The Medical Software Industry Speaks on The Future of E-Health in Australia.

A week or so ago the General Practice Network held an e-Health Conference.

AGPN eHealth Conference 2010

In response to the health reform environment and in recognition of the fundamental role of eHealth as an enabler of this reform, the Australian General Practice Network (AGPN) will be hosting a National eHealth Conference in Melbourne on 16 – 17 June 2010.

The conference will focus on the key theme of 'connecting the health care sector'.

The topics of connecting up the health sector and aligning eHealth activity behind a common national strategy will be explored. Also addressed will be the role of the general practice networks in the delivery of enabling eHealth infrastructure across primary health care.

Participants in this event will include representatives from the general practice networks, national eHealth organisations, governments, allied health and specialist communities, vendors and health consumer groups.

----- End Extract

A web site covering this is event is found here:

http://agpn.com.au/programs/ehealth-and-information-management/agpn-ehealth-conference-2010

I understand many of the presentations from the event will be posted in due course at this URL.

The president of the Medical Software Industry Association (MSIA) (Geoffrey Sayer) gave a very interesting presentation on the 17^th entitled ‘Vendors on the front line: 17^th June, 2010’.

Of special interest were the following slides:

Slide 5: e-Health Observations.

·         There is an urgent desire to hurry up and deliver e-Health but we are asked to wait –again!

·         e-Health has to combat silos but most initiatives are silo based and not aimed at the intersecting points in healthcare

·         e-Health is an enabler -Primary Care is fundamental to health care -but GPs appear late comers to the engagement process for e-Health

·         Everyone will have HI -industry, government and the profession agree on the benefits –but we are not looking to fast track the benefits

·         Two years to demonstrate benefits of PCEHR but longer time table to deliver the actual building blocks

·         We have examples of what works and what doesn’t -but seem to pursue the approaches that in the past haven’t worked

·         Patients don’t need to know their HI -or be concerned about it -but are expected to demand the benefits of a HI

·         e-Health is considered deterministic in nature yet healthcare is probabilistic

·         e-Health doesn’t face the same effectiveness analysis as other interventions do

---- End Slide:

From this I take, at the least, the MSIA is seeing a lack of co-ordination and direction in how e-Health is being planned and prospectively delivered.

Slide 6: HI Service: Vendors Perspective.

• The HI Service provides clear benefits to the Australian people and establishes a critical building block for an e-Health enabled health care system
• The passing of legislation is crucial and industry supports the passing of the proposed legislation and regulations
• However, when approved everyone will have a IHI but little will have any benefits for many years to come under the proposed approach
• Medicare will be from the outset incurring cost of production and support whether any one is accessing the HI service or not
• The estimated savings and benefits will not be realized unless the HI’s are functioning across the whole sector in the actual exchanges of information

Slide 12: HI Service: Vendors Perspective

MSIA have been very clear in vendors’ desire to deliver the benefits of HI Service through:

·         Timely delivering of capability across all sectors

·         Well specified requirements

·         Use of standards

·         Robust testing and infrastructure capabilities

·         Appropriate CCA

·         Effective support and education of end users

·         Appropriate business and financial drivers

Slide 13: Implementation Approach -Concerns

• Apparent acceptance of a extremely slow uptake of the HI Service
• Lack of community based initiatives i.e. GPs, Specialists, Diagnostic services
• Talk of a tipping point with no detail beyond jargon buzz word terminology
• Lack of understanding of business drivers that have successfully worked before in driving e-Health initiatives
• A strategy of relying on a “controlled release” and “lessons learnt” from early adopters that have the right to refuse the use of those lessons under confidentiality clauses
• Effective evaluation of any impact or benefits of HIs

----- End Slides

From these three slides I detect conviction that the HI Service – done right – will be a very good thing but that there is also a sense that right now it is not being done right.

Further on in the presentation there are two key themes.

First that the NEHTA ‘laissez faire’ approach to the tempo and focus on implementation of the HI Service had a huge opportunity cost associated, in safety and care quality  – and may I add also risks every one simply looses interest!

Second that the processes for Compliance, Conformance, Certification and Accreditation of Software and Services need some serious funded national attention, and soon.

Readers of this blog will recognise I believe all this is utterly correct – and very much parallels things I have been saying.

It is really way beyond time the ‘powers that be’ drop their arrogant ‘don’t you worry about that’ approach and get on with either providing competent leadership and governance or simply being disbanded.

Hopefully with the new Prime Minister we may see some more co-operation with industry, and a more vigorous effort to address the e-health needs of the whole Health System.

Thanks Geoff for sharing the MSIA perspectives.

David.