E-health barely rated a mention last week, but Mr Powick told The Australian "no government is going to invest in e-health or IT systems without a reform context, and we clearly have that now".
"Mr Rudd talked about the need to deliver better integrated, better co-ordinated care that's more responsive to patient needs, and about putting in place a health system for the 21st century," he said.
"I'd argue very strongly that you can't do either without electronic communications."
Mr Powick said the concept of local hospital networks offered a very useful way of advancing connectivity between the acute and primary care sectors -- but warned there was a risk that too much fragmentation could "splinter the e-health agenda into a thousand pieces".
"What's interesting is that the more successful e-health pilots -- in northern Brisbane, the NSW Hunter Valley, Barwon in Victoria, and the Northern Territory -- are all happening at a regional level," he said.
"So local engagement is very positive, provided we don't end up with a whole bunch of small-scale, disparate projects."
To avoid this, Mr Powick said, it would be necessary to bring together two to three neighbouring local hospital networks and GP divisions to create a workable scale.
"Where pilots are working, they're servicing population bases from around 250,000 to 1 million citizens, and that's large enough to be meaningful but small enough not to be unwieldy," he said.
"Certainly we haven't been able to crack the big nuts -- it's extremely difficult to crack a statewide implementation spanning all sectors for the larger states."
Mr Powick said it was time to move beyond pilots to useful, working exchanges of health information between hospitals, GPs and other medical providers, for significant numbers of patients.
"Good governance holds the key to ensuring we don't end up with the thousand flowers blooming scenario," he said.
"The government will need to very clearly define the standards and infrastructure components for regional operations, mandate compliance and institute monitoring.
"Quite probably the government will also have to provide sufficient central support in terms of project management, architectural changes and data quality, as regions don't have much spare IT capacity, and may not have the capability to deliver."
Mr Powick said new IT surveillance and reporting systems would be necessary to monitor many aspects of the proposed reforms, and putting such systems in place quickly would be "fundamentally critical to success".
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Autor(en)/Author(s): Karen Dearne
Quelle/Source: Australian IT, 09.03.2010
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