Investigating the Potential to Improve the Free Flow of Health Care Information


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Ross McKenna
Ministry of Health
(P40, 1/10/09, Works Room, 11.28)

Published in: Health & Medicine
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Investigating the Potential to Improve the Free Flow of Health Care Information

  1. 1. Investigating the Potential to Improve the Free Flow of Healthcare Information – a survey of New Zealand clinicians and health providers HINZ Conference 2009 Ross McKenna October 2009
  2. 2. Agenda <ul><li>Background and Purpose of Paper </li></ul><ul><li>Approach and Methodology </li></ul><ul><li>Findings </li></ul><ul><li>Conclusions </li></ul><ul><li>Questions </li></ul>
  3. 3. Background and Purpose <ul><li>Person- centered Health information needs to follow patients across care settings – not constrained by organisation boundaries </li></ul><ul><li>Implementation of ICT in health requires collaborative effort and clinical input </li></ul><ul><li>Increasing pressure on budgets and more technology options – setting priorities is difficult </li></ul><ul><li>Sector ICT decisions made in lots of places across the sector </li></ul><ul><li>Broad agreement on high level requirements (E.g. HISNZ 2005) but limited statistically significant evidence of specific sector ICT needs </li></ul><ul><li>Needed evidence based analysis of ICT needs of the New Zealand Health sector to: </li></ul><ul><ul><li>Provide more detail to assist targeting and prioritising effort and spend – Connected Health </li></ul></ul><ul><ul><li>Measure success and progress of ICT investments </li></ul></ul><ul><li>Research conducted by UMR under contract from MoH </li></ul><ul><ul><li>Provides ‘independent’ evidence of current Sector requirements – Clinicians and ICT Decision makers, DHB and non-DHB </li></ul></ul><ul><li>An informed, evidential starting point for communication between clinicians, purchasers, technical and vendors </li></ul>
  4. 4. Research Approach and Methodology Depth interviews with opinion leaders (n=8) Explore key issues Ideas for question-lines Depth interviews with key segments (n=103) Issues, barriers and drivers Decision making and influences Develop Questionnaires Issues, barriers and drivers Clinicians and Decision makers Detailed sector surveys undertaken (n=2,454) Sent to 7,000 individuals in 5,000 orgs DHB /non-DHB Clinicians/ ICT Decision makers 32% Response, 90% by mail - “It’s about time someone asked us” Margin of error = 2.3% non-DHB Clinicians, 3.4% ICT Decision makers, 7.9% DHB clinicians
  5. 5. Survey findings <ul><li>Diversity of the Health sector </li></ul><ul><ul><li>19% Clinicians and 25% specialists work in more than one DHB area </li></ul></ul><ul><ul><li>Wide variation in numbers of patients seen/treated per day per clinician </li></ul></ul><ul><ul><li>34% sector organisations part of a larger group </li></ul></ul><ul><ul><li>34% sole private practices </li></ul></ul><ul><ul><li>17% not-for-profit </li></ul></ul><ul><ul><li>25% GPs work from multiple locations </li></ul></ul><ul><li>Strong agreement across the Sector (94% DHB & 80% Non-DHB clinicians) that improved ICT would help to enhance service delivery - but limited perception of value for money. </li></ul><ul><li>Generally consistent view of top 4 priority information types needed electronically </li></ul>Test results Medication information Discharge summaries Referrals <ul><li>High level of technology capability in the sector </li></ul><ul><ul><li>93% Clinicians have internet access and use email . </li></ul></ul><ul><ul><li>80% Clinicians like to keep up with the latest technology </li></ul></ul>
  6. 6. Survey findings - continued <ul><li>51% Non-DHB clinicians and 72% DHB clinicians reported that at least once a day they could not find the patient electronic information they required to optimally treat their patients </li></ul><ul><li>Email Communications </li></ul><ul><ul><li>Most email use in the sector is for administrative communications. </li></ul></ul><ul><ul><li>51% Non-DHB clinicians use email for communicating with patients and 42% for sending/receiving referrals. . However, Fax is the ‘safe’ default technology – 95% non-DHB organisations. </li></ul></ul><ul><ul><li>Urban GPs use email to communicate with patients more than rural </li></ul></ul><ul><li>Improving their organisations use of ICT was </li></ul><ul><li>a priority for 74% ICT decision-makers </li></ul><ul><ul><li>Recognition of increasing importance of ICT to healthcare </li></ul></ul><ul><ul><li>But there are challenges to be overcome… </li></ul></ul>Privacy and security concerns Funding/resources inadequate Incompatible ICT (PMS) systems Need support from Ministry and DHBs Lack of Standards Barriers to increased use of ICT
  7. 7. What driving ICT investment in Health?
  8. 8. Conclusions <ul><li>General agreement that better access to “electronic” information leads to better care quality, efficiency and coordination of care delivery </li></ul><ul><li>Availability of technology for use does not always = productive use of that technology for healthcare </li></ul><ul><li>ICT flexibility and interoperability is needed to support diverse “business” models </li></ul><ul><ul><li>Must meet individual provider unique needs but also support business processes that span multi-provider </li></ul></ul><ul><li>More information should be accessible “electronically” – Big 4 types of valuable information consistently requested. </li></ul><ul><li>Factors influencing clinicians need for “electronic” information </li></ul><ul><ul><li>Current availability/use of technology </li></ul></ul><ul><ul><li>Patients treated per day </li></ul></ul><ul><li>What is stopping it? = Technology issues, funding needed, privacy/security, lack of standards. </li></ul><ul><li>More external coordination and guidance is needed (GP and Aged Care particularly) - from “DHBs and the Ministry of Health” </li></ul><ul><li>Need for agreement from all collaborators slows ICT purchasing cycles </li></ul><ul><li>Plenty of opportunities for ICT to support information exchange in the sector but needs: </li></ul><ul><li>Common direction - MoH, DHB, supported by Funders </li></ul><ul><li>Collaboration - Clinical, ICT decision makers, other providers, vendors </li></ul><ul><li>Connection to business and model of care </li></ul>
  9. 9. QUESTIONS? <ul><li>UMR Research findings will be available from the Ministry of Health Website </li></ul>