Digital Healthcare needs Incentives

This blog has often remarked that much of the healthcare system is either too distracted, poorly planned or too old-school to evaluate and implement digital solutions for practice and hospital management software.

The US government is trying to overcome this with incentives. Starting in 2011, physicians who show that they are “meaningfully” using health IT would be eligible for $40,000 to $65,000, and hospitals would be eligible for several million dollars. The incentives would be phased out over time, with penalties in place by 2016.

This news comes as another study is published showing that hospitals with automated notes and records, order entry, and clinical decision support had fewer complications, lower mortality rates, and lower costs.

The Australian government is trying to implement a Practice Incentives Program that encourages IT uptake, but is running into problems with disagreements over architecture.

E-Health Needed for Better Primary Care

The Australian Institute of Health and Welfare recently released a publication: Review and evaluation of Australian information about primary health care.

In it they have highlighted that accurate, reliable and timely information must be available to assess the quality, effectiveness and outcomes of services provided in general practice. These are currently not the norm.

Their findings are that existing data collections are limited. In particular:

• At the national level, ‘quality’ is currently only able to be assessed in specific circumstances and for particular health conditions (for example, tracking the annual cycle of care for diabetes).
• To enable thorough investigation of general practice care, data should:
  • be able to be analysed at the individual patient level
  • link each management action (such as a prescription, clinical procedure, pathology or imaging request) to a diagnosis or symptom pattern
  • be able to be linked to allow tracking of presenting problems and management actions over time and to examine patient outcomes.
  
  
  While there exist several info collections groups such as CONDUIT (Collaborative Network and Data Using IT), GPRN (the General Practice Research Network), the Australian Primary Care Collaboratives, ASPREN (the Australian Sentinel Practices Research Network) and the GP Census. These are only starting points. Features of each need to be adapted to a broader system.

Their Recommendations

• A minimum data set specification for GP–patient encounters should be defined, in consultation with all stakeholders, which builds on work already undertaken in this area.
• The options established as potential starting points for an electronic collection should be explored with all stakeholders to formulate an agreed approach for implementing collection of this minimum data set at the national level.
• Where existing collections provide useful data, they should continue to be supported during the transition period and, where appropriate, afterwards.

How they feel their findings relate to NEHTA’s work is not entirely clear from my brief perusal. But the data they provide is good market research for any company willing to enter the e-health arena.