Information management: the limitations of ROI

Abstract

THE REVIEW OF the 60-year history of the Australian Healthcare and Hospitals Association highlights the important role of information and information management in enhancing the Australian health care system. In 1990 Peter Read, the National Director of the (then) Australian Hospital Association, suggested that the health system would soon have hospitals where there are proper information systems which allow managers to identify problem areas by intra and inter hospital comparisons; hospitals where managers know how much treatment does cost and more importantly how much it should cost; and hospitals where the incentives encourage efficient high quality care and where payment received has some relevance to the cost of treatment given.1 But 2007 is almost over and, as outlined by Jared Dart our n=1 author (page 510), we are still waiting! Government funders and health service organisations typically view information as a cost to be managed and not as an asset in which to invest. While investment in health care information management and technology cannot often be justified on economic or financial terms (that is, the financial return on investment [ROI]), a broader perspective that included the positive impact on the quality of care, the improvement in patient safety and patient satisfaction, and the reduction in social costs would favourably tip the investment scale. A paradigm shift is required to balance an overriding concern with return on investment with return to care. This issue focuses on work that is being completed on information foundations (pages 523, 531, 540 and 546), exploitation of technology (page 527) and the use of information to improve care. I would like to draw your attention to the paper by Watson, Rayner, and Lumley from Mother and Child Health Research that outlines their experience in obtaining ethics approval for a study of preterm birth (page 514). This paper provides an example of the information inefficiencies that we have created and perpetuate in our health care system. Don?t miss this issue?s Models of Care paper by Francis and colleagues (page 499) and the concept of health in older age (page 642).