Summary of the National E-Health Strategy

2. National Vision for E-Health

Page last updated: 02 December 2009

2.1 Implications of the vision for stakeholders
2.2 The vision in action

Australia should aspire to continue to lead the world in health outcomes for its citizens. Central to the achievement of this will be a health system which more effectively responds to the health care needs of individuals and communities. Developing a world class E-Health capability would provide new options for how Australians manage their own health and interact with the health system across geographic and health sector boundaries.

E-Health will enable a safer, higher quality, more equitable and sustainable health system for all Australians by transforming the way information is used to plan, manage and deliver health care services



E-Health will:
• Ensure the right consumer health information is electronically made available to the right person at the right place and time to enable informed care and treatment decisions
• Enable the Australian health sector to more effectively operate as an inter-connected system overcoming the current fragmentation and duplication of service delivery
• Provide consumers with electronic access to the information needed to better manage and control their personal health outcomes
• Enable multi-disciplinary teams to electronically communicate and exchange information and provide better coordinated health care across the continuum of care
• Provide consumers with confidence that their personal health information is managed in a secure, confidential and tightly controlled manner
• Enable electronic access to appropriate health care services for consumers within remote, rural and disadvantaged communities
• Facilitate continuous improvement of the health system through more effective reporting and sharing of health outcome information
• Improve the quality, safety and efficiency of clinical practices by giving care providers better access to consumer health information, clinical evidence and clinical decision support tools
• Support more informed policy, investment and research decisions through access to timely, accurate and comprehensive reporting on Australian health system activities and outcomes.

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2.1 Implications of the vision for stakeholders

The E-Health vision can also be expressed in terms of what it might mean for each of the three key groups of impacted stakeholders:
Consumers – the individuals who receive Australian health care services and the friends, family and carers who are directly involved in the care of the individual
Care Providers – the individuals and organisations that provide Australian health care services
Health Care Managers – Australian health sector clinical managers, health service managers, planners, researchers and policy makers.


Stakeholder Groups


Current State


Future State

Consumer
  • Largely responsible for coordinating their own care delivery and acting as the integrator of health care information accross the health system
  • Spend time repeating the same information to multiple care providers and/or receiving duplicate treatment activities
  • Poor, and in most cases zero, access to personal health information which is storedin multiple, fragmented silos across the health system
  • Limited security of personal health information or ability to control who accesses it
  • Heavily reliant on individual care providers for access to reliable health information
  • Unequal access to health care services, particularly in remote and rural communities
  • When consumers interact with the health system, care providers will know who they are and have access to relevant details of their health information
  • Will rely on the health system to effectively coordinate their care regimes and treatment activities
  • Will have an ability to access their own health records and maintain a personal health diary
  • Will have confidence that their health information is managed securely and confidentially
  • Will have the ability to better manage their own health through access to reliable and accredited sources of health information
  • Will have technology enabled access to a broader and deeper range of health services from within rural and remote communities
  • Will be supported in the management of their care through automated monitoring of their health status and access to individual care plans
Care
Providers
  • Work with incomplete and fragmented information when providing care to consumers
  • Spend time collecting consumer information and duplicating treatment activities
  • Manually coordinate care with other providers and exchange information in an inefficient, incomplete and ad hoc manner
  • Risk the occurance of adverse events through incomplete information and a lack of access to decision support tools at the point of care
  • Limited ability to interact with consumers remotely
  • Limited to means to monitor effectiveness of service delivery outcomes
  • Will have an intergrated and complete view of consumer health information at the point of care
  • Will be able to share information electronically in a timely manner across different geographic locations and all parts of the health sector
  • Will have access to data that allows them to more effectively monitor and evaluate service delivery outcomes.
  • Will be able to electronically order tests, prescribe medication and refer individuals to other providers
  • Providers' care decisions will be supported by access to appropriate information sources and decision support tools at the point of care
  • Will be able to electronically interact with consumers regardless of where they are geographically located
  • Will be able to collaborate with other professionals by more easily sharing expertise and evidence
  • WIll have easy access to clinical knowledge and evidence sources to assist with skill development
Health Care
Managers
  • Rely on incomplete, fragmented and untimely information when trying to make decisions
  • Spend time trying to collect and manually intergrate information from many different data sources
  • Limited ability to share clinical and administrative management information across the health sector
  • Very difficult to meaningfully understand the national impact of strategic, operational or clinical treatment decisions
  • Will have access to timely and complete information about health systems activities and outcomes
  • Will have a reliable and comprehensive evidence base to inform and monitor the impact of clinical, policy, investment and administrative decisions
  • Will be able to better respond in the care of emergencies through real time monitoring of public health indicators
  • Will be able to rapidly assess the national impact of particular treatment regimes via access to nationally aggregated clinical datasets
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2.2 The vision in action


Young Child Scenario


Chronic Disease Scenario

Seven year old Tom injured his arm in a Saturday afternoon game of football and was in pain. His mother took him to the emergency department of the local hospital, where the doctor arranged for an X-ray in the radiology department. The X-ray was made available electronicallyto the doctor who was promptly able to diagnose the injury as a fracture. The doctor applied a cast to the broken limb, and prescribed medication to assist with the management of Tom's pain.

When Tom was discharged, an electronic discharge summary was sent to his regular GP with information about when Tom was admitted and discharged, the nature and treatment of the injury, and the recommended follow-up.

This allowed Tom's GP to see when the injury needed to be re-assessed and an appointment was made accordingly. This meant that Tom and his family sis not need to return to the hospital for additional injury assessment, only for the removal of the cast. It also informaed the GP of which medications had been prescribed, reducing Tom's risk of receivingadditional medications or medicines which might have an adverse reaction when used in combination.
Mrs Jones is a 68 year old lady who has been diagnosed with a chronic illness. Her GP determines that Mrs Jones would benefit from attending sessions with allied health professionals and educators who are able to assist with her condition. Mrs Jones' GP uses an electronic care planning system which assists in development of a team care plan tailored to her specific needs.

Through the care planning system, the GP has access to a registry of care providers and can search for suitable health professionals. During a consultation, Mrs Jones and her GP identify and discuss which care providers she would prefer to meet, taking into account geographic location. A printed map of each relevant location is then generated to assist Mrs Jones attend appointments.

The GP sends an electronic notice inviting each healthcare provider to participate in Mrs Jones' care. On acceptance of this invitation, and with Mrs Jones' permission, the GP sends relevant information from her electronic health records to each team member. When Mrs Jones' arrives for her appointment she is not required to relay her medical history, provide paper documents or remember test results. For Mrs Jones, this may reduce innecessary visits to healthcare providers and improve the effectiveness and timeliness of her care.


Aged Care Scenario


Indigenous Scenario

Mr Egan is a resident in a Residential Aged Care Facility that has been equiped with software enabling the electronic transfer of prescriptions.

As part of this system, Mr Egan's GP also has access to electronic decision support regarding the medicines prescribed. This alerts the GP to any potentialadverse reactions between the multiple medications that may nbe prescribed.

Since the introduction of the software, Mr Egan is no longer required to travel from his residence to the pharmacy to collect his prescription medications, nor is he required to send a paper prescription with a resident carer. His prescriptions are sent electronically to the pharmacy, reducing possible errors caused by misreading handwriting or re-keying of information. Mr Egan's carers and nurses also have real-time acceess to the status of his prescriptions, ensuring that they are aware of which medications have been redered or dispatched.
An indigenous resident of a remote area of Northern South Australia, English is Sally's third language and she finds it difficult to provide a full medical history when attending unfamiliar health care facilities.

Recently Sally had taken a trip from her home to a ceremony taking placee 150 km away in the Northern Territory. While there, she was involved in an accident and badly sprained her ankle. Sally attended the local medical centre for assistance but had difficulty communicating to the attending healthcare provider that she has allergies to certain medications.

Sally was registered with the Northern Territory Electronic Health Record program, and her medical history was available immediately. The doctor was able to see that she suffered from an allergy to a common anti-inflammatory drug. Once this allergy was identified, her treatment was determined accordingly and Sally was able to avoid a potentially harmful administration of a routinely prescribed drug.
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