Q&A: Bill Crounse, Microsoft

Microsoft's senior director for worldwide health, Bill Crounse, has long had a keen interest in Australian eHealth. He spoke to Pulse+IT on his recent trip to Australia.

Pulse+IT: What are your thoughts on Australia's current eHealth system?

Dr Bill Crounse: When we look at health worldwide, I see Australia on the same level of maturity in healthcare systems as Canada and America. And this surprises some people, thinking that surely America should be well ahead in terms of IT system adoptions. Most of Australia’s hospitals have core systems in place; certainly among GPs electronic records are fairly common. Ideally, it is the patient who should be at the centre of healthcare. People should have control over their eHealth record and be able to share it with whomever they choose including their doctors, caregivers, family members or others.

How do you rate the Australian eHealth sector compared to other countries?

America, Canada and Australia lag behind in the adoption and use of electronic medical records as compared to some of the sophisticated markets in western Europe and Asia (specifically the Netherlands and Japan) who are using eHealth technologies and have been for almost a decade.

Do you think Australia needs a federally pushed eHealth strategy?

Australia needs an eHealth strategy that goes beyond simple electronic health records. Although laying a robust and secure infrastructure in health IT is extremely important and laying a foundation of electronic records is fundamental to everything you do, neither of those things is where the value comes from. The value comes from is how you use that information, how patients have access to that information and how it’s used to improve prevention and wellness across the population.

What is your opinion of the PCEHR system we are in the process of implementing?

Today's focus on making medical records electronic is an important piece of the broader healthcare vision but it is only one part of that vision. Digitising health information is important and foundational, but the real value comes from how that digital information is used to improve care. To move from today's fragmented system to tomorrow's connected health ecosystem, we need a technology infrastructure that allows information to flow freely to ensure it is shared and used to inform decisions. Without it, we'll succeed only in recreating our disconnected paper system in the virtual space. Transforming healthcare is a complex issue, and no single entity is going to fix it.

In Australia we do electronic medical records well, especially NSW and SA. But what we don’t have is an overarching integrated record, which is the PCEHR that the government is funding. Across the Northern Territory they do have a shared electronic health record which is quite sophisticated. Australia is good at primary care, with 97 per cent of GPs using electronic systems. In the acute care hospital setting, we do quite well, but what we need a better job of in Australia and the government is helping with funding, is the integrating system across the healthcare system.

Do you think the PCEHR will be a bonus or a burden on clinicians?

Personally controlled electronic healthcare records are a way to engage consumers in healthcare and get them involved in their own care. Under the surface there are always big opportunities to improve the way clinicians, patients and administrators avail themselves to technology and put it into normal commerce of the industry. In Australia we’re focusing on communication collaboration, particular unified communication. Unified communication is bringing together all of the ways that you want to communicate and collaborate that include telephony, messaging, email, video and web conferencing.

What are the common problems you see with health ICT implementations?

Technology must be agreed to and implemented into a health care system with the participation of all parties, especially the end-users, be they clinicians or patients. Without this common agreement on what is needed, health ICT implementations run the risk of being ignored or abandoned, this is a common pitfall faced by administrators of new ICT implementations.

What work is Microsoft and its partners doing in Australia in eHealth?

It’s important to remember that there is so much more to ICT in health than electronic health records; locally we’re seeing some technologies that are making a big difference to patient care. Telemedicine is one example where collaboration and unified communications is being used. Westmead Children’s Hospital has endocrinologists using Microsoft’s unified communications product, Lync, to deliver tele-diabetes to patients in rural locations. Previously the physicians, who were treating patients with type 1 diabetes in rural areas, would have to travel for a day or two to regional centres for a scheduled face to face meeting.

Since implementing Microsoft Lync, the physician is able to arrange virtual meetings with remote patients and their paediatricians‎ for e-consultations, saving everyone time and travel. Ultimately, with the addition of more caregivers using these technologies, more patients can be served because the specialist, by not wasting time for travel, is more efficient.

As an added bonus, Westmead Children’s Hospital has found that this telemedicine format, used for specialist appointments with the patients who are typically children, has had a lovely side effect which sees the patients engaging in the technology thanks to the personalised service, as they have a person on TV talking directly to them.

Posted in Australian eHealth

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