The trouble with shared care planning

Welcome back to a new year of the weekend edition of Pulse+IT, in which we cast our glance over the events of the week and pontificate for your reading pleasure on what we think it all means for the eHealth and health IT sector. It looks set to be a make or break year for the My Health Record as it goes opt-out at some yet-to-be-decided date towards the end of the year and 20 million people are suddenly presented with a storage receptacle for their health information.

It might be a make or break year for the Health Care Homes project as well, already off to a rocky start with delays and bickering over bundled payments. There was also a bit of a kerfuffle at the end of last year over what shared care planning software the participating practices could choose from and the accuracy of the product information about them.

Team care arrangement have been promoted as the way forward for the primary care sector but actually getting GPs and other members of the care team such as specialists and allied health to use these tools has always been a tough gig. Precedence Healthcare was one of the pioneers of shared care plans in primary care through its cdmNet product, although there are a number of others out there, but even Precedence has found the going tough and shifted its focus once it was acquired by Sonic Clinical Services. It's a struggle for all of these companies, fighting it out for a small market share.

So it was not a big surprise when we discovered last week that Ocean Health Systems, which in addition to its other solutions co-designed a shared care planning tool with Western Sydney PHN called LinkedEHR, had entered voluntary administration. In what proved to be our most-read story for the week, we spoke to administrator Peter Krejci about the future of the company, about which he was positive. It looks likely that a company restructure will be undertaken to put it on a sounder financial footing and in the meantime, it will continue trading as usual.

It brings up the question of not just how hard it is to get practitioners to use shared care plans but who should pay for them. Precedence always boosted the practice efficiency benefits of cdmNet, a sales pitch common to other offerings aimed at GPs such as online booking services, apps and data extraction tools. However, general practices are notorious for not wanting to spend what meagre profit they make on what can be rarely used technology, unlike their practice management software. Besides which, half of the specialists and allied health practitioners they refer to aren't even computerised so coordinating shared care plans can be an administrative nightmare.

It's not that the technology is not readily available. As Adam Powick argues in his opinion piece this week on what he as a consumer, rather than a technologist, would like to see from the health system, his list of things the healthcare industry should offer are both technologically possible and what we would demand from other industries without a thought. Consumers expect their healthcare teams to share information between them and it often comes as a surprise to them to learn that they don't.

Again, this isn't due to a lack of available technology but cost barriers and more importantly, workflow. And like everything else in healthcare, anything that disrupts existing workflow is likely to fail.

That brings us to our poll question for this week: Do you think shared care planning tools will ever achieve widespread adoption? To vote in our poll, sign up for our weekend edition or leave your comments below.

At the end of last year we asked this question: Do you think the opt-out My Health Record will be a success? While success is a relative measure, 61 per cent of readers say opt-out is a goer, with 39 per cent still in the negative.

Comments   

# Fiona MacKenzie 2018-01-20 23:32
Yes!
# PHN staff member 2018-01-22 13:11
Not in their current form and cost. Anything that requires duplicate entry (either into the planning tool or out) will be difficult to get traction, and with the small market it would be hard to develop a fully inter-operable tool that will link with software as easily as it needs at a low cost.
# Murray PHN staff member 2018-01-24 10:13
YES!

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