Australias National Health Information System - Case Study Example

Insert full names Instructor’s name Insert Course name 11th May 2012 Introduction The major challenge facing many governments across the world is the provision of accessible and quality health care. As the population is aging and the number of people with chronic diseases is increasing every day, health service demand is increasing. Meanwhile, as medicines and technology continue to advance medical care is becoming more costly. The society is expecting more from the health care system as the fiscal constraints continue to intensify. Therefore, it is a choice for the governments to act accordingly for the health systems to be able to cope with the overwhelming challenges or just relax and watch as the health systems deteriorate. A health information system is a set of procedures and components put together for the purposes of generation of information meant to improve the management decisions of health care at all levels of a given health system (Crooks, Stuart, and Porto. 7). An approach for the description of Australia’s health information system will require the consideration of the following three factors. 1) Demand; who needs data and for what purposes does he or she need the data for? 2) Supply; the methods and tools available to generate the required information. 3) Level; the level at which the data is generated and utilized (National Electronic Health Records Task Force 11). This report is aimed at providing an overview of how the health information system is supposed to work in any given country particularly in Australia; it is going to examine the current health information system, how it is functioning, its weaknesses and the recommendations thereafter. The Australia’s Health Information System The Australian government is implementing major reforms to the governance and funding of its health system so as to place it on long term foundations that are sustainable. There is a change in the way the health services are delivered, through improved access to services of quality that are designed around the patients’ needs while emphasizing on early intervention, prevention and providing care out of hospitals. There are various agencies involved in the health information system in Australia. They include; the commonwealth, health insurance commission, Australian bureau of statistics and the National Health and Research Council (NHMRC). There have been significant improvements brought about by the establishment of the National e- Health and information Principal Committee (NEHIPC) since 2005. The committee is responsible for advising the Australian Health Ministers’ Advisory Committee (AHMAC) on matters pertaining the e- health and strategies of information and collaboration of facilities between the state of Australia and the territory government to implement these information strategies. The health information system’s policy is to integrate all the arms of the health care systems in Australia for the improvement of healthcare services offered. According to the second annual e health study in Australia 2002, approximately 1.4 million Australians who are 15 years of age and above use the internet to update themselves on the Australian health status (WHO 14). Based on the survey, 744 practitioners and specialists amounting to 1631, 31% of the practitioners and 53% of specialists use the internet as a tool of reference in their day to day activities. Through the health information system therefore, it is easy to measure the current statistics, service delivery, notifiable diseases and the reporting of health care system. Every Australians is able to do all these at the comfort of their homes. Financial and Human Resources In the current health information system the human resource department is proving to be active though not as expected. Little is being done although the different departments under it are working every day to ensure the system is running as expected. The government being the sole controller of the project with the help of the common wealth organizations is working effortlessly to ensure it performs effectively. The government has agreed to deliver a National Health and Hospitals Network which is the most vital reform to the Australia’s hospital and health system sine Medicare was introduced, and one of the largest reforms to the federation throughout its history. The territory government and state will work with the commonwealth government to enhance the delivery of the National Health and Hospitals Network. There are also several other bodies involved in the process. They include; the commonwealth, health insurance commission, Australian bureau of statistics and the National health and research council (NHMRC), Medicare practitioners, specialists and all healthcare workers. Different roles are also assigned to different organs of the system. The National Health Information Management Advisory Council (NHIMAC) could take on the role of overseeing the development of Health Information Network Agency. The commonwealth government could take the role of work which entails planning, policy, service delivery arrangements, progress monitoring and the general management (Win et al. 38) All these departments performing the different roles have three objectives in mind which include; reforming the health and hospital system which will include governance and funding so as to provide a lasting foundation for the provision of quality services presently and in the days to come. Another objective is to change the way in which health services are delivered, through advanced and easy access to high quality health care that is integrated and designed around patient’s needs and putting more focus on early intervention, prevention and provision of outside hospital care. The last objective is to provide better access and better care of services to patients through increasing investments in the provision of quality hospitals, more nurses and doctors and improved infrastructure (Productivity Commission 17) There is a budget allocated by the government for the purposes of the development of health information system but it is way too low compared to the budget in the last two years. According to WHO Mortality Database (22), $161.6 million is allocated to the Personally Controlled Electronic Health Record (PCEHR) system for the coming two years, which will cater for customer support and registration, benefits monitoring, adoption support and evaluation. Another $4.6 million is allocated to sustain the safeguards for privacy-related factors of the PCHER system. This means that individuals can be confident enough as the privacy of their personal health information is protected completely and $67.4 million is Commonwealth’s share of combined funding with the territories and states for the National E-Health Transition Authority (NEHTA) work program in the coming two years. This is meant maintain and operate critical standards and services to enhance the security of electronic exchange of health information like authentication services healthcare identifiers, and e Health standards (Win et al. 44) Infrastructure A health information system requires appropriate infrastructure on which it can run. Networks provide a channel for the exchange of data amongst computers which have become a basis for many settings, which heavily depend on computer aided assistance. The health sector in Australia needs its own virtual network which is enhanced by the existing installed infrastructure in communications but adds the essential security required in the internet which is basically insure system of the public. There would be needed additional investment in the information storage and telecommunications in order to support the capabilities that are required by the Health information system. Additional computers would be needed as the health care providers are increasingly being employed to provide the services. The healthcare providers bear the major responsibility for inputting the data that is required to form the basis of a national health information system. Therefore, they require support and encouragement in this critical work. This translates to the acquisition of necessary computer hardware and software to connect to the health information system together with the necessary training and support. Indicators There are various sources for generating data in the Australian health information system. Generally these methods are divided into the ones that can generate data in relation to the total population in the country like census, surveys and vital registration. The other category includes those methods that generate data as regards to the operations of the services like service records, administrative records, diseases and health records. Different type of data is required at different levels of the health information system. For the purposes of patient management, data concerning the patient which s normally presented in form of charts is essential at the lower management level. There are also summary indicators at the district and facility levels that are normally required for the planning and reporting purposes to the national level. The most common indicators found are adult mortality rates, age standardized mortality rate for cancer, cardiovascular diseases, injuries, deaths and infant mortality rates (Carter 29). In Australia, the increased focus on evaluation and monitoring has given rise to various challenges. There is unhelpful proliferation of onerous reporting requirements and indicators. It must not only deal with a huge reporting volume but also with the diverse reporting formats and periodicities. Specific programs of diseases tend to evaluate indicators that cover inputs like resources invested and the undertaken activities, outputs like the offered services and in certain times the quality of such services. There are also outcomes which entail interventions and risk factors and impact indicators which include the health status of a given population and the consequences of the usage of health information systems. Data Sources There are multiple sources from which health data is derived. The most prominent in Australia is household survey which is usually conducted under the national statistical offices’ responsibility. Administrative data like the financing data of health workforce and health care reporting are the ministry of finance’s responsibility and form the basis for the annual health management and monitoring at facility, district and national level. Registration of births and deaths and the cause of death is not a very reliable source of data. Australia is among the countries that conduct census population at least once in ten years. 2010 saw many countries conduct census which was a 7% rise, from 85% to 97% of countries that conducted census in the year 2000. The civil registration system is also very effective thus the civil registration, compulsory, continuous and universal recording of characteristics and occurrence of significant events like deaths and births which forms a source of mortality and fertility statistics (Kwok and Jones 12). There are also regular surveys concerning health examination survey to measure risk factors, health and intervention coverage in the adult population like grip strength, blood pressure and blood tests which provide more reliable and accurate data on health outcomes. Institution Based It is of essence to maintain quality electronic health systems. Appropriate information assists in decision making process of the health care. They are records being kept for the ongoing treatment of a patient. The health records therefore need to be complete and accurate because incomplete information can lead to inappropriate decisions. For example, because of the millennium bug error, inappropriate Down syndrome test results were sent to 154 women who were pregnant. This led to four Down syndrome babies being born to mothers whose tests put them in low risk group. Due to the incorrect test results, two terminations were also carried out. This is because the pregnant women’s ages were not recorded properly in the system. Appropriate records enhance reliable and timely health information which is the foundation of an effective public health action and health system management. Data Management In institution based sources of data, collection of data is a routine activity and health care workforce collects patients’ information which is later sent to the district level. Information is hence produced through the administrative procedures for the management of facilities, staff and finances (Coletti and Bleighn 32). Australia has an effective and efficient facility based health management system although the data collected has a several weaknesses. Interoperability is playing a significant role in the Australian health information system. It maintains workflow and making the health information available to all who need it (Crooks, Stuart, and Porto 7). This is meant to enhance efficient exchange of data among the systems. Therefore, there is a centralised system of operations which accepts the agreed messaging standards from the other systems through the use of networking. Patients’ sensitive and personal information is contained in the health records and therefore must be handled with utmost confidentiality. There could be detrimental impacts on the patient in case the information slips out unintentionally or accidentally. This therefore calls for any health information system to ensure the privacy and confidentiality of patients’ information. Therefore, to have full usage of the system, the health information system in Australia has built the consumer and health care provider trust. There are security measures put forth like encryption, firewall, network service management and public key infrastructure (Tange et al. 242). Staff The Australian health information system is struggling with the increasing demand and cost pressures and inadequate skilled health care workers. With this reality, efforts are being put in place to ensure there are sufficient health workers to translate data to information. There is need to appreciate the interaction between care providers and consumers brought about by health information system. This ensures that there is maximum impact on the outcomes of health are scarce resources being allocated effectively and efficiently. The consumers are playing a vital role in the management and protection of their health outcomes. Dissemination and Use According to WHO 25, a well functioning health information system is the one that ensures there are analysis, dissemination, production and use of timely and reliable information on determinants of health, performance of the health system and the status of health. The managers and clinician are able to use the information generated in the health system and enable them to make decisions or policies. By using the data in the information system, policy makers are able to derive information, and generate a report that is tabled to the ministry of health for decision making or policy implementations. The information system ensures that the right information is available to the right people at the right time and therefore it can be used by clinicians for planning purposes. Conclusion and Recommendations The Australian health information system is meant to enhance quick access and quality healthcare for all Australians. The implementation of the programs has received positive applause from Australians citizens and is proving to work to the advantage of the users. However, there are various improvements that need to be considered. First is the recording of all births and deaths to provide accurate statistics. Many of them are recorded but there is a small number that goes unrecorded. Another problem is the shortage of skilled personnel, the government need to invest in training adequate personnel to input data that will generate health information. The users of this system also need to get trained so that they are able to access information and be able to translate it. This will enhance health workers and consumer relationships since the health workers will not have a difficult task of explaining literally everything to the consumer. Most of the direct benefits of using the health information system to individual provider or consumer from the use of health information will be available within the electronic health records context and the communication of critical health information electronically. Works Cited Carter, K.M. “Integrated electronic health records and patient privacy: possible benefits but real dangers”, The Medical Journal of Australia, 172 (2000): 28-30. Web. 8 May 2012. Coletti, M.H., and Bleighn H.L. “Medical subject headings used to search the biomedical literature”, Journal of the American Medical Informatics Association, vol. 8, no.4. 317-23. Print. Kwok, J.A., and Jones, B. “Unnecessary repeat requesting of tests: an audit in a government hospital immunology laboratory” Journal of Clinical Pathology, 58.5 (2005): 457- 62. Web. 9 May 2012. National Electronic Health Records Task Force “A Health Information Network for Australia”. Canberra: Australia, 2000. Print. Productivity Commission. “AHWAC 2005 data in Australia’s Health Workforce.” Research Report, 2005. Print. Crooks, H. S., Stuart, P. J., and Porton, M., A. “An interventional program for diagnostic testing in the Emergency department.” Medical Journal of Australia, (2002): Web. 8 May 2012. Tange, H.J., Hasman, A.F., Robbe, P.V., and Schouten H.C. “Medical narratives in electronic medical records”, Yearbook of Medical Informatics, 1998: 230-51. Print WHO Mortality Database. Web. 10 May 2012. http://www.who.int/healthinfo/statistics/mort/en/index.html WHO. “The World Health Report. Health Systems: Improving Performance.” Geneva: World Health Organization, 2008. Print. Win, K.T., Song, H., Croll, P., and Cooper, J. “Implementing patient's consent in electronic health record systems”. Proceedings of Collector, Melbourne, Australia, 2002. Print. Read More