Monday 13 August 2012

A " Great Idea " bungled !

It sounded so Utopian !   To make use of the storage capacity of computers to collect our entire medical history so that it is available in the emergency room or to any treating doctor at the click of a mouse.  What was termed " E-Health " commenced on July I with a takeup target of attracting 500,000 participants.   This has fallen far short of target with just 5029 people signing on so far.

It is early days, but there are glaring weaknesses that spring to mind.   So far GP's lack the software to enable them to access this E-Health system and progress so far has cost $ 466 million, and that works out at $ 92,662 per head for each of those who have signed up.

The main weakness seems to be the need for each individual to make the effort to present their entire medical history to Medicare for inclusion.  Surely the best place to collect accurate medical information would be from the files of the doctor who regularly treats us as patients, and who has referred us to various specialists and ordered tests.   Can we really expect individuals to be able to accurately remember all the relevant health details ranging over their entire lifetime ?

E-Health has been set a budget of  6.8 million patient details over four years, but this relies on individuals signing on and going to the trouble of contacting Medicare with their medical information.  So far, 89% of those who have made the effort have done so online.  Others have done so by phone, letter or a personal visit to a Medicare office.

It looks like E-Health will be just another good idea that failed because of poor planning.  Even if the numbers signing on increase, the quality of the information gathered will probably be deficient.  To have any hope of success the plan will need to be revised to put the gathering content back into the hands of the medical profession.   All that should be required from the patient is his or her agreement to be included in E-Health - and the names and addresses of all those doctors that have treated them.

E-Health would then require each of those doctors to supply the details in their patient file, plus the names of any specialist to which the patient has been referred, and then a similar information check would be made from that source.   In this way, the entire life history of each person named on E-Health rolls would be gathered, including information on any hospital treatment that has occurred.

The sticking point would be - cost.   Doctors can not be expected to collate information from their files and do the necessary paperwork for nothing.   E-Health would need to negotiate a consultation fee to cover the time and staff needed to prepare each patients health portfolio, and this would include all the necessary medication prescribed.   It may also need a law change to validate the release of personal information and require the medical profession to comply.

This E-Health concept is a marvellous tool to health management - provided the information collected is accurate - and wide ranging.   Simply recording whatever the patient can remember is unlikely to meet that standard.  In particular,  medical information provided from those with age related illnesses such as Dementia  could be expected to be deficient.

Getting this concept to work properly is going to cost a lot of money.  It all depends on whether the government is prepared to meet that cost, or whether E-Health will be short changed to the point where whatever information is gathered is ignored by the medical profession as being worthless.

A point to ponder.  Can we accurately remember what prescriptions we were taking five years ago - and for what ailments ?

No comments:

Post a Comment