The inconvenient truth about EMRs
It's a common tactic of incoming governments facing big budget shortfalls to call for an independent inquiry to investigate the horrors bequeathed by their vanquished foes, and it happens no matter what stripe your political colours.
Tony Abbott federally and Campbell Newman in Queensland were big fans of “commissions of audit”, arranging them as soon as they took government in the high hopes that the blame for all nasty manner of remedial action could be sheeted back to their predecessors.
The WA government under Labor's Mark McGowan has done the same, ordering a commission of inquiry into government programs and projects in May last year that was charged with looking at some big ticket infrastructure items, including a billion dollar hospital or two, that may have had a hand in gutting WA's once healthy balance sheet.
An accompanying Sustainable Health Review was also called with the express mandate to look at how to rein in expenditure growth in the health budget. The review panel, headed by former NSW Health director-general Robyn Kruk, handed down its preliminary findings this week, warning in its preface that the state need to confront some inconvenient truths.
So we were surprised when the panel, hearing from consumers and clinicians that access to medical information was increasingly important but still quite haphazard, decided in its wisdom to recommend that the government consider implementing a statewide electronic medical record, pending available finance. Considering the review was aimed at reining in spending, we were mildly perturbed by this.
The inconvenient truth for our industry is that no matter what is promised, EMRs can cost a hell of a lot of money and cause all manner of heartache. Did the panel take a peek at how certain other states had fared with their EMR roll-outs? As a former NSW D-G, Ms Kruk would be well aware of the dramas that befell eMR version one in that state.
Victoria had its HealthSmart, Queensland has been accused of blowing its budget and South Australia continues to feel pain from EPAS. The smaller jurisdictions in their wisdom haven't tried as yet, although the NT is about to begin, at a cost of $259 million.
With all of the billions spent, we are yet to see any compelling evidence that this is something WA needs to get going on at the moment.
We also believe that with the dramas WA experienced with Fiona Stanley Hospital's IT systems – now, we understand, much improved – and with Perth Children's Hospital's drinking water problems still fresh in the memory, it would make anyone think twice about plunging into a big new spend. And WA Health's handling of clinical and administrative IT has not been the Mae West in the past, pardon the pun.
Just last week, WA Health was given a warning by a former under-treasurer looking at its infamous Fujitsu contract that it really needs to be a bit more careful next time, so while we think there are some very good suggestions in Ms Kruk's report – increasing the use of telehealth, which makes so much sense to anyone with a map of WA, and closer information sharing with GPs – we'd be a bit wary of rushing into a digital strategy and a state EMR when the finances are so tight and the resources to support it simply aren't there.
Elsewhere in what was a busy week in digital health, we heard from MedicalDirector's CEO Matt Bardsley, who despite the misgivings of his industry association thinks the idea of introducing some minimum standards for clinical IT systems has some merit, not the least for assuring twitchy doctors that their software is safe and secure. We also heard from MD's former owner Primary Health Care, which has launched itself down its own digital route.
Australian Digital Health Agency CEO Tim Kelsey popped down to Canberra for Senate Estimates, where he poured cold water and not a little scorn on a report from last year by News Corp that there were no plans to put an ad on the telly to publicise the advent of the opt-out period for the My Health Record. Sadly though, interrogations of the government's eHealth policies keep being consigned to the last session of what is a very long day and at a time when only political tragics and Michaelia Cash's whiteboard are prowling the corridors of power.
And finally we had news this week about some rather ambitious plans to begin the task of digitising baby and child health records, with the National Children’s Digital Health Collaborative announcing a five-pronged strategy to investigate how technology can help bring up a new generation of healthy nippers.
We reckon this is rather interesting stuff and we'll watch with interest. There's no doubt it will be tough converting the Red Book, the Yellow Book, the Purple Book, the Green Book and the Blue Book into various eBooks, but we think this is a worthwhile endeavour. The iPhone generation lives in a digital world so it won't be much use capturing it on paper for much longer.
We'll have more on that next week but in the meantime, have a think about our poll question. Do you think WA would be throwing good money after bad if it introduced a statewide EMR?
To vote in our weekly polls, sign up for our weekend edition or leave your comments below.
Last week we asked if you though the Global Digital Health Partnership would bear fruit for Australia. The global gabfest didn't seem to capture our readers' attentions: 38.5 per cent said yes while 61.5 per cent said no.