Hi Ken, Not on the list reply.
He may be a good mate of yours but I thought it was a load of unimplementable and ill considered rubbish. I plan to say so on my blog in due course with reasons. He has identified some of the problems but really does not have a workable plan I could detect.. Look forward to having a look at the policy.. Cheers David. ---- Dr David G More MB, PhD, FACHI Phone +61-2-9438-2851 Fax +61-2-9906-7038 Skype Username : davidgmore E-mail: [EMAIL PROTECTED] HealthIT Blog - www.aushealthit.blogspot.com On Sun, 22 Apr 2007 10:21:24 +1000, Dr. Ken Harvey wrote: > [Another well argued plea for action by Michael Georgeff - Executive summary > appended]. > > In this respect, people might be interested in the draft ALP health policy to > be debated at the 44th National Conference to be held in Sydney, 27th - 29th > April 2007. > > I've made "Chapter Ten, Improving Health and Well-Being: A Health System that > Delivers" available as a discrete 81 kb download from: > > http://www.kooyongalp.org.au/ > > In particular, GPCG members might like to read paragraph 67-73, "Harnessing > New Technology and Managing Patient Information". > > I'll be attending the ALP National Conference and I'd be happy to pass on any > comments people would like to make. > > The Conference program and the entire draft platform is available at: http://www.alp.org.au/features/conference.php > > Cheers > Ken > > Dr. Ken Harvey > Adjunct Senior Research Fellow > School of Public Health, La Trobe University > http://www.medreach.com.au > VOIP: +61 (03) 9029 0634; Mobile +61 (04) 1918 1910 > > ------------------------------------------------------------------------ > E-Health and the Transformation of Healthcare > > http://www.achr.com.au/ > > Professor Michael Georgeff, April 2007 > > Executive summary > > Of all the industries whose consumers stand to benefit from the wider > application of technology to enable connectivity and knowledge sharing, it is difficult > to go past health. > > No less than 25% of all Australians suffer from a chronic illness and nearly > every one of them would be better off if the medical practitioners who care for, > and treat them were more in touch with each other. It is hard to understand > how Australians can tolerate the fact that they're not. > > This paper sets out the cost – both to the patients and to the nation – of a > system in which providers of health care to chronically ill people operate in > disconnected silos where one doctor often does not know what another has > tested for and prescribed, sometimes even when they are members of the same care > team. > > The figures for this lack of information-sharing and co-ordination are > starkly worrying. > > • More than 50% of doctors do not follow best practice guidelines; • Between > 30 and 50% of patients with chronic disease are hospitalised because of > inadequate care management > • Fewer than 14% of people with chronic disease are placed on care plans; and > • Less than one per cent of patients are tracked to see if they adhere to > care plans. > > Thus, all but a tiny portion of those plans created are all but useless. The > impact on the individual can be imagined; the cost to the nation is immense. In > Australia, it's estimated that improved knowledge sharing and care plan > management for patients with chronic disease would generate direct savings to the > health care system of more than $1.5 billion per annum. Savings to the > community from associated non-health care costs are of the same order. And increased > workforce participation and productivity could add a further $4 billion per > annum to the economy. > > For the patients, home monitoring could reduce emergency room visits by up to > 40%, hospital admissions by 30-60% and length of hospital stays by up to 60%. > > The evidence for better outcomes through more proactive patient interaction is persuasive – one study demonstrated that better disease management improved > patient satisfaction (71%); patient adherence to care plans (47%); and > disease control (45%). > > Clearly, the benefits are there to be had. This paper posits that the two key characteristics of health care that should drive the type of Information and > Communications Technology (ICT) are: > > 1. an acknowledgement that the fundamental business of health care is > knowledge; > 2. the need to be fully cognisant of the inherent complexity of health care > composed as it is, of a large variety of highly autonomous, independent > practitioners, all with their own systems and practices. > > This Paper submits that – given the business environment – three elements > have proven to be keys to success: > > 1) a business model based on the knowledge enterprise; > 2) a focus on connectivity; and > 3) internet-like ICT solutions. > > The knowledge enterprise is characterised by networked information, support > for autonomy and personalisation and use of systems that are open, adaptive and > distributed. This is the business model that has proven to be successful for knowledge-based industries which, after all, health care is. Yet, the business > model we use in health is based on an industrial enterprise where the focus > is often on the management of physical resources with very little attention to > the management of knowledge. > > The second key is connectivity where competitive advantage accrues to those > who invest in connecting power, not raw computing power and large, monolithic > applications. The more connections, the better – don't spend time ensuring > all the systems conform, get connected. Once connected, individual value > propositions will drive stakeholders toward agreements and standards, > continually increasing the value of the data in an evolutionary way. This is not what > we have in health care where most investment has been directed at the > development of large, closed monolithic systems. > > The third key to success is the development of open, internet-like networks of businesses and users. We must design our systems to accommodate: > > • the heterogeneity and incompleteness of information, > • the distributed and diverse nature of the information sources and users; and > • the various forms of autonomous and governed institutions and businesses > that are part of the health care system. > > What we currently have are attempts to remove the heterogeneity and autonomy > from the system so that it can be better run, a bit like a well-organised bank. > > The internet is the clearest example of a system which accommodates autonomy > and heterogeneity because it > > 1) connects anything, anybody, anywhere and > 2) divests investment and control of the network (and its services) from a > central authority to suppliers and users. > > Taking these three elements seriously will involve a fundamental change in > the way we see both ICT and health care and opens the way to transform chronic > disease management in this country. > > Moving forward > > We should focus on three important areas: > > 1. get healthcare providers connected to one another > 2. track health events across the continuum of care > 3. create a broadband network of health services > > In business, most high priority and high volume communications are handled electronically. But in health care, high-importance communications – e.g. > referrals and hospital discharge summaries – are created using paper and pen > and delivered via fax, letter and even by hand. This is the point where we > should begin – simply, aim to get referrals and discharge summaries to be > delivered electronically in a convenient and secure form. > > Each of these important areas is discussed in some detail in the body of this > Paper. Once health information is flowing electronically and is able to be > accessed through open services interfaces, it will then be possible to add > incrementally a wide range of value-adding services to this network. The Paper > offers some examples in this area. The Paper raises one final, important > point - that of incentives. There is a cost to building this connectivity and > information sharing but there is a mis-alignment between those who pay and > those who receive the benefit. > > This barrier needs to be breached by: > > • partnerships between government and industry > • governments, private insurers and employers offering incentives for using > electronic services, broadband health network and best practice processes. > > While it is difficult to provide incentives based on health outcomes (given > the difficulty of measurement and variability of outcomes) it is relatively easy > to measure, and therefore provide incentives for, the use electronic services > and best practice processes. All this will take money, partnerships between > government and industry and, of course, goodwill. However, with the right > conceptual framework and by taking seriously the knowledge enterprise and the > autonomy of care providers and consumers, we can start to transform the way > we look after Australia's chronically-ill patients. > > http://www.achr.com.au/ > _______________________________________________ > Gpcg_talk mailing list > [email protected] > http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk > > __________ NOD32 2209 (20070421) Information __________ > > This message was checked by NOD32 antivirus system. > http://www.eset.com
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