Information systems in the new world: an emerging national approach

Abstract

AUSTRALIA IS ONE OF MANY countries around the world wanting to take advantage of clinical decision support systems to reduce misadventure, improve quality of care and enhance health outcomes. Policy and infrastructure developments that could remove many of the barriers to the implementation of these systems are being considered by the Australian Health Ministers? Advisory Council (AHMAC) over the next few months. These initiatives include processes for national identification of health care recipients; common approaches to consent to information sharing and access control in the electronic health care environment; secure messaging infrastructure; a national medicines directory and agreement on national terminology.1 These considerations are taking place in a context of jurisdictional cost sharing, with mutual benefits being sought. Detailed business cases have been developed, and supporting policy and practical pathways forward are actively sought. This joint policy and infrastructure development approach will seek to build consistent, shared formats and risk management, as well as shared financial responsibility. This approach is seen as more likely to lead to system change and implementation, where previously almost every advancement has succeeded in identifying more obstacles. The kind of objectives outlined above are a major underpinning of HealthConnect and state-based health information system initiatives across the country. These initiatives are extremely expensive, require significant infrastructure investment to achieve the benefits they promise, and none can be successfully implemented solely by information technology or information system professionals. It is vital that health care managers at all levels and domains of health care appreciate the success factors when making decisions about the introduction and management of these systems. The information world itself is changing for us all. These changes don?t just affect the information managers or the information technology (IT) enthusiasts found in many clinical areas of our health care organisations. As in other areas of our lives, IT has invasive effects on the clinical workplace, administration and government offices. Managers in health care are often frustrated by what is seen as a failure of IT to deliver on its promise of better decision support systems, sharing of clinical information between organisations and faster access to patient information and clinical knowledge. Nevertheless, these systems are already changing the method of collecting and using clinical information in the workplace, and are having an impact on the skills needed by all health professionals, including the health administrator.