Information and Industry Association (AIIA) has also thrown its weight behind the need for e-health focus in the federal budget, noting the need for expansion of the current PCEHR sites and expansion beyond the PCEHRs to include more technology-based healthcare projects.
AIIA chief executive, Ian Birks, said investment in real-time telehealth facilities for diagnosis, consultation and treatment, health informatics capabilities and the trialling of ICT services like Cloud computing to improve efficiencies across health and aged care facilities was paramount for e-health moving forward.
However, the industry body has called for greater training of health informatics experts, an area Birks claimed had been neglected by government in the past.
“There is a clear skills shortage on a global scale in this area which means that Australia has an opportunity to lead the world and attract the best people. If we delay, however, we may find ourselves in a position where we can’t catch up to other countries and fill the positions required, something that has the potential to derail not only e-health initiatives but the investment being made in health reform across the board,” Birks said.
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