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HealthConnect

Country: 
Australien
Partner Institute: 
Centre for Health, Economics Research and Evaluation (CHERE), University of Technology, Sydney
Survey no: 
(5)2005
Author(s): 
Marion Haas
Health Policy Issues: 
Neue Technologien, Zugang, Patientenbelange
Others: 
Consumer empowerment
Current Process Stages
Idee Pilotprojekt Strategiepapier Gesetzgebung Umsetzung Evaluation Veränderung/Richtungswechsel
Implemented in this survey? nein nein nein nein ja ja nein
Featured in half-yearly report: G-politik in Industrieländern 5

Abstract

HealthConnect is a network of electronic health records which aims to improve the flow of information in the health sector. It involves the electronic collection, storage and exchange of consumer health information via a secure network with strict privacy safeguards.

Purpose of health policy or idea

The objective of HealthConnect is to give health care providers quick and secure access to medical information about individual patients. A secondary objective is to improve the quality and safety of health care.

Information will be collected at the point of care such as a hospital clinic or doctor's surgery. The information will be documented in standard electronic format and stored in a secure network. It will be available to be retrieved for use by the collecting organisation and/or exchanged between authorised providers with the consent of the consumer.

The expected outcomes are:

  •  rapid access to health information
  • reduced duplication of services
  • increased portability of health records for consumers
  • increased control for consumers over who has access to their records
  • higher quality of information exchange between providers and therefore improved standards of diagnosis and care
  • more comprehensive information about utilisation, care and health status available to plan services and improve standards of care

The main incentives are non-financial and relate to the anticipated outcomes listed above. However, a range of incentives are being offered to assist GPs to become computerised including financial incentives to purchase computers and software and support for training and maintenance of the system. GPs are also encouraged to use the system through Divisions of General Practice which are actively supporting the trials and implementation of HealthConnect.  

Main points

Main objectives

The objective of HealthConnect is to give health care providers quick and secure access to medical information about individual patients. A secondary objective is to improve the quality and safety of health care.

Type of incentives

The main incentives are non-financial and relate to the anticipated outcomes listed above. However, a range of incentives are being offered to assist GPs to become computerised including financial incentives to purchase computers and software and support for training and maintenance of the system. GPs are also encouraged to use the system through Divisions of General Practice which are actively supporting the trials and implementation of HealthConnect.  

Groups affected

Consumers, Providers

 Suchhilfe

Characteristics of this policy

Innovationsgrad traditionell recht traditionell innovativ
Kontroversität unumstritten unumstritten kontrovers
Strukturelle Wirkung marginal recht fundamental fundamental
Medienpräsenz sehr gering gering sehr hoch
Übertragbarkeit sehr systemabhängig systemneutral systemneutral

This policy has the potential to change the workings of the health system in Australia. It is being carefully worked through and well evaluated and, if successfully implemented should, at the very least, result in better communication between providers and consumers, fewer adverse events and better access to clinical data for monitoring and research purposes.

Political and economic background

HealthConnect emerged from the need to integrate and better coordinate the delivery of health care. To ensure that this happens, improved communication of health information and portability of individual health records are necessary.

A significant impetus towards HealthConnect were the findings and implications of the 1995 Quality in Australian Health Care study which suggested that hospital errors are responsible for up to 18,000 deaths in Australia annually. It has also been reported that 140,000 hospital admissions per year are associated with the incorrect use of and adverse events connected with medications.

The Australian and State and Territory governments are working in partnership to investigate, trial and evaluate the best model for the proposed health information network. This has been done in consultation with stakeholder groups including consumers.

Purpose and process analysis

Current Process Stages

Idee Pilotprojekt Strategiepapier Gesetzgebung Umsetzung Evaluation Veränderung/Richtungswechsel
Implemented in this survey? nein nein nein nein ja ja nein

Origins of health policy idea

Over the past 5-7 years, the Australian and State and Territory governments have recognised that information technology has the potential to revolutionise the way in which consumer information is managed in the health sector. Computer-based records are currently used by many health care providers and organisations with the aim of increasing efficiency and accuracy.

The main purpose of HealthConnect is to utilise the advances in information technology to develop a secure network able to collect, store and exchange electronic consumer health records.

Policy makers, clinicians as well as information technology specialists are driving the ideas. The management and evaluation of HealthConnect is being coordinated by the Australian government through the HealthConnect Program office which support the HealthConnect Board.

Plans for implementation and evaluation are being developed in consultation with State and Territory governments. Trials are underway in Tasmania, South Australia and the Northern Territory.

Initiators of idea/main actors

  • Regierung: The government is involved through the Federal Department of Health and Ageing as well as its counterparts in State and Territory departments of health
  • Leistungserbringer: Providers are active as advisors and users of the proposed system
  • Wissenschaft: Scientific community: Information technology specialists required to develop an appropriate system

Approach of idea

The approach of the idea is described as:
renewed: MediConnect, a national electronic medication record system designed earlier to help improve the quality and safety of medication management in Australia, will now be integrated with HealthConnect.

Stakeholder positions

The ideas of using technology to improve the safety, quality and coordination of health care delivery has widespread support in Australia as a number of reports regarding problems within the system were widely disseminated and publicised. The general public, health care consumers, providers, policy makers and politicians all accept that more can be done to improve the system.

A number of papers and reports (both technical and evaluative) have been written and are available from the website below.

http://www.healthconnect.gov.au/publications/index.htm#Interim

It is not possible to determine whether there have been extensive disputes or if any conflicts of interest have arisen.

Actors and positions

Description of actors and their positions
Regierung
Governmentsehr unterstützendsehr unterstützend stark dagegen
Leistungserbringer
Providerssehr unterstützendunterstützend stark dagegen
Wissenschaft
Scientific communitysehr unterstützendsehr unterstützend stark dagegen

Influences in policy making and legislation

Not applicable

Actors and influence

Description of actors and their influence

Regierung
Governmentsehr großsehr groß kein
Leistungserbringer
Providerssehr großsehr groß kein
Wissenschaft
Scientific communitysehr großsehr groß kein
Government, Scientific communityProviders

Positions and Influences at a glance

Graphical actors vs. influence map representing the above actors vs. influences table.

Adoption and implementation

Implementation has been organised in stages:

In 2004 trials began in Tasmania, South Australia and the Northern Territory. Implementation projects were also identified in other States and have begun in NSW and Queensland.

During 2005, consumers and providers in the Tasmanian trial will be able to participate in a "live" HealthConnect network focussing on specific areas such as hospitals, general practice, pathology and pharmacy.

During 2006, consumers and providers in most of Tasmania and South Australia will be able to participate in HealthConnect.

In 2005 trials will also begin in NSW and Queensland.

Financial and non-financial incentives have mainly been directed at encouraging GPs to become computerised and computer literate.

Monitoring and evaluation

An overarching evaluation strategy has been developed and implemented for HealthConnect. It incorporates existing and planned trials and their evaluations, the means to take account of the lessons learnt from the trials and develop performance indicators for HealthConnect. It will also identify strategies for using de-identified HealthConnect information for evaluation, monitoring and associated research.

The first phase of HealthConnect has been evaluated (see HealthConnect Interim Research Report) http://www.healthconnect.gov.au/publications/index.htm#vol1 

The evaluation found that HealthConnect is both technically feasible and worth implementing and can be integrated into everyday work practice. The results of the report led to the implementation of a second, two-year phase of research and development from 2003-2005.

Dimensions of evaluation

Struktur, Prozess, Ergebnis

Results of evaluation

The structure of HealthConnect (its architecture) has been evaluated and has resulted in the production of the systems architecture design which provides the technical blueprint for how the system could be implemented nationally. Also, the privacy, consent and identification arrangements have been evaluated. The results indicate that HealthConnect can work and be integrated into the daily work of providers. The storage and access aspects are technically feasible and provide useful information.

The process of HealthConnect has been evaluated using trials in a number if States and Territories. Consumers and providers indicate that the information provided by HealthConnect is valuable in improving clinical care, particularly as it relates to communication and flow of information between providers. Takeup of HealthConnect in trial areas by consumers has been high and they have indicated their support for HealthConnect beyond the trial dates.

Some outcomes have been assessed. In the SA trial, the number of pathology and radiology test ordered has reduced and providers report better coordination of care and the ability to understand trends better thus informing better clinical care. One trial reported that a key outcome was a reduced number of GP consultations necessary to effectively treat consumers.

Expected outcome

So far, it has not been possible to evaluate the impact of HealthConnect on longer term outcomes, such as changes in health status. Such data is also not available from other systems as little formal evaluation has been undertaken. However, other countries are continuing on a similar path and the projected benefits may be realised.

The possible undesirable effects largely relate to the costs (total unknown but likely to be substantial) relative to the benefits (may not all be evaluated or realised) and to the risk that privacy will be breached to the extent that the project loses support from consumers, the general public and politicians. However, no instances of this occuring have been reported so far.

Successful implementation of HealthConnect has the potential to improve quality and safety (breaches of which are expensive). Improved information and communication may improve access to needed care in a timely fashion. Equity considerations are important as the system will rely on GPs taking it up and the likelihood of their doing so in remote or disadvantaged metropolitan areas will need to be evaluated.

This assessment is dependent upon the successful implementation of HealthConnect, assuming technical feasibility and high uptake. It could have a fundamental impact on the quality and safety of health care services in Australia due to improved information, communication, decision making and timely access.

It is difficult to judge the rate of uptake by providers across the country but given that technology is currently not evenly spread or available in Australia, it seeems likely that, initially, at least, there will be unequal availabiltiy of HealthConnect (even when implemented nationally). However, if such barriers can be overcome, it has the potential to reduce inequity of access and in the longer term, of utilisation and outcome. These gains could be substantial because the system is often accused by clinicians, consumers and the media of being uncoordinated.

Any substantial decrease in the level of health care-related adverse events and duplication of services has the potential to improve the efficiency of  health services. Therefore, if HealthConnect achieves its potential in this area, it may be cost-effective.

References

Sources of Information

http://www.healthconnect.gov.au/publications/index.htm#vol1

Author/s and/or contributors to this survey

Marion Haas

Empfohlene Zitierweise für diesen Online-Artikel:

Marion Haas. "HealthConnect". Health Policy Monitor, April 2005. Available at http://www.hpm.org/survey/au/a5/2