Presentations from:
Dr Jill Maxwell - Forum Facilitator
Dr Mukesh Haikerwal - Forum Close

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Dr Jill Maxwell - Pulling it all together

Why do we have E-Health?

We are in the 21st century and it has to happen. It will improve safety and quality. E-Health will improve communication between sectors, it will eliminate and reduce duplications of prescribing and testing, and will lead to efficiencies long term, with short term costs. E-Health will improve continuity of care and public health. So it is not what is the value of e-health but what is the value of the impacts it has on the things we think are important.

If the above reasons don't make the point it seems that the Government will eventually require e-health implementation.

Problems identified, and to be overcome, include slow data entry and typing. It is not what most doctors want to do. E-Health will be expensive to implement. The public hospital IT process is poor and they can't communicate with the rest of the system.

The red star and ringing bells issue is the lack of standards. Hopefully we will see improvement in the next year under NEHTA management. The Minister's timeframe is results in 18 months. NEHTA finishes in two and a half more years. Many of the types of systems talked about will take longer that that - there are some mismatches in time. 18 months seems unrealistic when we don't even have the standards yet. A key role for the AMA could be to monitor and report on NEHTA progress. The AMA could oversee health and industry taking the standards forward, perhaps with an MOU with NEHTA having more of an oversight role than a driving one. This approach would need a model for funding licencing and support of the standards. This approach is the method used by Integrating the Healthcare Enterprise - lead by the profession and industry in partnership with an honest broker to manage the process. The AMA could certainly assist in getting this process off the ground by joining with HISA and HL7.

Patients are suspicious of central storage, yet that is the outcome that seems to be proposed. There has to be a way around this one. E-Health must be patient centred.

Key features of the solutions include incremental and practical approaches, change management, not imposed from above, built on standards, involving consultation and partnerships with industry and commerce. Central will be the care of the patient, safety and quality, evidence based approaches and medical ethics and privacy.

Contrary to the views expressed by the Minister there is a lot happening, doctors are embracing information technology and it is clear that we need a good communication strategy to keep us all abreast of developments.

Overall there is a lack of leadership. .A vision needs articulation and there seems to be support for the AMA IT Expert Committee taking this forward. An education program needs to focus on engaging the profession and explaining the vision and realities of what is needed. There will have to be funding for set up costs regardless of the long-term efficiencies. We have to identify where the funding is coming from. There are a number blocking Government policies such as e-signatures, which need correction.

Who is to provide the leadership? We mustn't continue to wallow around in generalities again and need some concrete way forward. We have to get people connected as well as doing the big picture. This has been a constant call. The AMA is the professions medico-political body and would seem placed to take this forward.

It has been commented that we have heard all this before - well that is the challenge to the AMA - just do IT!

Forum Close
Dr Mukesh Haikerwal

Thank you to all the participants, there has been excellent engagement.

There has been a role for the AMA in putting on this forum and we can certainly work with you all to take this forward. Your involvement, and those who couldn't because of numbers be here, is critical as without broad involvement it wouldn't work - just as the Government has found it doesn't work. Peter Garcia-Webb's group will draft a paper outlining the way forward and then we would hope to move forward on some concrete activity. With regard to NEHTA we will be meeting with senior people in the next week or two and are certainly better informed. We have had some great academic input to guide us and input from industry on what is achievable and what we can take from the experience of other sectors. At a personal level I realise how fast things are moving and how difficult it is to keep up.

The AMA will be there to facilitate this process, it that is what is wanted; but not just the AMA! We have already started to engage further with Government on this issue, meeting with Minister Hockey and Minister Abbott to address the disconnect between the Departments of Health and Human Services.

The AMA can facilitate the input of our health and health informatics experts into the decision-making processes. We have to capitalise on the good will evident at this meeting and to move forward, however it certainly won't be wrapped up in the 18 months the Minister suggested.

Finally thank you to our sponsors:

Commonwealth Bank
Cisco Systems
IBM
Ocean Informatics

An thanks to Jill Maxwell for a job well done as facilitator and to Julia Nesbitt and her team at the AMA for putting on such an excellent meeting at relatively short notice.