I have just remembered one further interesting informatics-related
moment at last week's GP&PHC Research Conference. Professor Claire
Jackson at a plenary session presented her work on: "Integration,
co-ordination and multi-disciplinary care in Australia: growth via
optimal governance arrangements".
The abstract is at:
http://www.phcris.org.au/elib/render.php?params=3516
In her talk, Prof. Jackson showed a diagram with four pillars of the
system. One of those was pillars was called something like 'ICT and
information transfer'. She said that the issue of sharing and
transmitting health information had been solved fairly easily. This
caused me to stop and have a deep breath. In question time, I said that
I was amazed and delighted to hear that this issue has been solved and
asked how she had achieved it. I think that her answer was to use
Australia Post to move bits of paper around. Maybe I misheard. Graeme
Miller and others on this list were there and I hope will give their
account of what they heard.
The full report of Prof. Jackson's study at:
http://www.anu.edu.au/aphcri/Domain/MultidisciplinaryTeams/Final_25_Jackson.pdf
does not seem to support Prof. Jackson's claim that the information
management needs of the health system have been solved. I note at the
end of a list of 'Enablers' of integrated governance (p.29):
"Finally, there must be consistent integrated data collection and review."
and later on the very same page, 'Barriers':
"Finally, the lack of accountability and paucity of data regarding
outcomes in this area continues to be a significant barrier to
implementing new models."
Why does the need for data systems and means of collecting and
integrated data appear at the end of each of these lists, as if they
were an afterthought? I have seen this happen before - much discussion
of what is needed in terms of organisational and funding structures and
so on, and then a somewhat lame addendum along the lines of: "Oh, by the
way, none of this can happen without appropriate and adequate
information systems". I believe that the lack of and crying need for
adequate information systems should be first on these lists. How can we
plan what to do if we don't know what the current situation is, as the
note in the study about "paucity of data regarding outcomes in this area
continues to be a significant barrier to implementing new models" (see
above) states.
Again, on p. 53 in the section "What will be the key issues the
governance framework needs to address?", the information system needs
appear near the end of the list rather than at the beginning:
"(...)
* effective information management is crucial and must link with the
clinical need across the continuum to understand issues of all
stakeholders- need capacity to move info with the pt
* needs a regional model based around primary care with excellent
information connectivity and the capacity to link population health with
service delivery and resourcing"
--
Oliver Frank, general practitioner
255 North East Road, Hampstead Gardens, South Australia 5086
Phone 08 8261 1355 Fax 08 8266 5149 Mobile 0407 181 683
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