Sam Heard, visiting New Zealand from Darwin to talk with groups interested in health IT, is a founding partner in Australian firm Ocean Informatics, developers of a platform for health-information sharing called openEHR.
"I am a naysayer on massive, centralised repositories of health information," Dr Heard says. Offering instead a partnership, web 2.0 vision of clinician-controlled electronic data sharing, he says the cost to New Zealand of buying a commercial system "will be too big … it will be 10 times what you want to spend".
Forced into lockdown
As well, forcing people onto particular software, that cannot use the next new innovation that comes along, will not work. This threatens some big companies, says Dr Heard, who want to "lock things down and keep it the way it is".
The cost, typically $20 million per hospital plus $5 million and five years for configuring, is high.
Speaking as a guest of Victoria University's information management department to a seminar for the public in Wellington today, Dr Heard said Germany had pulled an electronic records system after investing a billion euros.
The answers will likely develop organically, around clinical communities and at lower cost, he says.
He warns also of pitfalls with sharing too far. Clinicians would not use a system if it responded with changed decision prompts when, for example, a naturopath inputted "high calcium".
Even in the siloed system, where health professionals can't share data across different hospitals, clinicians cannot now keep up with the volumes of patient data, he adds.
Global data searches
Using a dashboard - openEHR's clinical knowledge manager - he showed how searches can pull out requested information. The idea is that data on a patient be gathered from wherever it is stored; this can include records of, for instance, a hospital visit when overseas on holiday in a non-English speaking country. The terminology is not English-dependent.
New formats, of which openEHR is one contender, can gently push into the territory of legacy systems, he says. It is not a matter of quickly supplanting them. But he believes health IT is way behind the technology revolution that is making almost all things possible from a cellphone.
Dr Heard, chief executive and a director of Ocean Informatics, was principal author of the background document for the Australian Electronic Health Records Taskforce. He co-chairs the Australian health IT standards body.
He was for three years the co-chair of the EHR technical committee of HL7 International, the standards-setter for New Zealand electronic health data. An honorary senior research fellow with the Centre for Health Informatics & Multiprofessional Education at University College, London, Dr Heard has been a senior lecturer in general practice at both London and Flinders Universities.
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Autor(en)/Author(s): Virginia McMillan
Quelle/Source: New Zealand Doctor Online, 11.05.2010
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