Australia: Why The Government will Never Fund a Shared EHR – And Probably Shouldn’t.

This is a very interesting posting on a Blog entitled 'Australian Health Information Technology'. Dr. David More (the author) makes some interesting comments about the business case for developing and implementing a national inter-operable EHR in Australia. Some of the same questions apply irrespective of where one is considering similar systems change.

"For the health system within Australia to reap the full benefits from the IT, governments and healthcare providers need to make the case for undertaking further investment including the development of a national system of shared electronic health records. The case for the required level of investment depends on the credible quantification of the costs and benefits of providing such.”

Can I say that the whole plan has a total air of un-reality and fantastic (in the real sense) wishful thinking about it. Among the realities that need to be faced are the following:

Firstly the present Federal Government has had over a decade to consider a major investment of this sort on Health IT and has not done so – what has suddenly changed that a 2008 proposal would suddenly meet acceptance? The answer is not much. If Government changes at the end of the year then all bets would clearly be off ( and planning would start again most likely ) and if it does not I suspect the 2011 election would see change – and a long and detailed review would be inevitable. Timing thus seems less than optimal at best.

Secondly large scale top down complex IT projects – in mixed health sector funding environments – are likely to be very problematic. The only examples of success in such a strategy are Kaiser Permanente (and a couple of similar managed care entities in the US) and the UK NHS. Both of these projects have proved to be both quite expensive and very difficult to manage. The other successes at a national scale have been in countries like Denmark and the Netherland where a messaging based bottom up relatively simple, standards based and incremental strategy has been successful. The co-operative disseminated model adopted by Infoway in Canada also seems to be progressing reasonably well and is possibly the closest match to the Australian situation.....

Click on this link to read the full posting: Australian Health Information Technology: Why The Government will Never Fund a Shared EHR – And Probably Shouldn’t.

Are we doing sufficient due diligence in our approach to inter-operable EHR implementation in Canada? While there is a strong focus on standards, is there enough being done to promote a 'bottoms up' approach as has been demonstrated to be successful in connecting up the primary care and community care systems in Denmark and the Netherland?

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