(How) Can Safe Sharing of EHRs Transform the Health System?
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Dr Zoran Bolevich Ministry of Health
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(How) Can Safe Sharing of EHRs Transform the Health System?
- 1. (How) Can Safe Sharing of Health Information Transform the Health System? HINZ Seminar July 2009 Dr Zoran Bolevich Ministry of Health
- 4. Key Challenge: Living within Our Means
- 5. Strategic Direction: Better, Sooner, More Convenient Services
Notas del editor
- The Government is commited to its pre-election promise to spend up to $1.5 billion (expected to be matched by private sector investment) over 10 years on an ultra-fast fibre-optic broadband network reaching 75% (three-quarters) of the country's homes. The Government is also investigating options for connecting hospitals and health provider sites that lie outside the 75% coverage footprint. Specific plans were due out a few weeks ago, but Communications Minister Steven Joyce has delayed ‘announcement of plans’ for a couple of months due to the complexity of the issue (allocation etc).
- Opportunities Broadband is already used extensively within the health sector, but generally at lower speeds than those planned for in the Broadband Investment and Rural Broadband Initiative (‘the Broadband Initiatives’). However, the fast/ultra-fast broadband (‘Faster Broadband’) provided by the Broadband Initiatives could play an important role as an enabler of new healthcare delivery models. The systems and applications in the health sector that could use Faster Broadband are: Integrated family health centres IFHCs would comprise a range of clinical services (such as GPs, Specialists, Outpatients, Pharmacy and Radiology) under one roof and could include videoconferencing and centralised support for home based Telecare (as described below) – with ultra-fast broadband services available to organisations in the building. Video services Videoconferencing is a service that needs Faster Broadband connectivity and there are opportunities to extend the geographic reach and capability of current video conference services. Faster Broadband provides better performance and definition of images that can improve the safety and accuracy of video based health care processes. High definition diagnostic imaging Faster Broadband services can be used to link systems that allow clinicians to exchange high resolution images, such as CT scans, across multiple locations. This capability will support clinical collaboration and care quality and safety. Home-based telecare Home based Telecare is a rapidly evolving domain focused on providing care in a home setting with the primary intent of supporting the patient. This encompasses the use of patient care devices, audio, video, and other technologies to monitor patient status at a distance – without the requirement for a health provider at the patient’s location. Challenges For the health sector to be ready to adopt Faster Broadband there needs to be a common understanding of the ability of broadband to enable major improvements in the quality of patient care and the efficiency of the health service. In addition, the sector will need to be willing and able to make both the financial investment in technology required, and the clinical and business process changes needed, to realise these opportunities. Any use of resources to make the health sector ready for Faster Broadband must be considered in terms of the relative effectiveness against other efforts to address priority health challenges. There are four main challenges that will need to be addressed to enable wide sector adoption of the systems and applications that could use Faster broadband: Agreed clinical guidelines, protocols and business models to support integrated care and funding for these changes Provision of a managed health network to ensure health providers can use Faster Broadband safely and securely Funding to cover the cost of equipment required in each location serviced The capability for communication and interoperability between systems
- Strategy aims to: Create a more personalised primary care system Provide services closer to home Make kiwis healthier Reduce pressure on hospitals Towards Better Sooner More Convenient Primary Care outlines that these goals will be achieved by: Maintaining universal subsidies for GPs Moving some hospital services to Integrated Family Health Centres that provide a full range of services, including specialist assessments by GPs with special interests, minor surgery, walk in access, chronic care management, increased nursing and allied health services, as well as selected social services Developing specially trained nurses who are involved with chronic care patients engaged as brokers, and case managers for non-health agencies to support at risk families Providing a much wider range of care and support for patients with greater incentives for PHOs and general practice to coordinate the ongoing care of their patients Devolving more treatment and diagnostic services to primary care, holding DHBs accountable for the devolution of services to general practice and Integrated Family Health Centres.