Pity Our Planned NEHRS Portal Does Zilch Of What People Want. We Don’t Even Have The Basics.

This popped up a week or so ago.

5 things I want my patient portal to do

August 20, 2012 | By Gienna Shaw

Even the most common functions of the average patient portal are pretty impressive. Patients can check test results, request prescription refills and make appointments without actually having to talk to a human being. It's not hard to see how those functions can improve patient satisfaction and make life a little easier--not only for patients but also for front-line staff.

The technology is not exactly commonplace--in one recent survey, only 30 percent of physicians said they use patient portals. But as the number of providers that do offer patient portals rises, so too will consumers' expectations of them. I've been using my provider's patient portal for at least a couple years now. And I'm getting a little bored--even frustrated--with what once seemed innovative.

Here are just five things I wish my provider's patient portal offered:

1. Short-term reminders: I'm terrible at following up on my doc's directions. At my last physical, my doctor said I had six months to get my cholesterol under control on my own or she'd put me on medication. That was 18 months ago. A post-visit checklist would surely be handy: Get this lab test, schedule an appointment with this specialist, refill this prescription, try these exercises and follow these food guidelines. I could go online and check them off as I complete them. Better yet, the system could send me a reminder if I haven't checked them off within a certain amount of time. And at my next visit my doc would be able to see my progress (or lack thereof) at a glance, perhaps making the short time we have together a little more productive.

2. Annual alerts:

.....

3. Alerts for my physician:

.....

4. Personalization:

......

5. Supplemental information:

.....

The full article is here:

http://www.fiercehealthit.com/story/5-things-i-want-my-patient-portal-do/2012-08-20

We have not got the basic list covered - what about the even more useful stuff. I wonder is there one DoHA or NEHTA person who is planning how to do all this in the future. Would be good to know such planning is actually happening.

David.

Is cdmNet Setting Up To Compete or Coexist with the NEHRS? Hard To Tell Just Yet.

The following appeared a few days ago.

Chronic disease care goes online

21 August, 2012 Michael Woodhead

An online support site has been launched to help GPs caring for patients with chronic diseases such as diabetes.

Chronic Disease Management-Net (cdmNet), enables patients, GPs and allied healthcare professionals to develop care plans, share medical histories, test results, updates on patients’ conditions, send referrals, and set appointment reminders, says Professor Leon Piterman of Monash University.

 “What cdmNet has done is provide an efficient clinical information system that makes health records available and accessible electronically,” Professor Piterman said.

“This supports the GP’s decision making. It also provides a delivery system for information sharing and feedback with the care team. It ensures the team is working cohesively.”

More here:

http://www.6minutes.com.au/news/latest-news/chronic-disease-care-goes-online

We also had coverage here:

Victoria takes e-health national

A Victorian government-funded electronic health service will be offered to every Australian with a chronic illness

• Byron Connolly (CIO)
• 21 August, 2012 12:08

A Victorian government-funded electronic health service will be offered to people with chronic illnesses across Australia, following the announcement that 10,000 patients had signed up for the service.

Victorian health minister David Davis announced that the Collaborative Care Cluster Australia (CCCA) is now a national program that “empowers patients to work collaboratively with their GPs, specialists, pharmacists and other healthcare professionals to manage their own health issues using a new online capability.”

Davis was referring to the CCCA’s Chronic Disease Management Network (cdmNET), an online system that links patients with their own care plan and helps an entire healthcare team share information.

More here:

http://www.computerworld.com.au/article/434104/victoria_takes_e-health_national/

Here is the full media release:

The Hon David Davis MLC

Minister for Health

Minister for Ageing

Media release

Friday, 17 August 2012

Government provides big win for patients with chronic disease

Ten thousand patients are now taking back control of their lives with the help of a Victorian Government funded program that is transforming management of chronic diseases like diabetes, asthma and arthritis.

Health Minister David Davis today launched the Victorian-based Collaborative Care Cluster Australia (CCCA) as a national program that empowers patients to work collaboratively with their GPs, specialists, pharmacists and other healthcare professionals to manage their own health issues, using a new online capability.

“Currently over 10,000 patients, 1,000 GPs and nearly 3,000 allied health professionals have already signed up, the project is running successfully—and now this Victorian initiative is going national”, Mr Davis said.

“CCCA offers the Victorian-developed e-health platform, cdmNet, in a proven format that links a patient with their own care plan and helps their entire healthcare team to share information and collaborate more effectively.

“Now for the first time in Australia, patients with chronic illness can access their care plan with their pharmacist in the pharmacy using a simple barcode”, Mr Davis said.

“I urge all Victorian pharmacists, patients with chronic conditions and their carers to come on board, and join with GPs, specialists and healthcare professionals to embrace innovative technologies like cdmNet, which can transform the outcomes of chronic health management, reduce costs and improve quality of life.

“With no costs to patients, the system pays for itself through efficiencies it creates in the doctor’s surgery, so everyone wins,” Mr Davis said.

“Victoria is leading the nation in e-health and chronic disease management,” he said. “In future, patients and their carers will be able to join a care conference with their GP and specialists, accessed at the press of a button from cdmNet, by video, voice or online. CdmNet is enabling telehealth.”

----- End Release:

Link:

http://precedencehealthcare.com/site/wp-content/uploads/2010/05/120816-Davis-Government-provides-big-win-for-patients-with-chronic-disease-.pdf

This link allows you to explore what is presently happening:

http://precedencehealthcare.com/

What I find interesting are three things.

First that among a legion of Partners (IBM, Cisco, GP Organisations etc. etc.) the two that are missing are DoHA and NEHTA while the AIHW and the Broadband Ministry are involved!

Second the GP Incentive payments for chronic health care make a good commercial case for adoption.

Third what is being done looks very much like one of the major planned roles for the NEHRS.

Have I got this wrong or does the NEHRS have an already operational and successful private competitor. With this why would a patient need the Government offering?

David.

More Of The Ugly Truth Seems To Have Leaked Out About HealthSMART. It Was Not Run Well!

The following appeared a few days ago.

HealthSMART system cavalier: Vic auditor

• From: AAP
• August 21, 2012 2:18PM

THE proposal for Victoria's abandoned $500 million e-health system was cavalier and more of a concept than a properly developed business case, a senior bureaucrat says.

The HealthSMART rollout began in 2003, costed at $360 million under the previous state Labor government, but is fully operational at just four health services across Victoria.

The coalition government scrapped it last May after $500 million had already been spent.

Victorian Auditor-General's Office performance audit director Paul O'Connor said the HealthSMART business case lacked implementation detail.

"I would say it was more of a concept brief rather than a fully written business case in terms of how we are going to implement this," Mr O'Connor told a Victorian parliamentary inquiry into the delivery of major infrastructure projects on Tuesday.

"One of the problems that has occurred in Victoria is that some business cases with very large amounts of money have been quote cavalier perhaps in the way they've been constructed but they've received large amounts of funds and seemingly very little oversight.

http://www.heraldsun.com.au/news/breaking-news/healthsmart-system-cavalier-vic-auditor/story-e6frf7kf-1226454997229

Some good reporting also came from The Age.

Auditor scorns 'slack' officials

Date March 21, 2012

• Comments 63

Melissa Jenkins

DELUDED, lazy bureaucrats in Victoria don't give ministers the advice they need, and large projects are retrofitted to match political announcements, the state's auditor-general says.

Auditor-General Des Pearson and his colleague Paul O'Connor delivered a scathing assessment of the relationship between the public service and the government in giving evidence to a parliamentary inquiry into infrastructure projects.

They argued no effective mechanisms were in place to stop hundreds of millions of taxpayers' dollars being tipped into dodgy rail and road projects.

Dr Pearson said government agencies were too reliant on external advice and often accept it without scrutiny.

Departmental staff often base their advice around what has been announced by a minister and don't take other alternatives into consideration.

''Often, when we're talking to departmental staff, they are sort of saying 'oh, the government announced' and they're using that as what I call a get-out-of-jail card not to provide frank and fearless advice,'' he told the Public Accounts and Estimates Committee.

More here:

http://www.theage.com.au/victoria/auditor-scorns-slack-officials-20120320-1vi0a.html

There was also some commentary about a lucky Hospital that got an early installation.

Vic e-health system difficult: hospital

• AAP
• August 23, 2012 10:34AM

VICTORIA'S abandoned multi-million-dollar e-health system implemented in just a handful of hospitals was overly ambitious and has not improved patient safety, an inquiry has been told.

The HealthSMART rollout began in 2003, costed at $360 million, under the previous state Labor government, but is fully operational at just four health services across Victoria, including Melbourne's Royal Eye and Ear Hospital.

Hospital chief executive Ann Clark said it would have been better to have different information technology systems to suit individual hospitals but develop a set of common rules so information could be shared.

She said the hospital faced significant complexities integrating HealthSMART with its outsourced pathology system.

More here

http://www.news.com.au/breaking-news/national/vic-e-health-system-difficult-hospital/story-e6frfku9-1226456446088

Some quotes from the actual testimony of the Auditor General are just wonderful.

“Finally, I thought some contextual considerations were relevant, and again I pose a few questions there. Is adequate benchmarking and baseline data available to underpin the various projects we embark on? The next one is: are we punishing ourselves for cost overruns and not adequately managing expectations? There I relate — and we refer in our written submission — to the research by Professor Bent Flyvbjerg in 2009. Just to refresh your memory, he researched worldwide project outcomes and found for construction project budgets between 10 million and 150 million euros, the norm was a 50 per cent overrun and in IT projects it was up to 500 per cent on the target projects. In quoting that I am not saying it is all right to overrun, but it is a recognition that we are not alone in experiencing this problem. In my reading of his research, there are lessons to be learnt there of key lead indicators and issues to be addressed up-front in what I would call purposeful management.”

and here:

“I am very interested in Dr Flyvbjerg’s research, which you have referenced in your submission. It is quite frightening when you read that this is not just a Victorian phenomena, it is an international phenomena in terms of public sectors’ inability to deliver projects on budget and on time. I am particularly interested in what your views are of some of the propositions that have been adopted in other jurisdictions, specifically having peer-reviewed business cases or costings of projects, like they do in the UK with the National Audit Office. I also note Dr Flyvbjerg’s suggestion that there should be strong penalties, including criminal sanctions perhaps, for those who underforecast the cost of projects. And finally, I would be interested in your general comments around cultural change. What is it? Is it optimism bias? Is it that we have built the wrong political incentives and therefore that leads to the wrong bureaucratic incentives? What, culturally, do you think, would signify the greatest circuit break and give us more legitimate grounds for what you describe as purposeful management?”

The full transcript is here:

http://www.parliament.vic.gov.au/images/stories/committees/paec/iedmfsdsip/hearings/March_transcripts/PAEC_Significant_infrastructure_projects_20_March_2012_-_VERIFIED_VAGO.pdf

I have to say I think the comments are relevant to both HealthSMART and the NEHRS.

I think we may be kidding ourselves if we think that just because it is a Federal Project all will be well.

Reading Professor Bent Flyvbjerg’s 2011 paper in the Harvard Business Review is Highly Recommended - especially for DoHA and NEHTA if they have not already done so!

See here:

http://www.sbs.ox.ac.uk/centres/bt/Documents/RISKYICTHBR3%200REPRINT.pdf

Enjoy or cringe!

David.