Enabling the Integrated Collaborative Healthcare System

The promises of IT in healthcare, with a major part of this application known as eHealth, has had many false dawns, but today we can see some real changes that mean Healthcare IT may at last be able to overcome the barriers that have prevented it from moving into the 21st century.

In terms of IT maturity, Healthcare IT today is in the same position that other industries were in 10 or 20 years ago. Proprietary/closed architectures still prevail; many do not support open standards such as SQL and the vast majority do not separate the application and data tiers. This makes sharing information with other applications extremely difficult, and lack of data transparency means there is no ‘plug and play’ interface for accessing or extracting data.

However, contemporaneously, business and clinical requirements of Healthcare IT have moved on substantially as a result of several impacting factors, such as:

  • Improved understanding of the scientific causes of diseases based on genomics and proteomics.
  • A rapidly ageing population and a decreasing number of healthcare workers.
  • Increasingly wealthy and empowered citizens in developed/developing economies where lifestyles have changed (become more unhealthy) and expectations of their healthcare system are rising.
  • An epidemic in chronic conditions, particularly Type II Diabetes, Chronic Obstructive Pulmonary Disorder (COPD), Congestive Heart Failure (CHF), Coronary Artery Disease and mental illness, with patients increasingly having more than one condition.
  • Continued advancement in treatments, which has led to greater medical specialisation and increased survival rates for many conditions that now have the characteristics of chronic disease — for example HIV and many cancers.

And the corollary is that greater medical specialisation leads to a further increase in the fragmentation in healthcare delivery, and an even greater co-ordination challenge.

This has resulted in healthcare services needing to be supplied in completely different configurations with services delivered, not only in single healthcare facilities, but also now across multiple clinical organisations, outside of clinical settings and in the home, moving from episodic to chronic care.

None of these issues are new. They have been the same for the last 15 - 20 years, but many of the barriers to change can be laid at the door of IT.

Even as the proportion of GDP spent on healthcare has continued to increase — despite acceptance that countries cannot afford to continue in this way — IT has not been applied at scale and with the participation and buy-in of patients, clinicians, policy makers and payers.

Governments see the cost of healthcare as a tremendous drain on the economy contributing to very large budget deficits and stifling economic growth in some countries. Facing such basic issues, Governments now have the will, and often the political mandate, to make the necessary changes to at last join up the fragmented islands of healthcare information and to provide integrated patient records accessible by healthcare providers, patients and individuals within their circle of care across the complete Patient Journey.

Orion Health is seeing Governments increasingly considering how to implement this kind of Strategic Healthcare Management at large scale to obtain the necessary economies of scale and to achieve a step change in reducing costs and improving patients’ quality of life and safety.

In particular this includes population management, in terms of optimising access to scarce healthcare resources and supporting more self-care: large scale clinical workflow supporting end-to-end care processes across primary and acute care, rehabilitation, community, remote and self-care while achieving economies of scale to do more with less.

Disease management and citizen collaboration allows empowered patients and carers to make informed choices about the healthcare services they use and to integrate them into the care team.

Many countries have embarked on transformational Healthcare IT projects, including, for example, Australia, New Zealand, Canada, Denmark, England, Netherlands, Singapore, Sweden and the US. While each country’s individual focus may be slightly different — each has a different starting point — they all have similar objectives of improving cost-effectiveness of healthcare services and improving patient care by better integrating the end to end care delivery process, from the planning and commissioning of healthcare services through to the shaping and delivery of care.

Orion Health has identified seven key areas crucial to developing an integrated collaborative healthcare system. In no order of priority, these are:

  • Focus on the prevention and management of chronic disease.
  • Place the citizen at the centre of healthcare.
  • Secure sharing of clinical information within facilities, between organizations and across regions, to alleviate issues resulting from the fragmentation of healthcare delivery, yet maintaining the provenance and security of data and complying with privacy programmes.
  • Improve adherence by healthcare providers to evidence-based guidelines.
  • Remove the care-barriers between social, aged care and healthcare to better support those capable of independent living and reduce the heavy toll paid by the healthcare system of people not getting enough care for their needs consequently returning as frequent non-elective admissions.
  • Improve the productivity and outcomes of the overall healthcare system through more effective utilisation of healthcare resources; such as transformative clinical workflows that support the pooling of resources to achieve economies of scale in delivery, improving patient safety through the reduction in iatrogenic treatment and providing a platform for delivering more healthcare, for example through the use of telehealth or telemedicine.
  • Improve the management of public health through situational awareness with local and larger scale disease outbreaks.

At Orion Health, we see the move to integrated collaborative healthcare happening today. This includes healthcare, social care and mental health to form a complete cross-care record supporting integrated collaborative care workflows. It is all about strategic healthcare management, not just healthcare interoperability and integration.

David Hancock
Head of Commercialisation, Orion Health
This email address is being protected from spambots. You need JavaScript enabled to view it.

David Hancock is Orion Health’s Head of Commercialisation. Since July 2010 he has been responsible for Industry Strategy and Product Marketing. Prior to his appointment at Orion Health, David worked at Oracle Corporation for 13 years focusing on Healthcare and Life Sciences. Orion Health is a leading healthcare software solution provider with expertise in clinical workflow and integration technology for the healthcare sector.

Posted in Australian eHealth

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